Problematik der fehlgeschlagenen Endoprothese bei posttraumatischer Arthrose am oberen Sprunggelenk View Full Text


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Article Info

DATE

2019-03

AUTHORS

Sebastian Fischer, Yves Gramlich

ABSTRACT

Die posttraumatische Arthrose des oberen Sprunggelenks (OSG) stellt noch immer eine Herausforderung in der operativen Versorgung dar. Während bei frustranem konservativem Therapieansatzes die Arthrodese mittels Schrauben- oder Plattenosteosynthese in der Literatur mittlerweile durchgängig als Goldstandard bezeichnet wird, stellt die Endoprothese der dritten Generation dennoch eine Therapieoption dar. Ungeachtet des modernen Prothesendesigns und etablierter Operationsschritte ist ein stetiger Rückgang der Primärimplantationen zu verzeichnen. Bei Versagen der Prothese bleibt zumeist nur die Konversion in eine OSG-Arthrodese. Unter Durchführung einer selektiven Literaturrecherche sowie Darstellung eigener Forschungsergebnisse werden Ursachen für das Versagen von OSG-Prothesen als auch die Diagnostik bei schmerzhafter Endoprothese und Therapieoptionen aufgezeigt. Im eigenen Patientengut stellte die symptomatische Zystenbildung mit 20 % den häufigsten Revisionsgrund dar. Die Konversion einer fehlgeschlagenen OSG-Prothese in eine OSG-Arthrodese birgt ein unbefriedigendes klinisches Ergebnis und bleibt sowohl der Primärimplantation als auch der primären Arthrodese in den Funktions- und Lebensqualitätsscores unterlegen. Der Gedanke, eine Prothesenimplantation am oberen Sprunggelenk als ersten Schritt und die OSG-Arthrodese als Rückzugsmöglichkeit zu betrachten, ist obsolet. More... »

PAGES

48-54

Journal

TITLE

Trauma und Berufskrankheit

ISSUE

1

VOLUME

21

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10039-019-0415-1

DOI

http://dx.doi.org/10.1007/s10039-019-0415-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1112112977


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36 schema:description Die posttraumatische Arthrose des oberen Sprunggelenks (OSG) stellt noch immer eine Herausforderung in der operativen Versorgung dar. Während bei frustranem konservativem Therapieansatzes die Arthrodese mittels Schrauben- oder Plattenosteosynthese in der Literatur mittlerweile durchgängig als Goldstandard bezeichnet wird, stellt die Endoprothese der dritten Generation dennoch eine Therapieoption dar. Ungeachtet des modernen Prothesendesigns und etablierter Operationsschritte ist ein stetiger Rückgang der Primärimplantationen zu verzeichnen. Bei Versagen der Prothese bleibt zumeist nur die Konversion in eine OSG-Arthrodese. Unter Durchführung einer selektiven Literaturrecherche sowie Darstellung eigener Forschungsergebnisse werden Ursachen für das Versagen von OSG-Prothesen als auch die Diagnostik bei schmerzhafter Endoprothese und Therapieoptionen aufgezeigt. Im eigenen Patientengut stellte die symptomatische Zystenbildung mit 20 % den häufigsten Revisionsgrund dar. Die Konversion einer fehlgeschlagenen OSG-Prothese in eine OSG-Arthrodese birgt ein unbefriedigendes klinisches Ergebnis und bleibt sowohl der Primärimplantation als auch der primären Arthrodese in den Funktions- und Lebensqualitätsscores unterlegen. Der Gedanke, eine Prothesenimplantation am oberen Sprunggelenk als ersten Schritt und die OSG-Arthrodese als Rückzugsmöglichkeit zu betrachten, ist obsolet.
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