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Hüftluxation nach Hüftgelenktotalendoprothesenimplantation

Hip dislocation following THA

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Zusammenfassung

Bei einer Luxation nach einer Hüftgelenktotalendoprothesen- (HTEP-)Implantation hat die Analyse des Luxationsmechanismus die höchste Priorität. Ergänzend müssen der Operationszeitpunkt und die Stellung der Luxation berücksichtigt werden. Bei der Ursachenanalyse spielt die Bildung der Neokapsel zumindest bei Frühluxationen innerhalb der ersten 6 postoperativen Wochen eine Rolle. In diesem Zeitraum treten die meisten Luxationen auf und können relativ einfach und folgenlos in Kurznarkose reponiert werden. Durch eine gute Schulung des Pflegepersonals und der Physiotherapeuten, v. a. aber des Patienten, können Frühluxationen vermieden werden. Die Spätluxationen (ab 7. postoperative Woche) haben ihre Ursachen meist entweder in einer Malpositionierung oder Migration der Prothesenkomponenten und bedürfen häufiger einer operativen Behandlung. Die Luxation nach einer HTEP-Implantation ist eine ernst zu nehmende Komplikation, die akut zu behandeln ist, und stellt dem Operateur zunächst viele offene Fragen, von den Ursachen bis zu deren Behandlung.

Abstract

In the event of a hip dislocation following THA analysis of its mechanism is the main priority. In addition, the time since the operation and the direction of the dislocation need to be taken into account. When the cause of the dislocation is analysed the formation of the neocapsule plays a part at least in the case of early dislocations (within the first 6 weeks after the operation). Most dislocations happen during this postoperative period, and these can usually be treated nonoperatively by closed reduction with only a short period of general anaesthesia. Late dislocations (in the 7th and subsequent postoperative week) generally occur because of malpositioning or migration of the components of the prosthesis and quite often do need operative treatment. Dislocation after implantation of a total hip replacement is a serious complication; it should be treated quickly, and initially it confronts the operator with many unanswered questions, from the causes to their treatment.

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Authors and Affiliations

  1. Orthopädische Klinik und Poliklinik, LMU München / Großhadern, Marchioninistr. 15, 81377, München, Deutschland

    F. Mazoochian,  M.F. Pietschmann, S. Hocke, A. Fottner, C. v. Schulze-Pellengahr & V. Jansson

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  1. F. Mazoochian
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  2. M.F. Pietschmann
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  3. S. Hocke
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  4. A. Fottner
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  5. C. v. Schulze-Pellengahr
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  6. V. Jansson
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Correspondence to M.F. Pietschmann.

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Die Autoren F. Mazoochian und M.F. Pietschmann haben zu gleichen Teilen zur Erstellung dieses Manuskriptes beigetragen.

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Mazoochian, F., Pietschmann, M., Hocke, S. et al. Hüftluxation nach Hüftgelenktotalendoprothesenimplantation. Orthopäde 36, 935–943 (2007). https://doi.org/10.1007/s00132-007-1143-y

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