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DOI: 10.1055/s-2007-960541
© Georg Thieme Verlag Stuttgart · New York
Die endoprothetische Versorgung der Koxarthrose bei kongenitaler Hüftgelenksluxation: Implantation einer Hüfttotalendoprothese kombiniert mit Z-förmiger Verkürzungsosteotomie des Femurs
Total Hip Replacement in High Total Hip Dislocation by Performing a Z-Shaped Shortening OsteotomyPublication History
Publication Date:
08 March 2007 (online)
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Zusammenfassung
Studienziel: Die Implantation einer Hüfttotalendoprothese ist in Fällen schwerer proximaler Femurmigration besonders anspruchsvoll und komplikationsbehaftet. Eine deutliche proximale Femurmigration unter Ausbildung einer Sekundärpfanne wird am häufigsten bei kongenitaler Hüftgelenksluxation beobachtet. Wir präsentieren sechs Fälle einer endoprothetischen Versorgung einer Dysplasiekoxarthrose kombiniert mit Z-förmiger Verkürzungsosteotomie des proximalen Femurs. Methode: In allen sechs Fällen handelte es sich um eine Koxarthrose bei hoher iliakaler Luxation. Bei allen Implantationen wurde als Pfannenlager das ursprüngliche Azetabulum verwendet und das proximale Femur gemäß präoperativ angestellter Berechnungen Z-förmig verkürzt. Ergebnisse: Wir präsentieren klinische und konventionell-radiologische Ergebnisse nach einer durchschnittlichen Nachuntersuchungsperiode von 60 Monaten. Anlässlich der letzten Kontrolluntersuchung konnten wir keine Nervenläsion, Osteotomiepseudoarthrose oder Luxationsneigung objektivieren. Schlussfolgerung: Die hier verwendete Methode eignet sich zur Versorgung der Koxarthrose bei kongenitaler Hüftluxation.
Abstract
Aim: Total hip arthroplasty for severe chronic proximal femoral migration, most commonly seen in congenital dislocation of the hip, has been associated with high rates of complications. Placement of the acetabular component in the true acetabulum has yielded the most durable results, but leads to significant limb lengthening. In this paper six cases of a total hip arthroplasty combined with a Z-shaped osteotomy of the proximal femur are described. Method: All patients presented with a complete congenital dislocation of the hip. In all procedures the acetabular component was placed in the true acetabulum and the proximal femur was shortened according to a preoperative drawing in a Z-shaped manner. Results: The clinical and radiological results of the patient collective are presented in this study, the mean follow-up period was 60 months. At the last follow-up no nerve palsy, osteotomy pseudarthrosis or dislocation were detected objectively. Conclusion: The performed procedure seems to be a viable technique in the treatment of coxarthritis in high total hip dislocation.
Schlüsselwörter
Dysplasiekoxarthrose - Verkürzungsosteotomie - Hüfttotalendoprothese
Key words
hip - dysplasia - shortening - osteotomy
Literatur
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