Endoprothetische Gelenk-versorgung bei Hüftkopfnekrose

Zusammenfassung

Die Hüftkopfnekrose führt unbehandelt in der Regel innerhalb weniger Jahre zu schweren sekundären Koxarthrosen. In Abhängigkeit der Lokalisation und Ausdehnung der Osteonekrose stehen verschiedene operative Verfahren zur Verfügung. In fortgeschrittenen Stadien mit Einbruch der Gelenkfläche stellt die endoprothetische Versorgung die Methode der Wahl dar. Angesichts des meist jungen Alters der Betroffenen sind (femorale) Oberflächenersatzprothesen für geeignete Fälle ohne größere zystische Läsionen zu erwägen, ansonsten bleibt die Implantation einer Hüfttotalendoprothese der Goldstandard. Die verschiedenen endoprothetischen Versorgungsmöglichkeiten werden kritisch vor dem Hintergrund evidenzbasierter Therapiestrategien diskutiert.

Summary

Osteonecrosis of the femoral head mostly leads into severe secondary coxarthrosis, if left untreated. Depending on the localization and the extent of the osteonecrosis various surgical treatment options can be considered. Advanced stages with collapse of the articular surface or advanced cartilage lesions mostly require endoprosthetics. Due to the mostly young age of the patients, (femoral) resurfacing arthroplasty can be considered, if not grossly cystic. Otherwise, a total hip replacement should be performed which keeps the gold standard. The different prosthetic options are discussed on evidence-based pricipals.

Schlüsselwörter

Femurkopfnekrose - Hüftkopfnekrose - Osteonekrose - Endoprothetik

Keywords

Femoral head necrosis - osteonecrosis - endoprosthesis

• Literatur

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