Der Oberflächenersatz am Hüftgelenk

Der Oberflächenersatz am Hüftgelenk
Fengler H. Wubtaye TD. Straßberger C. Böhme Ch. Orthopädische Klinik Klinikum Dresden – Friedrichstadt Akademisches Lehrkrankenhaus des Universitätsklinikums Dresden

Historie Einführung Charnley 1950 Gerard 1960 Paltrinieri Trentani
Oberflächen- ersatz Charnley 1950 Gerard 1960 Paltrinieri Trentani 1970 Amstutz Wagner 1980 Mc Minn Amstutz Wagner and Wagner Buechel-Pappas Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Historie Charnley 50-ger Jahre
Einführung Oberflächen- ersatz Charnley 50-ger Jahre experimentelle Versuche mit 2 zementfrei befestigten Teflonschalen >>> Abbruch wg. Gewebereaktionen Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery. Charnley J. Arthroplasty of the hip: A new operation. Lancet 1, 1961

Historie Gerard 1970 Doppelcup Prothese aus Metall zementfrei
Einführung Oberflächen- ersatz Gerard 1970 Doppelcup Prothese aus Metall zementfrei Klinische Ergebnisse unbefriedigend Survivorship 11 Jahre % (van Raay et al. 1993) Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery. Gerard Y. Arthroplasty of the hip with coupled cups Rev. Chir. Orthop. 60 , 1974

Historie Paltrinieri / Trentani 1971 zementierte Oberflächenprothese
Einführung Oberflächen- ersatz Paltrinieri / Trentani 1971 zementierte Oberflächenprothese Metall - Polyethylen Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery. Paltrinieri M., Trentani C. A modifikation of the hip arthroplasty Chir. Organi Mov.60 , 1971

Historie Furuya / Tanaka (Japan) Freeman (England) Amstutz (USA)
Einführung Oberflächen- ersatz Furuya / Tanaka (Japan) Freeman (England) Amstutz (USA) Wagner (BRD) Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Wagner Schalenprothese
Einführung Oberflächen- ersatz Wagner Zementierte Polyethylenpfanne Zementierte Femurkopfschale Metall/Keramik Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

THARIES - System Amstutz USA Zementierte Polyethylenpfanne
Einführung Oberflächen- ersatz Wagner THARIES Amstutz USA Zementierte Polyethylenpfanne Zementierte Femurkopfschale Metall (Co-Cr-Mo Oberfläche) Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery. THARIES - Total Hip Articular Replacement using Internal Eccentric Shells

TARA Zementierte Polyurethan/Polyethylenpfanne
Einführung Oberflächen- ersatz Wagner THARIES TARA Zementierte Polyurethan/Polyethylenpfanne Zementierte Femurkopfschale Metall (Co-Cr-Mo Oberfläche) Keramik Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery. TARA – Total Articular Replacement Arthroplasty

Ergebnisse Autor Fallzahl Zeitraum (a) Revisionen SHF
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Autor Fallzahl Zeitraum (a) Revisionen SHF Wagner 1979 426 3 1,4 % Ferdini 1986 466 7 12,7 % 1,6 % Howie 1990 100 8-10 55 % 3 % Paul 1998 305 12,49 73,4 % 5,4 % Amstutz 1981 200 2-5 5,5 % Nesse 1991 109 10 84 % k. A. Mesko 1994 185 3,5-10 13,2 % k.A. Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery. Wagner-Schalenprothese THARIES-System TARA-System

Ergebnisse aseptische Lockerung der Pfannenkomponente Einführung
Oberflächen- ersatz Wagner THARIES TARA Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse aseptische Lockerung der Pfannenkomponente Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Erste Schlussfolgerungen
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Einführung Oberflächen- ersatz Wagner THARIES TARA PE-Schale als Pfannenkomponente zu dünn Hoher Abrieb Verformung Osteolyse dch. Osteoklasten-stimulation Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery. LOCKERUNG

Metall – Metall Gleitpaarung
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall McKee Farrar Prothese (1960) Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Ring Prothese Stanmore Prothese Weber-Huggler Siwasch Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery. Ring

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Autor Prothese Fallzahl Ergebnisse Zeitraum August 1986 Mc Kee-Farrar 808 81% 13,9 a Brown 2002 153 84% 74 % 20 a 28 a Jacobsson 1996 Charnley 107 70 77 % 73 % Bryant 1991 Ring 253 60,4 % 21 a Emery 1997 Stanmore 804 Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Metasul Prothese Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery. Autor Prothese Fallzahl Revision Zeitraum Dorr 2000 Metasul 70 2 % 5,2 a

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall lange Standzeiten Hohe Rate an Frühlockerungen Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Ursachen: Sphärizitätsungenauigkeit bis 120 µm geforderter Standart: 5 µm (Ungethüm et al. 1972) Metallpfanne dünnwandig Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Renaissance der Oberflächenprothese Anfang der 90-ger Jahre
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Beuchel-Pappas (Endotec) Wagner and Wagner Conserve plus (Amstutz) McMinn Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Mc Minn 1. Generation Oberflächenersatz als Metall – Metall
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Oberflächenersatz als Metall – Metall Gleitpaarung zementfrei (pressfit) 70 Implantationen 02/1991 – 02/1992 follow up 50,2 Monate 9 Revisionen (3 Infektionen, 6 aseptische Lockerung) Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Oberflächenersatz als Metall – Metall Gleitpaarung zementfrei Hydroxyapatit-Beschichtung 6 Implantationen 02/1992 – 03/1992 follow up 40,2 Monate keine Revisionen Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Oberflächenersatz als Metall – Metall Gleitpaarung zementiert 43 Implantationen 03/1992 – 12/1993 follow up 33,2 Monate 4 Revisionen (1 Infektionen, 3 Pfannenausbruch) Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Mc Minn - definitiv - Oberflächenersatz als Metall – Metall
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Oberflächenersatz als Metall – Metall Gleitpaarung Hybrid-Verankerung 116 Implantationen 03/1994 – 10/1995 follow up 8,3 Monate keine Revisionen Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Mc Minn - definitiv - ab Juli 1997 als BHR
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn ab Juli 1997 als BHR - Birmingham Hip Resurfacing – Porous coated acetabulum Kein zentraler Zapfen Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Epidemiologie 10 % des Gesamtmarktes Wahleingriffe
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie 10 % des Gesamtmarktes Wahleingriffe Ca Stück 2005 Mittelfristig 20 % Segment mit stärkstem Wachstum Momentan 5 Anbieter î Basierend auf McMinn; 1992 Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Epidemiologie Warum Oberflächenersatz ? Jüngeres Patientenkollektiv
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Warum Oberflächenersatz ? Jüngeres Patientenkollektiv Erhöhter Mobilitätsanspruch Geringeres Luxationsrisiko Rückzugsmöglichkeit bei Revision Kurze Verweildauer Nachfrage durch Patient Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Epidemiologie Ziel des Oberflächenersatzes:
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Ziel des Oberflächenersatzes: Größtmöglicher Knochenerhalt Femur Acetabulum Größtmöglicher Weichteilschutz Größtmöglicher Bewegungsumfang Sichere Langzeitfixierung Geringstmöglicher Abrieb Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Epidemiologie Kritische Faktoren:
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Kritische Faktoren: Größtmöglicher Knochenerhalt Acetabulum Vermeiden eine Schenkelhalsschädigung Nervenschädigungen Erhalt des vitalen Knochens am Femur Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Epidemiologie pro contra Einführung
Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie pro contra - junger Patient (unter 65 Jahre) - älter als 65 Jahre - Keine Osteoporose(t-score normal) manifeste Osteoporose (t-score) - umschriebene Femurkopfnekrose ausgedehnte Femurkopfnekrose - RA ohne Osteoporose RA mit schwerer Osteoporose - Keine oder geringe Dysplasie - schwere Dysplasie (CT) - Dünner Schenkelhals/große Pfanne - dicker Schenkelhals/kleine Pf. - Keine Beinlängendifferenz größere Beinlängendifferenz - Keine Metallallergie klinisch relevante Metallallergie Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

130 Implantationen (115 Mc Minn, 15 ASR)
Eigenes Krankengut Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie 130 Implantationen (115 Mc Minn, 15 ASR) Mittleres Alter 53,2 Jahre 13 Patienten beiderseitige Versorgung 9,7 % Totalendoprothesen am Hüftgelenk Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Indikationen [McMinn 1996] Einführung Indikationen Oberflächen- ersatz
Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery. [McMinn 1996]

Altersverteilung Einführung Indikationen Oberflächen- ersatz Wagner
THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Patientenselektion Indikationsstellung Biologisches Alter
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Indikationsstellung Biologisches Alter Patientenanspruch Allergien (Nickel) Knochendichte (DXA, Q-CT) Femurkopfnekrose ? (MRT) Dysplasie ? Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Eigene Erfahrungen OP-Zeit: 125 min Ø (Schaftprothese : 81 min)
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient OP-Zeit: 125 min Ø (Schaftprothese : 81 min) Transfusionen: 32,3 % (Schaftprothese : 40,6 %) Krankenhausverweildauer: 15,5 d Ø (Schaftprothese : 13,2 d Ø) Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Eigene Erfahrungen - Komplikationen
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Perioperative Fraktur 0 Postoperative Schenkelhalsfraktur 1 Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Perioperative Fraktur 0 Postoperative Schenkelhalsfraktur 1 Prothesenluxation 1 Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Perioperative Fraktur 0 Postoperative Schenkelhalsfraktur 1 Prothesenluxation 1 Pfannenfrühlockerung 2 Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Perioperative Fraktur 0 Postoperative Schenkelhalsfraktur 1 Prothesenluxation 1 Pfannenfrühlockerung 2 Malposition 1 Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Perioperative Fraktur 0 Postoperative Schenkelhalsfraktur 1 Prothesenluxation 1 Pfannenfrühlockerung 2 Malposition 1 Primärinfekt Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Patient 29 Jahre posttraumatische Femurkopfnekrose nach operativ behandelter Schenkelhalsfraktur 14 Tage p.o. Infektzeichen, Staphylococcus aureus und epidermidis Wundresektion, Lavage und Antibiose Abheilung des Infektes Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Perioperative Fraktur 0 Postoperative Schenkelhalsfraktur 1 Prothesenluxation 1 Pfannenfrühlockerung 2 Malposition 1 Primärinfekt Ischiadicusschädigung reversibel 1 Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Patientin 46 Jahre schwere Dysplasiekoxarthrose rechts Implantation einer Mc Minn-Schalenendoprothese mit Fehllage postoperativ Ischiadicusparese Janda 2 rechts Am 5. p.o. Tag Wechsel auf zementfreien S-ROM-Schaft und Neurolyse des N. ischiadicus (nahtbedingte Einschnürung) Ischiadicusparese rasch rückläufig Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Mittelfristige Ergebnisse
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Daniel J. et al. 2004 446 Implantationen bei Pat. unter 55 a McMinn / BHR Prothese Mean Follow up 3,3 a Alter bei Implantation im Mittel 48,3 a 1 Revision Kumulative Überlebensrate 99,8 % Max. follow up 8 Jahre Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Treacy RB. et al. 2005 144 Implantationen BHR Prothese Alter bei Implantation im Mittel 52,1 a Mean Follow up 5 a Überlebensrate 97 % 6 Revisionen (3 Lockerungen Femurkomponente, 2 Infektionen, 1 Schenkelhalsfraktur) Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Amstutz HC. et al. 2004 400 Implantationen Conserve plus Prothese Alter bei Implantation im Mittel 48 a Mean Follow up 4 a Überlebensrate 94,4 % 12 Revisionen (7 Lockerungen Femurkomponente, 3 Schenkelhalsfrakturen, 2 ohne Angabe) Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Autor Prothese Anzahl Alter Patienten Follow up Jahre Survival Daniel 2004 Mc Minn / BHR 446 48,3 3,3 a 99,8 % Menge 2005 Cormet 2000 ASR Durom ESKA Bionics 800 54 6 a 97,9 % Treacy 144 52,1 5 a 97 % Amstutz Conserve Plus 400 48 4 a 94,4 % Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Schenkelhalsfrakturen
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Shimmin AJ. et al. 2005 Statistische Erhebung bei 3497 BHR Implantationen in Australien 50 Schenkelhalsfrakturen (1,46 %) Männer – Frauen 1:2 Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Biomechanik Materialabrieb: Materialpaarung Abriebraten Metall/Metall
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Biomechanik Materialabrieb: Hüftsimulatoren - Anissian, H.L. (1999) – Scholes, S.C. (2001) Materialpaarung Abriebraten Metall/Metall wenige µm/Jahr Keramik/Keramik Keramik/PE ca. 100 µm/Jahr Metall/PE ca. 200 µm/Jahr Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery. In Vivo Abriebraten McKee-Farrar: Studie Abriebrate Sieber, H.-P. (1999) 5 µm/Jahr McKellop, H. (1996) 6 µm/Jahr

Biomechanik Watanabe Y. et al. 2000 Finite Elemente Studie
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Biomechanik Watanabe Y. et al. 2000 Finite Elemente Studie Erhöhte mechanische Belastung der Kortikalis am Adam‘schen Bogen unterhalb des Prothesenrandes Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Biomechanik „Stress Shielding“ Knochenresorption / Umbau in
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Biomechanik „Stress Shielding“ Knochenresorption / Umbau in Belastungszonen durch erhöhte Scherkraftwirkung Philip (1987), Mc Minn (1996), Watanabe (2003) Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

Metall - Ionen Dunstan E. et al. 2005
Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Biomechanik Metall-Ionen Dunstan E. et al. 2005 Metall Ionen Konzentration nach H-TEP 30 Jahres Follow Up Signifikante Erhöhung für : Titan (Blut) Vanadium (Blut) Chrom (Urin) 50 – 300 fache Erhöhung der Cobalt Konzentration bei Prothesenlockerung Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

McKee-Farrar-Prothese: Karzinom-Inzidenz
Metall - Ionen Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Biomechanik Metall-Ionen Kanzerogenität McKee-Farrar-Prothese: Karzinom-Inzidenz nach 15 Jahren Beobachtungszeitraum ohne erklärbare Veränderung durch das Implantat! (Lungentumoren-Inzidenz verringert, Leukämie-Inzidenz nicht signifikant erhöht, Sarkom-Inzidenz unbeeinflusst) Visuri MD. et al. (1996) Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery. Ähnliche Ergebnisse: Mathiesen (1995) ohne Zusammenhang zwischen Implantat und Karzinomen. Goodfellow (1992) mit wenigen Fällen maligner Erkrankungen

Schlußfolgerungen Einführung Oberflächen- ersatz Wagner THARIES TARA Ergebnisse Metall-Metall Mc Minn Epidemiologie Indikationen Patient Biomechanik Metall-Ionen Zusammen- fassung Oberflächenendoprothesen sehr gut geeignet zur endoprothetischen Hüfgelenkversorgung junger Patienten (biologisches Alter) sehr gute mittelfristige Ergebnisse und Standzeiten (8 Jahre) Vorsicht Femurkopfnekrose, Dysplasie, Osteoporose Langzeitstudien fehlen noch Metallionen im Serum Vertebroplasty as a minimal invasive cement augmentation technique has been firstly described in 1986 by Mr. Galibert in France. In the past the major indications were osteoporotic fractures and spinal metastasis. The clinical effect is a internal fixation and stabilisation of the fractured or structure damaged vertebral body and resulting a fast pain relief for patients benefit. The procedure does include a percutaneous and mostly transpedicular insertion of a cannula one-sided or both sides and injection of a augmentation material usually pmma bone cement wich is known from orthopeadic arthroplasty surgery.

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