Posted in NEWS, NEWS on skeletal system implants
Evidence- and consensus-based indication criteria for total hip arthroplasty for coxarthrosis
24 March 2021
Implantation of a total hip arthroplasty (hip TEP) is the most common endoprosthetic procedure in Germany. However, there are significant regional differences in the frequency of treatment. Despite predominantly very good results, risks are also associated with this intervention. The correct indication is therefore of great importance for the individual patient as well as for the health care system.
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| Checklist: Indication for hip TEP in coxarthrosis
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| Indication criteria | |
| Structural damage | Coxarthrosis at least Kellgren/Lawrence grade 3 (or femoral head necrosis at least ARCO III c) |
| Conservative therapy | Combination of drug and non-drug therapy for at least therapy for at least 3 months |
| Core elements of non-drug conservative therapy takes place: Information, exercise therapy, weight reduction if necessary |
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| High suffering despite conservative therapy | Hip-related complaints (pain, functional limitation) |
| Health-related quality of life | |
| Contraindications | Active infection (of joints, soft tissues or spreading hematogenously) |
| Acute or chronic concomitant diseases with increased risk of mortality | |
| BMI ≥ 40 kg/m2 | |
| Other contraindications to surgery | |
| Modifiable risk factors | Nicotine: abstinence at least 4 weeks before surgery until wound healing recommended |
| Diabetes mellitus: HbA1c value below 8 | |
| BMI > 30 kg/m2 | |
| Anemia: optimization done | |
| Intra-articular injection of corticosteroids: no hip TEP within 6 weeks | |
| Suspicion of mental illness: specialist clarification recommended | |
| Participatory decision making | Patient goals |
| Author(s) | Source |
| Schmitt J (Guidelines Coordinator) | AWMF Online 24.03.2021, German Original: ©DGOU, Kurzfassung „Indikation Hüfttotalendoprothese“ AWMF-Registernr. 178-001| Version 1. |
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