{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T05:26:12Z","timestamp":1741325172861,"version":"3.38.0"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund Ziel dieser Arbeit war die Darstellung der kn\u00f6chernen Verbundfestigkeit und Belastbarkeit einer in der Sinterungstechnik hergestellten 3-dimensionalen Titannetzbeschichtung einer k\u00fcnstlichen H\u00fcftpfanne. Unter den Extrembedingungen von abriebbedingten Osteolysen bis hin zu Pfannenperforationen wurden der Grad des verbleibenden Knochens und die Unversehrtheit der Beschichtung bestimmt. Die Untersuchung sollte Aufschluss dar\u00fcber geben, in welchen Schadensstadien nach Paprosky ein Belassen des Implantates mit alleinigem Wechsel des Inlays aus rein materialtechnischer Sicht einer stabilen Beschichtung noch vertretbar war.<\/jats:p><jats:p>\n          Material und Methoden In einer retrospektiven Studie wurden 31 aseptisch gelockerte H\u00fcftgelenkspfannen des Typs Harris-Galante II mit einer durchschnittlichen Standzeit von 19,7 Jahren (11\u201327 Jahre) untersucht. Der periazetabul\u00e4re Knochenverlust wurde bei der Revisionsoperation in einer modifizierten Schadensklassifikation nach Paprosky (PAP) erfasst. Die an der Beschichtung verbleibenden Knochenareale, die knochenfreien Zonen und die besch\u00e4digten Areale des Titannetzes wurden mittels digitaler Fl\u00e4chenmessung bestimmt. Vollhemisph\u00e4rische Schnitte von 4 H\u00fcftgelenkspfannen mit einer Standzeit von 16, 20, 22 und 27 Jahren wurden mit der Diamantschlifftechnik histopathologisch untersucht.<\/jats:p><jats:p>\n          Ergebnisse Der periazetabul\u00e4re Knochenverlust f\u00fchrte in 8 F\u00e4llen zur Schadensklassifikation PAP I, in 7 F\u00e4llen zu PAP IIa, in 2 F\u00e4llen zu PAP IIb, in 9 F\u00e4llen zu PAP IIc, in 3 F\u00e4llen zu PAP IIIa und in 2 F\u00e4llen zu PAP IIIb. Der durchschnittliche Anteil des Knochens, der nach der Explantation noch fest an der Beschichtung haftete, betrug. In den Paprosky-I-Schadensf\u00e4llen 40%, in den Stadien Paprosky IIa und IIb insgesamt 17,9%. Der durchschnittliche Anteil des Knochens der in den Stadien IIc, IIIa und IIIb nicht mehr im Wirtslager verankerten Implantate betrug 2,21%. Der Beschichtungsschaden des Titandrahtgeflechtes betrug im Durchschnitt 11% (0\u2013100%) und war ausschlie\u00dflich den instabilen Implantaten der Stadien IIc, IIIa und IIIb zuzuordnen. Die histopathologischen Befunde zeigten einen bis zu 27 Jahre nachweisbaren adaptiven Knochenumbau durch das Titannetz hindurch bis tief an die Grenzfl\u00e4che zum soliden Pfannenkern hin. Die Titaneinzeldr\u00e4hte waren meist von\n          lamell\u00e4rem Knochen umwachsen.<\/jats:p><jats:p>\n          Schlussfolgerung Die Ergebnisse zeigen, dass die Verbindung der Pfannenkernschale aus Tivanium und der bisher \u00e4ltesten und unver\u00e4ndert im Sinterungsverfahren hergestellten Beschichtung in Form eines im Punkt- und Linienkontakt aufgesinterten 3-dimensionalen Netzes aus Reintitandr\u00e4hten auch unter den Extrembelastungen der periazetabul\u00e4ren Osteolysen belastungsstabil bleibt. Die noch kn\u00f6chern angebundenen Zonen der Beschichtung sind zwangsl\u00e4ufig einer Mehrbelastung ausgesetzt, da sich die Kraft\u00fcbertragung nur noch auf diese Restareale verlagert. Da in den periazetabul\u00e4ren Schadensstadien Paprosky I, IIa und IIb trotz einer erheblichen Verkleinerung der Anbindungsfl\u00e4che keine Beschichtungssch\u00e4den in den noch kn\u00f6chern angebundenen Arealen auftraten, ist die Belassung des Implantates in situ und seine Weiterverwendung mit alleinigem Austausch des Inlays in diesen Schadensstadien aus rein materialtechnischer Sicht vertretbar.<\/jats:p>","DOI":"10.1055\/a-2003-6374","type":"journal-article","created":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T22:57:11Z","timestamp":1681340231000},"page":"263-271","source":"Crossref","is-referenced-by-count":0,"title":["20-Jahres-Ergebnisse der Verbundfestigkeit einer aufgesinterten 3-D-Titannetzbeschichtung von 31 H\u00fcftpfannen"],"prefix":"10.1055","volume":"162","author":[{"given":"Katharina","family":"Koch","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kleintiere, Tier\u00e4rztliche Hochschule Hannover, Hannover, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingo","family":"Nolte","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kleintiere, Tier\u00e4rztliche Hochschule Hannover, Hannover, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Hahn","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Osteologie und Biomechanik IOBM, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Becker","sequence":"additional","affiliation":[{"name":"Orthop\u00e4die und Unfallchirurgie, GFO- Kliniken Troisdorf, Troisdorf, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1302\/0301-620x.81b1.9111","article-title":"Effect of flexibility of the femoral stem on bone-remodeling and fixation of the stem in a canine total hip arthroplasty model without cement","volume":"81","author":"EJ Harvey","year":"1999","journal-title":"J Bone Joint Surg Am"},{"issue":"274","key":"ref2","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1097\/00003086-199201000-00020","article-title":"Determinants of stress shielding: design versus materials versus interface","author":"DR Sumner","year":"1992","journal-title":"Clin Orthop Relat Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1515\/BMT.2006.071","article-title":"FE-Simulation zur Lokalisierung hoch beanspruchter Bereiche in der H\u00fcftpfanne von Endoprothesen","volume":"51","author":"BA Behrens","year":"2006","journal-title":"Biomed Tech (Berl)"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"101","DOI":"10.2106\/00004623-197153010-00009","article-title":"Sintered fiber metal composites as a basis for attachment of implants to bone","volume":"53","author":"J Galante","year":"1971","journal-title":"J Bone Joint Surg Am"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2651","DOI":"10.1016\/j.biomaterials.2005.12.002","article-title":"Fabrication methods of porous metals for use in orthopaedic applications","volume":"27","author":"G Ryan","year":"2006","journal-title":"Biomaterials"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1621","DOI":"10.1016\/s0142-9612(97)00146-4","article-title":"Titanium alloys in total joint replacement \u2013 a materials science perspective","volume":"19","author":"M Long","year":"1998","journal-title":"Biomaterials"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/S0022-0728(99)00260-0","article-title":"Study of the corrosion behavior of titanium and some of its alloys for biomedical and dental implant applications","volume":"471","author":"JEG Gonzalez","year":"1999","journal-title":"J Electroanal Chem"},{"volume-title":"Titan und Titanlegierungen: Struktur, Gef\u00fcge, Eigenschaften. 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