Periprothetische Frakturen – Azetabulum

Periprothetische Azetabulumfrakturen (PPAF) sind seltene Komplikationen in der Hüftendoprothetik, die hohe Komplikationsraten aufweisen. Ihre Behandlung erfordert eine präzise Beurteilung der Pfannenstabilität, der Beckenringstabilität und der Knochenqualität. Trotz neuer Klassifikationssysteme und Therapiealgorithmen fehlt es an belastbarer Evidenz, was zu variablen Behandlungsergebnissen führt. Operative Versorgungen sind meist notwendig, bergen aber signifikante Risiken aufgrund des Ausmaßes des Eingriffs und der Komorbidität der zumeist älteren Patienten.

Schlüsselwörter

periprothetische Fraktur - periprothetische Azetabulumfraktur - Hüftendoprothetik - Hüftpfanne - Beckenchirurgie

Keywords

periprosthetic fracture - periprosthetic acetabular fracture - hip arthroplasty - acetabulum - pelvic surgery

Publication History

Article published online:
10 November 2025

• Literatur

• 1 Peterson CA, Lewallen DG. Periprosthetic Fracture of the Acetabulum after Total Hip Arthroplasty. J Bone Joint Surg Am 1996; 78: 1206-1213
• 2 Hasegawa K, Kabata T, Kajino Y. et al. Periprosthetic Occult Fractures of the Acetabulum Occur Frequently During Primary THA. Clin Orthop Relat Res 2017; 475: 484-494
• 3 Callaghan JJ. Periprosthetic fractures of the acetabulum during and following total hip arthroplasty. Instr Course Lect 1998; 47: 231-235
• 4 Della Valle CJ, Momberger NG, Paprosky WG. Periprosthetic fractures of the acetabulum associated with a total hip arthroplasty. Instr Course Lect 2003; 52: 281-290
• 5 Pascarella R, Sangiovanni P, Cerbasi S. et al. Periprosthetic acetabular fractures: A New classification proposal. Injury 2018; 49 (Suppl. 3) S65-S73
• 6 Davidson D, Pike J, Garbuz D. et al. Intraoperative periprosthetic fractures during total hip arthroplasty. Evaluation and management. J Bone Joint Surg Am 2008; 90: 2000-2012
• 7 Duncan CP, Haddad FS. The Unified Classification System (UCS): improving our understanding of periprosthetic fractures. Bone Joint J 2014; 96-B: 713-716
• 8 Selmene MA, Moreau PE, Zaraa M. et al. Update on post-traumatic periprosthetic acetabular fractures. Bone Jt Open 2024; 5: 28-36
• 9 Simon P, von Roth P, Perka C. Treatment algorithm of acetabular periprosthetic fractures. Int Orthop 2015; 39: 1995-2003
• 10 Rommens PM, Herteleer M, Handrich K. et al. Medial buttressing of the quadrilateral surface in acetabular and periprosthetic acetabular fractures. PLoS One 2020; 15: e0243592
• 11 Bartosik M, Mayr E, Culemann U. Periprothetische Azetabulumfrakturen: Klassifikationen, Therapie und Herausforderungen. Orthopadie (Heidelb) 2024; 53: 773-781
• 12 Bartosik M, Mayr E, Culemann U. Combined surgical management of periprosthetic acetabular fractures: a retrospective study. Injury 2025; 56: 112461
• 13 Zettl R, Eschbach D, Ruchholtz S. Management of periprosthetic acetabular fractures in elderly patients—a minimally invasive approach. Int Orthop 2015; 39: 1845-1849
• 14 Harold RE, Butler BA, Delagrammaticas D. et al. Patient-Reported Outcomes Measurement Information System Correlates With Modified Harris Hip Score in Total Hip Arthroplasty. Orthopedics 2021; 44: e19-e25
• 15 Josipović P, Moharič M, Salamon D. Translation, cross-cultural adaptation and validation of the Slovenian version of Harris Hip Score. Health Qual Life Outcomes 2020; 18: 335