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DOI: 10.1055/s-2003-812402
Funktionelle Ergebnisse sekundärer Girdlestone-Hüften
Functional Results Following Girdlestone ArthroplastyPublication History
Publication Date:
16 December 2003 (online)
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Zusammenfassung
Studienziel: Ziel der Arbeit war die Identifikation prognostischer Faktoren, die die zu erwartende Funktion einer Girdlestone („G”)-Arthroplastik vorhersagen. Methode: Retrospektiv wurde das Kollektiv einer Klinik von 87 Patienten, 90 Hüften analysiert, die zwischen 1983 und 2000 mit Anlage einer „G”-Hüfte behandelt worden waren. Ergebnisse: Hüftscores waren durchschnittlich 38,7 Punkte (HHS) und 3,5 Punkte (Merle D'Aubigne und Postel Score). Die Standzeit der „G”-Hüfte, im Durchschnitt 90,6 Monate, und das funktionelle Ergebnis korrelierten nicht (r = 0,0920; p = 0,6289). D. h. die Funktion einer „G”-Arthroplastik wurde mit zunehmender Zeit nicht schlechter. Die Anzahl der implantierten Hüftprothesen vor „G”-Anlage korrelierte nicht mit dem funktionellen Ergebnis der „G”-Hüfte bei Nachuntersuchung (r = - 0,1400; p = 0,4524). Die Standzeit der letzten explantierten Hüftprothese, im Mittel 44,6 Monate, und die Funktion der „G”-Hüfte korrelierten nicht (r = 0,0705; p = 0,7065). Lebensalter bei Erstimplantation der Hüftprothese, Lebensalter zum Zeitpunkt der Nachuntersuchung oder Lebensalter bei Anlage der „G”-Hüfte korrelierten nicht mit dem HHS (r = - 0,0367; p = 0,8418 sowie r = 0,1527; p = 0,4121 sowie r = - 0,0151; p = 0,9356). Die Notwendigkeit einer Revision der „G”-Hüfte und das Vorhandensein eines Diabetes korrelierten (p = 0,0104). Die Korrelation zwischen verbliebenem Knochenzement und radiologischen Zeichen eines persistierenden Infektes war signifikant (p = 0,0572). Schlussfolgerung: Das Lebensalter des Patienten, der Zeitraum seit „G”-Anlage, die Zahl vorangegangener HTEP-Wechsel waren keine geeignete prognostischen Merkmale, die Funktion einer „G”-Hüfte vorherzusagen.
Abstract
Aim: Aim of the investigation was to identify prognostic factors predicting the level of postoperative function following Girdlestone (“G”)-arthroplasty. Methods: Data were derived from 87 patients, 90 hips, treated with “G”-arthroplasty at one institution between 1983 and 2000. Results: Hip scores amounted to 38.7 (HHS) and 3.5 (Merle) points. The number of previously implanted total hip arthroplasties (THR) did not correlate with the functional result of “G”-arthroplasty (r = - 0.1400; p = 0.4524). On average, the duration of THR prior to “G”-arthroplasty was 44.6 months. Survival time of the latest THR and function of “G”-arthroplasty did not correlate (r = 0.0705; p = 0.7065). Patient age at primary THR, at follow-up, or at “G”-procedure did not correlate with HHS (r = - 0.0367, p = 0.8418, r = 0.1527, p = 0.4121; r = - 0.0151; p = 0.9356, respectively). Time following “G”-arthroplasty, averaging 90.6 months, did not correlate with patients function (r = 0.0920, p = 0.6289). Revision following “G”-procedure and the presence of diabetes positively correlated (p = 0.0104). The appearance of cement in the femoral canal and radiographic signs of persistent bone infection correlated significantly (p = 0.0572). Conclusion: Patient age, duration of “G”-hips, and number of prior THR were not reliable to predict the function of “G”-arthroplasty.
Schlüsselwörter
Girdlestone - Gelenkersatz - TEP - Hüfte
Key words
Girdlestone - arthroplasty - THR - hip
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PD Dr. med. Markus Rittmeister
Orthopädische Universitätsklinik, Friedrichsheim
Marienburgstraße 2
60528 Frankfurt am Main
Phone: + 49-69-6705-406
Email: m.rittmeister@friedrichsheim.de