Hohe Bedeutung in der klinischen Anwendung ist der Patientenselektion, der präoperativen Planung und der chirurgischen Präparation beizumessen. Aufgrund der hohen Komplexität der intra- und perioperativen Prozesse, der insgesamt erhöhten Komplikationsrate und des multimorbiden Patientenguts sollte die Versorgung aus unserer Sicht in spezialisierten und erfahrenen Zentren erfolgen. Unter diesen Voraussetzungen stellt der individuelle Beckenteilersatz bei ausgeprägten ossären Defektsituationen eine zunehmend etablierte Behandlungsoption in der Revisionsendoprothetik der Hüfte dar.

Interessenkonflikt: keine angegeben.

Korrespondenzadresse

Dr. med. Dr. med. univ.
Peter M. Prodinger

Klinik für Orthopädie
und Sportorthopädie

Klinikum rechts der Isar

Technische Universität München

peter.prodinger@tum.de

Literatur

1. Baauw M, van Hellemondt GG, van Hooff ML, Spruit M: The accuracy of positioning of a custom-made implant within a large acetabular defect at revision arthroplasty of the hip. Bone Joint J. 2015; 97-B: 780–5

2. Baauw M, van Hooff ML, Spruit M: Current Construct Options for Revision of Large Acetabular Defects: A Systematic Review. JBJS Rev. 2016 8; 4: 0.2106/JBJS.RVW.15.00119

3. Berasi CCt, Berend KR, Adams JB, Ruh EL, Lombardi AV, Jr: Are custom triflange acetabular components effective for reconstruction of catastrophic bone loss?. Clin Orthop Relat Res. 2015; 473: 528–35

4. Berry DJ, Lewallen DG, Hanssen AD, Cabanela ME: Pelvic discontinuity in revision total hip arthroplasty. J Bone Joint Surg Am. 1999; 81: 1692–702

5. Bettin D, Katthagen BD: Die DGOT-Klassifikation von Knochendefekten bei Hüft- Totalendoprothesen-Revisionsoperationen. The Documentation of the German Society Cor Orthopedics and Traumatology (DGOT) for Bone Defects in Hip Revision Alloarthroplasty .Z Orthop Unfall 1997; 135: 281–4

6. Bostrom MP, Lehman AP, Buly RL, Lyman S, Nestor BJ: Acetabular revision with the Contour antiprotrusio cage: 2– to 5-year followup. Clin Orthop Relat Res. 2006; 453: 188–94

7. Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ: The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009 Jan; 91:128–33

8. Bradford MS, Paprosky WG: Acetabular defect classification: a detailed radiographic approach. Semin Arthroplasty. 1995; 6: 76–85

9. Burke DW BC, Jasty M, Haire T, Harris WH: Dynamic measurement of interface mechanics in vivo and the effect of micromotion on bone ingrowth into a porous surface device under controlles loads in vivo. Trans ORS. 1991; 163 (103)

10. Bus MP, Boerhout EJ, Bramer JA, Dijkstra PD: Clinical outcome of pedestal cup endoprosthetic reconstruction after resection of a peri-acetabular tumour. Bone Joint J. 2014; 96-B:1706–12

11. Christie MJ, Barrington SA, Brinson MF, Ruhling ME, DeBoer DK: Bridging massive acetabular defects with the triflange cup: 2– to 9-year results. Clin Orthop Relat Res. 2001; 393: 216–27

12. Citak M, Kochsiek L, Gehrke T, Haasper C, Suero EM, Mau H: Preliminary results of a 3D-printed acetabular component in the management of extensive defects. Hip Int. 2017 4:0. epub ahead of print

13. Colen S, Harake R, De Haan J, Mulier M: A modified custom-made triflanged acetabular reconstruction ring (MCTARR) for revision hip arthroplasty with severe acetabular defects. Acta Orthop Belg. 2013 Feb; 79: 71–5

14. D‘Antonio JA, Capello WN, Borden LS et al.: Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop Relat Res. 1989; 243:126–37

15. DeBoer DK, Christie MJ, Brinson MF, Morrison JC: Revision total hip arthroplasty for pelvic discontinuity. J Bone Joint Surg Am. 2007; 89: 835–40

16. Egawa H PC, Beykirch SE, Hopper RH Jr, Engh CA Jr, Engh CA: Can the volume of pelvic osteolysis be calculated without using computed tomography? Clin Orthop Relat Res. 2009; 467: 181–7

17. Eisler T, Svensson O, Tengstrom A, Elmstedt E: Patient expectation and satisfaction in revision total hip arthroplasty. J Arthroplasty. 2002 ; 17: 457–62

18. Friedrich MJ, Schmolders J, Michel RD et al.: Management of severe periacetabular bone loss combined with pelvic discontinuity in revision hip arthroplasty. Int Orthop. 2014; 38: 2455–61

19. Furnes O, Lie SA, Espehaug B, Vollset SE, Engesaeter LB, Havelin LI: Hip disease and the prognosis of total hip replacements. A review of 53, 698 primary total hip replacements reported to the Norwegian Arthroplasty Register 1987–99. J Bone Joint Surg Br. 2001; 83: 579–86

20. Garbuz DS, Penner MJ: Role and results of segmental allografts for acetabular segmental bone deficiency. Orthop Clin North Am. 1998; 29:263–75

21. Gollwitzer H, von Eisenhart-Rothe R, Holzapfel BM, Gradinger R: Revisionsendoprothetik: Hüftpfannenwechsel. Der Chirurg 2010; 81, 284–92

22. Goodman S, Saastamoinen H, Shasha N, Gross A: Complications of ilioischial reconstruction rings in revision total hip arthroplasty. J Arthroplasty. 2004; 19: 436–46

23. Gravius S, Pagenstert G, Weber O, Kraska N, Rohrig H, Wirtz DC: Azetabuläre Defektrekonstruktion in der Revisionschirurgie der Hüfte – Autolog, homolog, Metall? [Acetabular defect reconstruction in revision surgery of the hip. Autologous, homologous or metal?]. Der Orthopäde. 2009; 38: 729–40