Azetabuläre Revision: Rekonstruktion kavitärer und segmentaler Defekte unter besonderer Berücksichtigung modularer hoch poröser Pfannensysteme

Zusammenfassung

Aufgrund der steigenden Zahl endoprothetischer Primärimplantationen am Hüftgelenk werden auch Wechseleingriffe eine zunehmende Herausforderung darstellen. Nicht selten wird der Operateur hierbei mit relevanten azetabulären Defektsituationen konfrontiert. Eine sorgfältige präoperative Planung ist unerlässlich, um für den Patienten eine funktionell zufriedenstellende und möglichst langfristige Versorgung zu erreichen. Zu den Behandlungsmöglichkeiten azetabulärer Defekte gehören poröse hemisphärische Pfannen, metallische Augmente, elliptische Pfannen, zementierte Implantate, Ringe, Allotransplantate, Individualimplantate und Kombinationen der genannten Komponenten. Neben großen hemisphärischen Pfannen werden zunehmend modulare hoch poröse Revisionssysteme zur Versorgung höhergradiger Defektsituationen eingesetzt. Der vorliegende Beitrag bietet einen Überblick über die relevante Literatur und implantatspezifische Besonderheiten der unterschiedlichen Versorgungsstrategien.

Abstract

Due to the increasing number of primary hip arthroplasty procedures, revision surgery will be an increasing challenge. The surgeon is frequently confronted with important acetabular defects. Careful preoperative planning is essential to achieve functional and long-term success. Treatment options include porous hemispheric cups, porous metal augments, oblong cups, cemented implants, rings, allografts, patient specific implants and component combinations. In addition to large hemispherical cups, modular porous metal revision systems are increasingly being used to treat severe acetabular bone loss. This article provides an overview of relevant literature and implant-specific features of different reconstruction strategies.

Schlüsselwörter

Hüfttotalendoprothesenwechsel - azetabuläre Defekte - Versorgungsstrategien

Key words

revision total hip arthroplasty - acetabular defects - reconstruction strategies

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