Zusammenfassung
Die chirurgische Hüftluxation ist eine sichere und etablierte Technik für die Behandlung des femoroazetabulären Impingements. Die Komplikationsrate ist niedrig und mit der korrekten Technik, welche die Blutversorgung respektiert, tritt eine Femurkopfnekrose nicht auf. Die häufigsten Komplikationen sind milde ektope Ossifkationen und die Trochanterpseudarthrose. Die intraartikuläre Chirurgie schließt sowohl die azetabuläre wie auch femorale Korrektur ein. Klinisch kann in ca. 75–80% der Fälle ein gutes bis sehr gutes Resultat erzielt werden. Allerdings fällt die Erfolgschance beim Vorliegen fortgeschrittener degenerativer Veränderungen, welche eine Grad-1-Arthrose nach Tönnis überschreiten, rapide ab. Der Erhalt des Labrums hat einen signifikanten Einfluss auf das klinische Ergebnis und die radiologische Progression der Arthrose. Das Erhalten des Labrums scheint deshalb unabdingbar zu sein.
Abstract
Surgical dislocation of the hip is a safe and established technique for treating femoroacetabular impingement. The complication rate is low, and if the correct technique that respects the blood supply is used, femoral head necrosis does not occur. The most frequent complications are minor ectopic bone formation and nonunion of the greater trochanter. Surgical treatment includes the correction of femoral and acetabular pathology. Clinically, in approximately 75–80% of cases a good-to-excellent result can be obtained. However, patients with advanced degenerative changes (exceeding stage 1 osteoarthritis using the Tönnis score) have worse outcomes. It has also been shown that preservation of the labrum has a significant influence on both clinical outcome and progression of osteoarthritis: It seems that preservation of the labrum is mandatory.
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Beck, M., Fucentese, S., Staub, L. et al. Therapie des femoroazetabulären Impingements über die chirurgische Hüftluxation. Orthopäde 38, 412–418 (2009). https://doi.org/10.1007/s00132-008-1385-3
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DOI: https://doi.org/10.1007/s00132-008-1385-3