Diagnostischer Algorithmus der schmerzhaften Knietotalendoprothese

Fink, B; Lass, Richard

doi:10.1055/s-0034-1368226

Cited by 8 publications

(4 citation statements)

References 30 publications

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“…4). Diese Ergebnisse sind der Biopsie bei Knietotalendoprothesen allerdings unterlegen, was daran liegen dürfte, dass wir an der Hüfte nur die artikulierenden Prothesenareale und damit weniger Prothesenoberfläche als bei der Knie-TEP erreichen können [62]. führt werden sollte, da dann eine nicht vertretbar geringe Erfolgsaussicht der Operation gegeben ist [11].…”

Section: Unspezifische Testverfahrenunclassified

Diagnostischer Algorithmus der schmerzhaften Hüfttotalendoprothese

Fink¹,

Lass

2016

Z Orthop Unfall

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Total hip arthroplasty (THA) is one of the most common and successful surgical procedures in orthopedic surgery and clinical success can be characterized by the revision rate and improvement of function, as well as the patient's satisfaction and pain. Despite the clinical success of primary THA with 10-year survival rates as high as 96 % (Swedish Hip Arthroplasty Register, 2011), the prevalence of groin pain after conventional total hip replacement ranges from 0.4 to 18.3 % and activity-limiting thigh pain is still an existing problem linked to the femoral component of uncemented hip replacement in up to 1.9 to 40.9 % of cases in some series. Obvious causes of failure might be identified with clinical examinations and standard radiographs only, whereas the unexplained painful THA still remains a challenge for the surgeon. They can be classified into extra- and intraarticular disorders, the latter being divided into biological and mechanical origins. The onset of the pain after the operation and the differentiation between pain in motion and at rest are helpful to distinguish between mechanical and non-mechanical problems. An infection should be the first diagnosis to be ruled out in a painful THA. It is generally accepted that a clear understanding of the failure mechanism in each case is required prior considering revision surgery. In this review a practical diagnostic algorithm is described for failure analysis in more detail. The evaluation of a painful THA includes a detailed history with an extended analysis of the type of pain, thorough clinical examination including the spine and knee joints, radiographic and laboratory analysis, as well as invasive examinations like joint aspiration and biopsies. This diagnostic algorithm offers an important tool for a sufficient failure analysis in almost all patients with painful THA.

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Section: Unspezifische Testverfahrenunclassified

Diagnostischer Algorithmus der schmerzhaften Hüfttotalendoprothese

Fink¹,

Lass

2016

Z Orthop Unfall

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“…The periprosthetic infection (PPI) of hip, knee, and shoulder endoprostheses is, with an incidence of around 1%, an uncommon but nevertheless devastating complication of arthroplasty procedures [1, 2]. The classification proposed by Tsukayama et al [3] differentiates between acute early and chronic late infections whereby the threshold between the two is 4 weeks after the surgical intervention.…”

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confidence: 99%

“…A preoperative diagnostic before revision surgery takes place is helpful because therapeutic strategy differs in septic revisions from aseptic revision; local and systemic antibiotic therapy can be planned specifically before surgery takes place and can be started at a time before new biofilm formation on a new prosthesis has taken place [1, 2].…”

mentioning

confidence: 99%

Periprosthetic Joint Infection

Fink

Anagnostakos

Winkler³

2019

BioMed Research International

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“…Ein weiterer Schwerpunkt der veröffentlichten Arbeiten ist die Kinderorthopädie und Kindertraumatologie. Hierzu seien exemplarisch Arbeiten zur Epiphysiolysis capitis femoris [18], Unterarmpseudarthrosen [19] [21], Skaphoidfraktur/Skaphoidpseudarthrosen [22] oder auch diagnostischer Algorithmus der schmerzhaften Knietotalendoprothese [23] oder Komplikationen bei Acetabulumfrakturen [24] werden hier aufgegriffen und auf hohem Niveau bearbeitet. In der Zukunft werden wir uns bemühen, all die genannten Rubriken auf hohem Niveau weiterzuführen und insbesondere weiterhin für die Arbeitsgemeinschaften und Sektionen der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie die Plattform für Publikationen bilden.…”

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