IMPLANT INFORMATION: Skeletal System (“Endoprosthesis”)

What … for? (Indications)

Skeleton implants serve for the replacement of bone structures or joints, e. g. hip endoprosthesis, osteoarthritis (pain), fractures and more special diseases.

Numbers

Knee 49%, Hip 42% (global, 2012) 310.800, hip endoprostheses, U.S.A. (2010) 400.000, joint implants (220.000 hip, 150.000 knee, Germany 2014)

Times

Dependend on technique mobilization is possible after 1 -7 days. Rehabilitation happens after 6-12 weeks dependend on many individual factors.

Risks (Contraindications)		short term:		Inflammation, thrombosis, hematoma, injury of nerves or vessels, hemorrhagia, metal hypersensitivity, metal toxicity, leg length inequality.
		long term:		Loosening, dislocation, osteolysis, inflammation, chronic pain, death (<1%).
Failures		5% after 1st surgery
Materials available		Titanium (TiAl6V4 a.o.), CoCrMo-alloys, Polyethylen (Teflon), PMMA
Statistics		Hip replacement lasts 25 years in around 58% of patients (The Lancet, 2019) 95% more than 10 years 90% 20 years, 95% are satisfied, 2017: failure rate 2,2 – 3,2% (3rd year)(hip, Germany, Dtsch Ärzteblatt 2018)
Literature	– Basic		Patient Information (manufacturer/Zimmer) (english) Endoprotheses: regaining independence and mobility (english) Endoprothetik – Zwischen Anspruch und Realität (german)
	– Prevention		Age-in-Place Home Improvements: A Room-by-Room Guide (Kris Lindahl Real Estate)
	– Problems		Hip-Replacement-Recalls (Drugwatch) 103.104 hip prosthesis injuries between 2008-2017, USA (AP/FDA) 2018 Selbsthilfegruppe für schadhafte Hüftprothesen (german) Der Spiegel: Rückruf von Hüftgelenksprothesen (german) Kniearthrose (Gonarthrose)
	– Science/Future		3D-printed spine
Register (links)		Canadian Joint Replacement Registry (Canada) Czech National Register of Joint Replacement (NRKN, Czech Republic) Deutschland Endoprothesenregister (german) Romanian Arthroplasty Register (Romania) Slovak Arthroplasty Register (Slovakia) Swedish Hip Arthroplasty Register (swedish) UK National Joint Registry (UK) Gelenkersatz: Anwendungsstandards und Register verbessern Qualität (german) Register und Netzwerke: Zusammenarbeit ist wichtig für den Erfolg (german)In the register of the registries you can check which ones are available.
		If your implant is not covered: The Implant-Register offers registration of implants online (fee) and you can download a printable version (free) for your personal use.

Disclaimer
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