Zusammenfassung
Osteotomien am Becken oder am Femur stellen auch erfahrene Endoprothetiker vor eine Herausforderung. In einigen Fällen kann verbliebenes Metall das Einsetzen der Endoprothese erschweren. Nicht selten können auch anatomische Abweichungen vorliegen, die die Implantation einer Endoprothese verkomplizieren. Abhängig von der Voroperation können diese Abweichungen sehr unterschiedlich aussehen. An der Pfanne kann dies den Einsatz eines Revisionssystems für die Primärimplantation erfordern. Am Schaft kann eine zusätzliche Korrekturosteotomie notwendig werden. In jedem Fall ist eine genaue präoperative Planung erforderlich und eine präoperatives CT mit 3‑D-Rekonstruktion ist ein sehr nützliches Instrument, um Besonderheiten, die nicht zwingend aus der konventionellen Bildgebung hervorgehen, präoperativ erkennen zu können.
Abstract
Pelvic and femoral osteotomies can be a challenge even for experienced orthopedic surgeons. Residual metal may complicate the insertion of the endoprosthesis in some cases. Sometimes, the anatomical modification of the previous osteotomy complicates the total hip replacement. This may require the use of an acetabular revision system for the primary implantation. Femoral deformities can require additional osteotomies of the femur during the implantation. In every case, accurate preoperative planning should be performed. A preoperative CT with 3D reconstruction is a powerful tool for further information beyond conventional imaging.
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Abbreviations
- BO:
-
Beckenosteotomie
- CT:
-
Computertomographie
- ERAO:
-
„Eccentric Rotational Acetabular Osteotomy“
- HHS:
-
Harris Hip Score
- ITO:
-
Intertrochantäre Osteotomie
- PAO:
-
Periazetabuläre Osteotomie
- RAO:
-
„Rotational Acetabular Osteotomy“
- TEP:
-
Totalendoprothese
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A.R. Zahedi und C. Lüring geben an, dass kein Interessenkonflikt besteht.
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Zahedi, A.R., Lüring, C. Hüftendoprothetik nach Osteotomien des Beckens und des proximalen Femurs. Orthopäde 48, 308–314 (2019). https://doi.org/10.1007/s00132-019-03693-x
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DOI: https://doi.org/10.1007/s00132-019-03693-x