Zusammenfassung
In den letzten zwei Jahrzehnten hat die Verwendung von Metall/Metall-Gleitpaarungen in der Hüftgelenkendoprothetik (HTEP) aufgrund der geringeren Abriebraten und des attraktiven tribologischen Profils an Popularität gewonnen. MoM-Großkopf-HTEPs haben den Vorteil einer verbesserten Stabilität. Sie wiesen jedoch hohe Pfannenlockerungsraten und unerwünschte Reaktionen auf Metallabrieb (ARMD) mit frühen Implantatausfällen auf. MoM-HTEP der zweiten Generation mit einem Kopf mit kleinem Durchmesser haben anerkanntermaßen ein geringeres Reibungsmoment, eine bessere Metallurgie und eine bessere Kontrolle über das Maßspiel. Diese Gleitpaarung wird im Allgemeinen mit einer geringeren Inzidenz der durch Polyethylenpartikel verursachten Osteolyse in Verbindung gebracht. Jüngste Berichte haben jedoch Bedenken hinsichtlich erhöhter Serum-Metallionenspiegel und ARMD bei MoM-Kleinendoprothesen in der Langzeitbeobachtung geweckt. In dieser Übersichtsarbeit wird die klinische Leistung von MoM-HTEPs in Abhängigkeit von der Femurkopfgröße mit einer Literaturübersicht über die Geschichte und die tribologischen Eigenschaften von MoM-Gleitpaarungen, Abrieb und Korrosion, Metallionenspiegel und ARMD diskutiert.
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Moon, JK., Yoo, JI., Kim, Y., Kim, YH. (2023). Metall-auf-Metall-Hüftgelenkersatz. In: Drescher, W.R., Koo, KH., Windsor, R.E. (eds) Fortschritte in der speziellen Hüftchirurgie. Springer, Cham. https://doi.org/10.1007/978-3-031-27202-8_15
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