Die zementfreie Schenkelhalsprothese CUT – klinisch-radiologische Ergebnisse nach 5 Jahren

Abstract

This study demonstrates the CUT prosthesis as a bone-preserving prosthesis with good functional and radiological results and therefore as an alternative joint replacement in younger patients.

5-year clinical and radiostereometric analysis (RSA) follow-up of 39 CUT femoral neck total hip prostheses in young osteoarthritis patients

“…Only these 3 prostheses showed radiolucent lines in zones 1 and 4, and the excessive continuous migration was mainly in the medial-lateral direction, which is compatible with the reported failure mode of the prosthesis—of increased horizontal migration and varisation (Ender et al 2007, Ishaque et al 2009, Steens et al 2010). Unfortunately, no factors could be related to loosening: no excessive (medial) bone resorption was present and no gross abnormalities, regarding for example stem alignment or the amount of femoral neck resection, were noted.…”

“…3 of the 39 prostheses were revised: 1 prosthesis was revised because of dislocation following excessive subsidence due to usage of an undersized component and 2 prostheses, which were both firmly fixed, were revised due to severe, persistent thigh pain. Severe persistent pain of the operated hip as a reason for revision is not uncommon after implantation of a CUT prosthesis, and has been reported by several authors (Ender et al 2007, Ishaque et al 2009, Steens et al 2010). As such, it may be a characteristic of this particular prosthesis.…”

“…Furthermore, as noted by us and others (Ender et al 2007, Ishaque et al 2009, Steens et al 2010), implantation of the CUT femoral neck prosthesis is a demanding procedure—even for skilled surgeons familiar with its implantation technique. Thus, at the moment, we cannot recommend the CUT femoral neck prosthesis as a routine treatment option in (young) patients requiring THA, and we should await the results of longer follow-up.…”

“…Only short and medium-term clinical results of the CUT prosthesis have been published (Thomas et al 2004, Ender et al 2007, Rudert et al 2007, Ishaque et al 2009, Steens et al 2010). In these reports, the reported medium-term survival varied from 50% to 98%.…”

Erforschung Ti-Co-basierter, bioaktiver Auftraglötschichten auf oxidischen Hochleistungskeramiken in der Medizintechnik

“…Das hat eine voluminösere Geweberesektion des gesunden Knochens bei der Implantation zur Folge. Daher wäre eine dünnwandige titanbasierte Ummantelung des keramischen Inserts vorteilhaft . Eine vielversprechende Beschichtungstechnologie für die gezielte Funktionalisierung von Oberflächen aus Hochleistungskeramik mittels bioaktiver titanbasierter Beschichtung ist das Auftraglöten, durch das die Herstellung einer dünnen Beschichtung ohne massive Knochenresektion beim Protheseneinsatz möglich wird .…”