Hoberg M, Holzapfel B M, Rudert M
Orthopädische Klinik König-Ludwig-Haus, Universitätsklinikum Würzburg, Brettreichstr. 11, 97074 Würzburg, Deutschland.
Orthopade. 2011 Jun;40(6):474-80. doi: 10.1007/s00132-011-1756-z.
The number of implantations of hip prostheses in Germany is now approximately 190,000 per year. By improving the implants and the development of modern surgical techniques and instruments the revision rate has been significantly reduced. The survival rate of the implants could be further increased in recent years, however, up to 22% of patients complain about persistent pain after hip arthroplasty. The diagnosis of existing pain after total joint replacement of the hip joint to achieve a causal therapy needs a systematic approach because of the heterogeneity of the symptoms and diseases. The etiology of the pain can be joint-associated and also hip joint independent. Often the causes of pain are multifactorial so that a standardized assessment should be conducted using an algorithm. The clarification of pain begins with the history, inspection and palpation followed by a clinical examination. It is then useful to perform radiological imaging followed by invasive procedures if necessary. The exploratory revision is nowadays considered to be obsolete in the literature.
德国每年髋关节假体植入的数量目前约为19万例。通过改进植入物以及开发现代手术技术和器械，翻修率已显著降低。近年来，植入物的存活率可以进一步提高，然而，高达22%的患者在髋关节置换术后仍抱怨持续疼痛。由于症状和疾病的异质性，为了实现病因治疗，对髋关节全关节置换术后现有疼痛的诊断需要一种系统的方法。疼痛的病因可能与关节相关，也可能与髋关节无关。疼痛的原因通常是多因素的，因此应使用一种算法进行标准化评估。疼痛的明确始于病史、检查和触诊，随后进行临床检查。如有必要，进行放射影像学检查，然后进行侵入性操作是有益的。如今，在文献中探索性翻修被认为已过时。
