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Aktuelle Rheumatologie 2020; 45(01): 67-76
DOI: 10.1055/a-0982-3939
Übersichtsarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Primäre Endoprothetik bei Kox- und Gonarthrose

Primary Total Hip and Total Knee Replacement in Osteoarthritis
Tim Grothe
1   Universitätsklinikum Carl Gustav Carus Dresden, Universitäts, Zentrum für Orthopädie & Unfallchirurgie, Dresden
,
Anne Postler
1   Universitätsklinikum Carl Gustav Carus Dresden, Universitäts, Zentrum für Orthopädie & Unfallchirurgie, Dresden
,
Jörg Lützner
1   Universitätsklinikum Carl Gustav Carus Dresden, Universitäts, Zentrum für Orthopädie & Unfallchirurgie, Dresden
,
Klaus-Peter Günther
1   Universitätsklinikum Carl Gustav Carus Dresden, Universitäts, Zentrum für Orthopädie & Unfallchirurgie, Dresden
› Author Affiliations
Further Information

Publication History

Publication Date:
15 October 2019 (online)

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Zusammenfassung

Der primäre Hüft- und Kniegelenkersatz sind ein sehr häufig durchgeführtes und erfolgreiches Behandlungsverfahren bei fortgeschrittener Arthrose. Für moderne Hüft- und Knietotalendoprothesen wird über sehr gute Langzeitüberlebensraten berichtet. Vor dem Hintergrund steigender Aktivitätsansprüche und der zunehmend häufigeren Behandlung von Patienten mit schwererem Nebenerkrankungsprofil gewinnt die Analyse von patientenbezogenen Einflussfaktoren und Outcome-Kriterien weiterhin an Bedeutung. Mit der Etablierung interdisziplinärer Behandlungskonzepte zur rascheren Genesung und Komplikationsreduktion wird auf diese Entwicklung eingegangen. Bei einer Versorgung in zertifizierten Endoprothetikzentren (EndoCert©) sind standardisierte Behandlungspfade und die Vorhaltung spezialisierter Infrastruktur gewährleistet. In die Ergebnisbewertung gehen neben Routine-Indikatoren der externen Qualitätssicherung mittlerweile auch Daten aus dem Deutschen Endoprothesenregister (EPRD©) ein, das von der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC) etabliert wurde. Dieser Übersichtsbeitrag berichtet über die Versorgungssituation in der Hüft- und Knieendoprothetik bei Arthrose in Deutschland. Es wird auf Indikationsstellung, Prinzipien der Operationsmethodik, Implantatsysteme sowie aktuelle Entwicklungen und Behandlungskonzepte eingegangen.

Abstract

Primary total hip and total knee replacement are very common and effective interventions for advanced hip and knee osteoarthritis. Proven implant designs and application techniques have contributed to very good long-term survival rates. Decision-making is influenced by increasing expectations of patients regarding quality of life as well as the potential impact of relevant comorbidities on treatment. Therefore, the implementation of patient-relevant outcomes has become more and more important. Interdisciplinary treatment concepts integrating enhanced recovery strategies and the application of clinical pathways in certified joint replacement centres (EndoCert©) are factors contributing to the overall outcome. Benchmark data is provided by several quality assurance measures, including the implementation of the German Arthroplasty Registry (EPRD©) established by the German Society for Orthopaedic Surgery (DGOOC). This report highlights the current healthcare situation regarding hip and knee arthroplasty in Germany including indication, surgical treatment approaches, implant selection and perioperative strategies.

Schlüsselwörter

Arthrose - Endoprothese - Hüftgelenkersatz - Kniegelenkersatz

Key words

osteoarthritis - arthroplasty - hip replacement - knee replacement
 

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