Anatomische Rekonstruktion des Hüftgelenks mit der schenkelhalserhaltenden Silent Micro Hip™

Zusammenfassung

Hintergrund: Das Design und die Implantationstechnik der Silent Micro Hip™ unterscheiden sich von herkömmlichen Prothesentypen durch die konische Verankerung im Schenkelhals. Ziel der vorliegenden Studie war es, die biomechanische Rekonstruktion des Hüftgelenks mit der Silent Micro Hip™ zu analysieren und mit anderen Kurz- und Standardschäften zu vergleichen. Zudem wurden implantatspezifische Besonderheiten herausgearbeitet. Methoden: Zur Evaluation der biomechanischen Parameter wurden die prä- und postoperativen Beckenübersichtsaufnahmen von 150 konsekutiven Patienten (je 50 Silent Micro Hip™, Nanos™ und SL-Plus™ MIA) retrospektiv verglichen. Ergebnisse: Die Veränderung des horizontalen femoralen Offsets und die Veränderung der Beinlänge zeigten keinen signifikanten Unterschied zwischen der Silent Micro Hip™ und den anderen beiden Prothesentypen. Mit allen Prothesentypen konnte eine nahezu anatomische Rekonstruktion des Drehzentrums erreicht werden. Schlussfolgerungen: Durch die Silent Micro Hip™ lässt sich das Hüftgelenk annähernd anatomisch rekonstruieren. Diese kurzfristigen Ergebnisse der biomechanischen Parameter unterstützen die knochensparende Hüftgelenksrekonstruktion mit proximaler femoraler Krafteinleitung. Weitere Studien über die Mittel- und Langzeitergebnisse müssen folgen.

Abstract

Background: The design and the surgical technique of the Silent Micro Hip™ are different compared to other hip stems due to a conical shape for fixation within the metaphyseal femur. The purpose of the present study was to evaluate hip joint biomechanics of the Silent Micro Hip™ in comparison to other implants. Implant-specific differences are highlighted. Material and Method: 150 consecutive patients (each group 50 Silent Micro Hip™, Nanos™ and SL-Plus™ MIA) were analysed retrospectively. For evaluation of biomechanical parameters pre- and postoperative X-rays (pelvic AP views) were used. Results: The horizontal femoral offset and the limb length showed no significant difference between the Silent Micro Hip™ and the Nanos™ or SL-Plus™ MIA stem at the reconstructed hip. An almost anatomic reconstruction of hip joint biomechanics was reached with all three types of implants.

Conclusions: The Silent Micro Hip™ allows for almost anatomic reconstruction of hip joint biomechanics. Short-term results support the bone-preserving reconstruction with a proximal femoral load transfer. Further studies on the mid- and long-term outcomes are ongoing.

Schlüsselwörter

Coxarthrose - Kurzschaft - knochensparend

Key words

osteoarthritis - short-stem - bone preserving procedure

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