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Update Metall-Metall-Gleitpaarungen

Update on metal-on-metal hip joints

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Zusammenfassung

Mittlerweile gibt es zunehmende Hinweise auf die potenzielle Entwicklung lokaler bzw. systemischer Nebenwirkungen beim Einsatz von Metall-Metall-Gleitpaarungen. Ihre Häufigkeit bzw. klinische Relevanz sind noch umstritten, und implantat- bzw. operationsbedingte sowie patientenspezifische Risikofaktoren beeinflussen das Ausmaß der Freisetzung von Metallprodukten. Während Kleinkopfprothesen (maximaler Durchmesser bis 32 mm) und Subgruppen beim Oberflächenersatz gute Ergebnisse aufweisen können, wird vom Einsatz gestielter Großkopfprothesen (Durchmesser ab 36 mm) inzwischen abgeraten.

Abstract

Increasing data are available describing risk factors for the development of local and systemic adverse events following operations using metal-on-metal (MoM) hip implants. The prevalence and clinical relevance of metal-associated problems are, however, still under debate. They can be influenced by type and position of implant as well as patient-specific factors. Patients with small MoM heads (maximum diameter 32 mm) and subgroups of resurfacing arthroplasty can achieve good long-term survival. The use of large head MoM implants (diameters greater than 36 mm), however, is currently not advised due to the unsatisfactory results.

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Danksagung

Die Autoren bedanken sich bei Claude Rieker für seine Durchsicht des Manuskripts und seine Unterstützung beim systematischen Review zur Datenlage von Metallionenkonzentrationen in Körperflüssigkeiten nach Implantation von Metall-Metall-Gleitpaarungen. Dank schulden wir auch Gerd Dinnebier und Joachim Kunze für fachliche Hinweise bei der Metallionenbestimmung.

Interessenkonflikt

Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehungen hin: Forschungsarbeiten der Orthopädischen Universitätsklinik Dresden zu Metallgleitpaarungen wurden partiell mit finanzieller Unterstützung von Implantatherstellern (Zimmer Inc., Smith&Nephew, DePuy) durchgeführt. Die im Text erwähnte Expertenkonferenz wurde durch die Deutsche Arthrose-Hilfe e. V. gefördert.

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  1. Klinik für Orthopädie, Universitätsklinikum Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Deutschland

    K.-P. Günther, J. Lützner, F. Hannemann, J. Schmitt, S. Kirschner, J. Goronzy, M. Stiehler, C. Lohmann & A. Hartmann

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  1. K.-P. Günther
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  2. J. Lützner
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  3. F. Hannemann
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Correspondence to K.-P. Günther.

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Günther, KP., Lützner, J., Hannemann, F. et al. Update Metall-Metall-Gleitpaarungen. Orthopäde 42, 373–390 (2013). https://doi.org/10.1007/s00132-013-2100-6

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