[Partial hip resurfacing-a critical analysis]. / Der Oberflächenteilersatz an der Hüfte ­ eine kritische Analyse.

ABSTRACT

BACKGROUND: Localized cartilage lesions or osteochondral defect areas of the hip joint often affect young patients with an active professional and personal live. There are multiple causes of these defect zones, but they determine the therapeutic options to some extent. THERAPEUTIC OPTIONS In addition to the domain of joint-preserving, implant-free hip surgery, so-called mini-prostheses or partial implants represent another treatment strategy prior to the application of a total hip arthroplasty (THA). In the following, partial joint resurfacing implants (e. g., HemiCAP®, Arthrosurface, Franklin, MA, USA) are presented and results from the literature are cited. The described procedure is not widely offered, especially in Germany, because most indications are congruent with those for implantation of a THA, which is an established technique. Consequently, the results from the literature are based on case series with inferior validity compared to the studies and registry data of the THA and accordingly have to be scrutinized in a more critical way. Total surface replacement (hip resurfacing, e.g., Birmingham hip replacement, BHR, Smith and Nephew, Memphis, TN, USA) distinguish from partial surface replacement. On the one hand the BHR shows parallels with regard to the femoral surface reconstruction, but on the other hand due to the obligatory replacement of the acetabular side of the joint it meets conditions of THA, which can therefore play at best an intermediate role between a stem-anchored THA and a partial replacement.