Benignus C, Morlock M, Beckmann J
Sportklinik Stuttgart GmbH, Taubenheimstraße 8, 70372, Stuttgart, Deutschland.
Institut für Biomechanik, TUHH Technische Universität Hamburg, Hamburg, Deutschland.
Orthopade. 2019 Apr;48(4):292-299. doi: 10.1007/s00132-019-03692-y.
Carefully and correctly implanted components are the prerequisite for the lifespan of a prosthesis. Whether higher levels of activity lead to prior failure of total hip arthroplasty in young patients is controversially discussed. The right choice of bearings is still of great relevance.
Ceramic-on-ceramic as well as polyethylene-on-ceramic bearings achieve comparable results, although ceramic-on-ceramic bearings should be avoided in patients with high demands on their range of motion. Polyethylene-on-metal bearings also show good clinical results, if corrosion between head and stem is absent. Metal-on-metal bearings lead to adverse systemic effects due to metal wear and should be implanted in individual cases only, e. g. as hip resurfacing. Alternative bearings have to give proof of effectivity first. Custom-made prostheses constitute an option for young patients with special conditions of hip anatomy. Planning and study results of these prostheses are elucidated in this review article.
精心且正确植入的部件是假体使用寿命的前提条件。对于年轻患者而言，较高的活动水平是否会导致全髋关节置换术提前失败，这一问题存在争议。正确选择轴承仍然至关重要。
陶瓷对陶瓷以及聚乙烯对陶瓷轴承可取得相当的效果，不过对于活动范围要求较高的患者应避免使用陶瓷对陶瓷轴承。如果股骨头与股骨柄之间不存在腐蚀，聚乙烯对金属轴承也显示出良好的临床效果。金属对金属轴承由于金属磨损会导致不良的全身影响，仅在个别情况下才可植入，例如作为髋关节表面置换术。替代轴承必须首先证明其有效性。定制假体为髋关节解剖结构特殊的年轻患者提供了一种选择。本文综述阐述了这些假体的规划及研究结果。
