Das destruierte Hüftgelenk

Abstract

Because of the considerable progress achieved in alloplastic hip joint replacement, very few indications for arthrodesis remain, for instance loss of the stabilizing muscles in the hip. The possibilities for total hip arthroplasty are not only limited to the generally accepted standard procedures, but should also take individually customized tumor prostheses into consideration including partial pelvis replacement as well as fallback options using a saddle prosthesis and combinations of alloplastic implants and corrective osteotomy. Pelvic support osteotomy represents a convincing functional alternative particularly for younger patients after bacterial coxitis in early childhood with corresponding loss of the femoral head and neck. Further options consist of Girdlestone resection arthroplasty and ultimately hip disarticulation. After hip arthroplasty accompanied by subsequent complaints in the neighboring joints the indication for reorienting de-arthrodesis should be assessed on an individual basis. Relevant examples are presented for all of the procedures and surgical techniques mentioned.