Hüftendoprothetik beim jungen Patienten mit hohem BMI

Zusammenfassung

Der endoprothetische Hüftgelenksersatz von jungen und adipösen Patienten bedarf aufgrund des erhöhten Risikos von perioperativen Komplikationen und frühem Implantatversagen besonderer Aufmerksamkeit. Funktionsgewinn und Schmerzreduktion durch die Endoprothese sind bei diesem Patientengut nicht eingeschränkt, sodass die Indikation keinen anderen Kriterien unterliegt. Die Implantatstandzeit ist bei sehr jungen Patienten reduziert, hängt jedoch wesentlich von der verwendeten Gleitpaarung ab. Das Risiko von Fehlpositionierungen, insbesondere der Pfanne, kann durch eine intraoperative Röntgenkontrolle minimiert werden. Es ist immer noch fraglich, ob perioperative Risiken durch bariatrische Chirurgie reduziert werden können. Demgegenüber ist belegt, dass ein präoperativ entgleister Diabetes mellitus das Infektionsrisiko erhöht. Bekannte spezifische Risikofaktoren dieses Patientengutes sollten im Rahmen des perioperativen Managements berücksichtigt werden und in die individuelle Operationsplanung und Risikoaufklärung einfließen.

Schlüsselwörter

Hüftendoprothese - Adipositas - junge Patienten - Risikofaktoren - perioperatives Management

• References/Literatur

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