Verbesserte Implantationstechnik der Oberflächenendoprothese des Hüftgelenks

Abstract

In the first 14 hips the midpoint of the femoral head was ascertained by using the manufacturer's centering device. In 31 subsequent hips the midpoint of the femoral head was found by central drilling of the femoral neck. Using the centering device, the average deviation of the angle of the prosthesis from the preoperative CCD angle was 7 degrees (+/- 5.7 degrees ); for central drilling of the femoral neck it was only 3 degrees (+/- 3.4 degrees ). The exact alignment of the resurfacing component is crucial for the success of surgery. It is achieved with greater precision with central drilling of the neck than with the manufacturer's centering device.

A Simple Technique for Alignment in Total Hip Resurfacing Arthroplasty: Technical Note and Preliminary Report

“…In order to minimize deviations in the positioning of the components, surgeons have introduced improvements in surgical instruments, intraoperative fluoroscopy, and navigation [3, 4, 19]. Navigation, when used alone or in combination with computed tomography or intraoperative fluoroscopy, may be the most reliable option, although it is not universally available and may prolong the procedure.…”

“…The use of preoperative X-ray to correctly position the wire in both planes may also require a change in position for the surgeon, unless we use double-beam fluoroscopy. Depending on the approach adopted, it may also require a change in position for the patient once the wire is inserted, and this could prolong operative time [4]. Any intraoperative aid that allows surgeons to reliably place the femoral component at the planned angle can reduce inconsistencies in surgical technique, especially during the early phases of the learning curve.…”

“…The favorable results of total hip resurfacing arthroplasty depend on an adequate surgical technique and patient selection [1, 2]. Improvements in surgical technique, better instrumentation [3], assistance from intraoperative fluoroscopy [4], and navigation [5–8] may help to optimize the position of the femoral component. Further, improvements in technique may help prevent femoral neck fractures resulting from incorrect alignment or notching of the femoral neck [9–14].…”

Evaluation of a new fluoroscopy-based navigation system in the placement of the femoral component in hip resurfacing

“…Placement of the centred drill guide, and in particular the desired valgus orientation, depends on the surgeon's experience and is limited by the extent of exposure of the femoral neck possible during surgery [13,14]. Hip disorders with deformity of the femoral head, for instance in the case of previous epiphyseolysis or Perthes' disease, may render placement of a centred drill guide more difficult [15,16].…”