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Minimalinvasive Hüftendoprothetik – nur Trend oder schon Standard?

Eine Metaanalyse

Minimally invasive total hip arthroplasty – trend or state of the art?

A meta-analysis

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Zusammenfassung

Minimalinvasive Zugänge in der Hüftendoprothetik haben sich weltweit verbreitet und erfreuen sich zunehmender Popularität. Obwohl früh auf teilweise katastrophale Fehlschläge hingewiesen wurde, nimmt die Zahl der Publikationen zu diesem Thema ebenso wie die Anzahl der Operateure, die minimalinvasive Hüftendoprothetik anbieten, weiter zu. Anhand einer systematischen Literaturübersicht werden potenzielle Vorteile und Risiken der minimalinvasiven Hüftendoprothetik gegenüber gestellt. Während ein kürzerer Hautschnitt, ein geringeres Muskeltrauma, eine schnellere Rehabilitation und ein klinisch irrelevant geringerer Blutverlust für die Anwendung minimalinvasiver Techniken sprechen, liefern die potenzielle Beeinträchtigung der Wundkosmetik, periprothetische Frakturen, Implantatmalpositionierungen und die ausstehenden Langzeitergebnisse Argumente dagegen, die minimalinvasive Hüftendoprothetik als Standardtechnik einzusetzen.

Abstract

Minimally invasive approaches in total hip arthroplasty are being used worldwide and continue to grow in popularity. Despite early reports of catastrophic failures, both the number of scientific publications as well as the number of orthopaedic surgeons practicing minimally invasive techniques in total hip arthroplasty are steadily increasing. By means of a systematic review of the literature, the current article weighs the potential advantages and disadvantages of minimally invasive techniques. A shorter skin incision, potentially less muscle damage, a faster rehabilitation and a clinically irrelevant lower blood loss may support the use of minimally invasive techniques. However, the potential impairment of wound cosmetics, the increased risk of periprosthetic fractures, implant malpositioning and lack of long-term results contradict the use of minimally invasive total hip arthroplasty as a standard treatment.

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  1. Orthopädische Universitätsklinik Ulm , Universitäts- und Rehabilitationskliniken Ulm (RKU), Oberer Eselsberg 45, 89081, Ulm, Deutschland

    T. Kappe, R. Bieger, D. Wernerus & H. Reichel

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  1. T. Kappe
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Kappe, T., Bieger, R., Wernerus, D. et al. Minimalinvasive Hüftendoprothetik – nur Trend oder schon Standard?. Orthopäde 40, 774–780 (2011). https://doi.org/10.1007/s00132-011-1751-4

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