Frakturendoprothetik des Azetabulums

Zusammenfassung

Die Endoprothetik des Hüftgelenks bei traumatischen bzw. posttraumatischen Zuständen des Azetabulums betrifft ein kleines Patientenkollektiv. Der Zeitraum zwischen Verletzung und Hüfttotalendoprothese (H-TEP) nimmt mit steigendem Alter ab. Die endoprothetische Therapie umfasst neben der primären H-TEP-Implantation (ggf. mit additiver Osteosynthese) auch die sekundäre Implantation einer H-TEP, v. a. bei posttraumatischer Koxarthrose, und die verzögerte primäre Endoprothetik. Im primären Fall kommt zumeist ein Abstützring mit Bone Graft zur Verwendung und im sekundären Setting ein zementfreies Standardimplantat. Die Ergebnisse sind im Durchschnitt mit den Komplikationsraten und Langzeitergebnissen der Revisionsendoprothetik vergleichbar. Das OP-Team sollte sowohl Erfahrung in der Azetabulumchirurgie als auch in der Revisionsendoprothetik des Hüftgelenks haben.

Abstract

Total hip replacement (THR) after acetabular fracture or posttraumatic arthrosis of the acetabulum is only performed on a small group of patients. The period between trauma and THR decreases with increasing patient age. Apart from primary THR after acute acetabular fracture – if necessary with additional osteosynthesis –, therapy also includes secondary THR for posttraumatic arthrosis or delayed primary THR. For primary THR, a reconstruction ring is usually used in combination with bone graft and for secondary THR a regular cementless implant can be inserted. Results can usually be compared to those of revision THR. The team should be skilled in acetabular surgery as well as in revision THR.

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