Minimalinvasive operative Technik und Mini-Implantate

Zusammenfassung

Das Hüftgelenk ist regelmäßig bei der rheumatoiden Arthritis involviert und häufig besteht im Verlauf die Notwendigkeit, einen Gelenkersatz zu implantieren. Wegen des zumeist jungen Alters zum Zeitpunkt der Versorgung und der zu erwartenden Revisionen, verdienen minimalinvasive Zugänge und kleine Implantate bei diesen Patienten durchaus Aufmerksamkeit. Allerdings ergeben sich wesentliche Einschränkungen durch die meist reduzierte Knochenqualität. Für keines der neueren Implantate wie Oberflächenersatz oder Kurzschaftprothesen liegen ausreichende Langzeitinformationen vor. Der Einsatz muss daher sorgfältig abgewogen werden vor dem Hintergrund ausgezeichneter Langzeit-Ergebnisse konventioneller Hüft-Totalendoprothese auch bei Rheumatikern.

Summary

Involvement of the hip is common in rheumatoid arthritis (RA), patients regularly require total joint replacement. Since RA patients are often relatively young at the time of the index surgery, minimally invasive approaches and bone conserving implants may be considered. However, limitations are evident in these patients due to poor bone quality. There are no long term results available for the hip resurfacing systems or metaphyseal fixation of conservative stems. Hence, those should be used with caution, considering that conventional stems show an excellent long term survival in RA patients.

Schlüsselwörter

Rheumatoide Arthritis - Hüfte - Endoprothese - minimalinvasiv

Keywords

Rheumatoid arthritis - hip - total joint replacement - minimally invasive

• Literatur

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