Depending on the initial osseous situation as well as the age of the patient cementless anchored implants, so called grow-in prostheses, are used enabling a bone-sparing primary treatment. Especially with young patients this is a good starting situation for possible necessary follow-up interventions. We are using acetabular so called “Press-Fit”-implants, which also need to grow in Postoperatively, a phase of partial loading/stress of about 3 weeks is necessary. In individual cases the cementless implant fully stressed immediately.
A full capacity from the first. postoperative day onwards is given by cemented implants, which consist of a combination of a stainless steel shaft (chrome-cobalt-molydenum) and a polyethyl socket. The sliding pair consists of ceramic/polyethylene as it does with cementless implants. The anchorage is fixed with bone cement (PMMA), which contains an antibiotic (gentamycin).
Special experience lies in the primary treatment of dysplastic joints (hip joint dysplasia, hip joint dislocation). In these cases a reconstruction of the original acetabulum is often necessary. Usually this is done with autogenous bone. Leg length differences up to 8 cm can be corrected. A preoperative extension treatment is not necessary.
The surface replacement of the hip joint is a currently widespread surgical procedure. The HELIOS ENDO-Clinic does not carry out this procedure, as there are too many open questions. Especially the question of harmfulness of the significantly increased metal ion concentration is subject to controversial discussions. Furthermore, the primary loss of acetabular bone substance is high. This is not accepted by the surgeons of the HELIOS-ENDO-Clinic. Recent returns prove us right.
Exchange surgeries on the hip joint require a high degree or surgical experience. These procedures should only be performed in specialized clinics. Exchange surgeries are performed repeatedly, independent of the type of anchorage of the implant. Frequently reconstructive measures are necessary due to the loss of bone substance.
Large osseous defects are reconstructed with foreign bone transplants, which are provided by the bone bank. The HELIOS ENDO-Clinic has one of the largest bone banks in Germany. In individual cases the defects must be screwed with additional plates. Very extensive pelvic defects are provided with pelvic partial prostheses. In individual cases special prostheses are manufactured according to a CT-based pelvis model.
Advanced bone substance losses in the upper thigh region also require osseous reconstruction to enable the implantation of a shaft prosthesis. The fixation of the shaft, with cement or cemenless, depends on the condition of the implant site.
Very advanced bone substance losses, which result in the loss of the complete femur, require a total femur endoprosthesis, which reaches from the acetabulum to the knee joint.