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Hüftgelenksendoprothetik: Aktueller Stand -- Perspektiven by R. Rahmanzadeh, M. Faensen

Hüftgelenksendoprothetik: Aktueller Stand -- Perspektiven

by R. Rahmanzadeh , M. Faensen
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Book cover type: Paperback
  • ISBN13: 9783540130772
  • Binding: Paperback
  • Subject: N/A
  • Publisher: Springer
  • Publisher Imprint: Springer
  • Publication Date:
  • Pages: 252
  • Original Price: EUR 51.39
  • Language: German
  • Edition: N/A
  • Item Weight: 431 grams
  • BISAC Subject(s): Orthopedics

Die normale Beanspruchung des koxalen Femurendes ist eine Biegebeanspru- chung, die ein charakteristisches Muster der VerUiufe der Normalspannungstrajek- torien und eine Schubbeanspruchung im Querschnitt des Schenkelhalses zur Folge hat. Wird der Schenkelhals bei Implantation einer Endoprothese rechtwinklig zur Halsachse reseziert, so wirkt an der Resektionsebene eine Schubkraft. Die Prothese selbst erfahrt ein Kippmoment. Besonders hohe Beanspruchung tritt dabei an der Medialwand des Schenkelhalsstumpfes auf. An seiner Lateralwand konnen Zug- spannungen nur bei einzementierten Prothesen und bei guter Haftung des Zements am Knochen auftreten. Anderenfalls, auch bei Lockerung zementierter Prothesen, kommt es durch Oberlastung zu Knochenresorption am medialen Auflager und an der Abstiitzung des Prothesenstiels an der lateralen Diaphysenwand, und zu ent- sprechender Kippbewegung des Implantats. Isoelastische Prothesen bieten theoretisch im Idealfall deutliche Vorteile, sind aber in der geforderten Weise technisch nicht realisierbar. Die valgische Aufrichtung der implantierten Prothese konnte die Beanspru- chungsverhaltnisse im Bereich der Resektionsebene des Schenkelhalses erheblich giinstiger gestalten. Dieser Vorteil wird jedoch durch eine etwas ungiinstigere Gelenksresultierende und durch eine Biegebeanspruchung der Medialwand des Schenkelhalsstumpfes beeintrachtigt. Literatur Kummer B (1956) Eine vereinfachte Methode zur Darstellung von Spannungstrajektorien, gleich- zeitig ein Modellversuch fUr die Ausrichtung und Dichteverteilung der Spongiosa in den Gelenk- enden der Rohrenknochen. (Achter Beitrag zur funktionellen Anatomie und kausalen Morpho- logie des Stiitzapparates von Friedrich Pauwels). Z Anat Entwicklungsgesch 119: pp223-234 Kummer B (1959) Bauprinzipien des Siiugerskelettes. Thieme, Stuttgart Kummer B (1968) Die Beanspruchung des menschlichen Hiiftgelenks. I. Allgemeine Problematik.

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