Die Reimplantation des künstlichen Gelenkersatzes in Girdlestone Hüften ist der belassenen Girdlestone Situation überlegen

Zusammenfassung

Studienziel: Es war das Ziel, die funktionellen Ergebnisse der Girdlestone Hüfte mit den Ergebnissen nach Reimplantation eines Gelenkersatzes in Girdlestone Hüften zu vergleichen. Methode: 72 Patienten mit künstlichem Hüftgelenksersatz (HTEP) in Girdlestone Hüften und 87 Girdlestone-Patienten (90 Hüften), die keine HTEP erhielten, wurden hinsichtlich definierter Merkmale verglichen. Ergebnisse: Patienten mit HTEP nach Girdlestone unterschieden sich wesentlich von Patienten mit Girdlestone Hüfte hinsichtlich ihrer Zufriedenheit (89 % versus 13 %) und Hüftfunktion (Harris hip score 63 versus 39 Punkte). Die Gruppen unterschieden sich nur geringfügig hinsichtlich des Auftretens postoperativer Komplikationen (0,32 versus 0,26 je Patient) und der Notwendigkeit von Revisionen (0,38 versus 0,31 je Patient). Schlussfolgerung: Die Reimplantation einer HTEP in Girdlestone Hüften war im Vergleich zu der dauerhaften Girdlestone Situation mit einer viel größeren Patientenakzeptanz bei einer in beiden Kollektiven annähernd gleich hohen Rate an Komplikationen und Revisionen vergesellschaftet. Dieser Unterschied ebenso wie die signifikant bessere Hüftfunktion nach HTEP Reimplantation lassen den Versuch einer Konversion der Girdlestone Hüfte gerechtfertigt erscheinen, wenn dies technisch durchführbar, dem Allgemeinzustand zumutbar und vom Patienten gewünscht ist.

Abstract

Aim: The aim of this work was to compare the functional results of secondary Girdlestone hips with the results of total hip replacement (THR) after a Girdlestone situation. Methods: 72 patients with THR following a Girdlestone situation and 87 patients with a Girdlestone situation (90 hips) were compared with regard to defined endpoints. Results: THR following a Girdlestone situation provided for significantly higher patient satisfaction (89 % versus 13 %) and hip function (HHS 63 versus 39 points). The groups only marginally differed with regard to the incidence of complications (0.32 versus 0.26 per patient) and the necessity for surgical revision (0.38 versus 0.31 per patient). Conclusion: Conversion of Girdlestone hips with THR provided patient satisfaction and functional results superior to secondary Girdlestone hips while the incidence of postoperative complications and revisions were similar for both groups. These differences justify attempts at the conversion of Girdlestone situations with THR, if technically possible, in accordance with the patient's wish and as allowed by his/her general health.

Schlüsselworte

Girdlestone - Gelenkersatz - TEP - Hüfte

Key words

Girdlestone - arthroplasty - THR - hip

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