Totalendoprothetischer Hüftgelenkersatz

Zusammenfassung

Studienziel: Mit der klinischen Studie sollen mittelfristige Ergebnisse des totalendoprothetischen Hüftgelenksersatzes mit dem modularen System ANCA-Fit® erfasst werden.

Methode: Eswurden 89 konsekutive Patienten nachuntersucht (51 weiblich/38 männlich). Rechte und linke Hüfte wurden in je 48 Fällen operiert, sieben Patienten wurden beidseits operiert; vier weitere Patienten konnten nicht nachuntersucht werden. Das Nachuntersuchungsintervall betrug durchschnittlich vier Jahre (3-6 J.). Das Durchschnittsalterzum OP-Zeitpunkt betrug 63 Jahre (30-84 J.).

Ergebnisse: Postoperativ erreichten die Patienten durchschnittlich einen Score nach Merle-d’Aubigné-Postel von 16 Punkten (9-18 P.). Der Harris-Hip-Score betrug im Schnitt 92 Punkte (58-100 P.). Bei dem radiologisch evaluierten Score nach Engh-Massin wurden im Schnitt 21 Punkte (12-25 P.) erreicht, der Ara-Femoral-Osseointegration-Score betrug durchschnittlich 3,8 Punkte (1-5 P.) und der Ara-Acetabular-Osseointegration-Score 5,98 Punkte (5-6 P.). Die Komplikationsrate betrug insgesamt 9,4%. Ein echtes Implantatversagen wurde mittelfristig bei 5,2% beobachtet.

Schlussfolgerung: Mit dem modularen Hüftendoprothesen-System ANCA-Fit lassen sich mittelfristig gute klinische Ergebnisse und eine sichere Osseointegration erreichen.

Summary

Aim: In a clinical trial intermediate term results after hipjoint alloarthroplasty with the modular system ANCA-Fit®. were explored.

Method: 89 consecutive patients (51 female/38 male) were examined after four years (3-6 y). Right and left hip joints were operated on in 48 cases each, seven patients hadan alloarthroplastyon both sides; anotherfour patients dropped out. The average age at thetime of operation was 63 years (30-84 y).

Results: Postoperatively the MDA-global assessment averaged 16 points/“good” (9-18 p), the HHS averaged 92 points/“good” (58-100 p). The radiological Engh-Massin global assessment reached 21 points/“ingrowth confirmed” 12-25 p), the ARA femoral global assessment 3.8 points/“good” (1-5 p) and the ARA acetabular global assessment 5.98 points/“excellent” (5-6 p). Complications occured overall in nine percent of our patients, in five percent they were caused bymechanical problems oftheendo- prosthesis.

Conclusion: With the modular system ANCA-Fit® for total hip replacement within intermediateterms good clinical results and confirmed osseointegration are found.

Schlüsselwörter

Hüftendoprothetik - Modularsystem ANCA-Fit®

Keywords

Hip-joint-alloarthroplasty - modular system ANCA-Fit®

• Literatur

• 1 Brooker AF, Bowerman JW, Robinson RA, Riley LH. Ectopic ossification following total hip replacement. Incidence and amethod of classification.. J Bone Joint Surg Am 1973; 8: 1629-1632.
• 2 Engh CA, McAuley JP, Sychterz CJ, Sacco ME. The accuracy and reproducibility of radiographic assessment of stress-shielding. A postmortem analysis.. J Bone Joint Surg Am 2000; 2-A (10) 1414-1420.
• 3 Garellick G, Malchau H, Herberts P. et al. Life expectancy and cost utility after total hip replacement.. Clin Orthop 1998; 346: 141-151.
• 4 Gonzalez MH, Ortinau ET, Buonanno W, Prieto J. Cementless total hip arthroplasty in patients with advanced avascular necrosis.. J South Orthop Assoc 1997; 6 (03) 1-162.
• 5 Harris WH. Preliminary report of results of Harris total hip replacement.. Clin Orthop 1973; 95: 168-173.
• 6 Hirota S, Takeuchi E, Fujita S. et al. Ectopic bone formation after total hip arthroplasty.. Bull Hosp Jt Dis 1997; 56 (04) 206-210.
• 7 Karaismailoglu TN, Tomak Y, Gulman B. Late detachment modular femoral component after primary total hip replacement.. Arch Orthop Trauma Surg 2001; 121 (08) 2-481.
• 8 Katz JN, Losina E, Barrett J. et al. Association between hospital and surgeon procedure volume and outcomes of total hip replacement in the United States medicare population.. J Bone Joint Surg Am 2001; 83-A (11) 1622-1629.
• 9 Kawamura H, Dunbar MJ, Murray P. et al. The porous coated anatomic total hip replacement. A ten to fourteen-year follow-up study of a cementless total hip arthroplasty.. J Bone Joint Surg Am 2001; 83-A [phone].
• 10 Kim YH, Oh SH, Kim JS. Primarytotal hip arthroplasty with a second-generation cementless total hip prosthesis in patients younger than fifty years of age.. J Bone Joint Surg Am 2003; 85-A [phone].
• 11 Merle D’Augibné R. Numerical evaluation of hip function [Cotation chiffree de la fonction de la hanche.].. Rev Chir Orthop Reparatrice Appar Mot 1970; 56 (05) 1-481.
• 12 Mohamed NN, Barrett JA, Katz JN. et al. Rates and outcomes of primary and revision total hip replacement in the United States medicare population.. J Bone Joint Surg 2003; 85-A (01) 27-32.
• 13 Müller U, Gautier E, Roeder C, Busato A. The relationship between cup design and the radiological signs of aseptic loosening in total hip arthroplasty.. J Bone Joint Surg Br 2003; 85 (01) 2-31.
• 14 Phillips CB, Barrett JA, Losina E. et al. Incidence rates of dislocation, pulmonary embolism, and deep infection during the first six months after elective total hip replacement.. J Bone Joint Surg Am 2003; 85-A (01) 20-26.
• 15 Soderman P, Malchau H, Herberts P. et al. Outcome after total hip arthroplasty: Part II.. Diseasespecific follow-up and the Swedish National Total Hip Arthroplasty Register Acta Orthop Scand 2001; 72 (02) 2-113.
• 16 Toom A, Haviko T, Rips L. Heterotopic ossification after total hip arthroplasty Int. Orthop 2001; 24 (06) 2-323.
• 17 Veysi VT, Jones S, Stone MH, Limb D. Out-patient follow-up after total hip replacement in one health region.. J R Coll Surg Edinb 1998; 43 (02) 1-95.