TREATMENT

During the last 20 years the volume of information for replacing the natural hip joint by a Total Endoprosthesis (TEP) is growing. Current indications for hip implants are

• Osteoarthritis
• Fracture
• Other degenerative illness of the hip joint

The performance of the prosthesis itself and the operation procedure have been improved. TEPs have a restricted lifetime due to aseptic and septic loosening between 5 and 20 years. Mechanical failure of the prosthesis itself is beyond statistical significance. A loose TEP cannot be refixed. If loosening occurs, the TEP is exchanged in a revision surgery. In septical cases an infection located at the probably well fixed prosthesis requires a hip revision procedure. A hip revision is one of the most common orthopedic operations. It is a relatively costly surgery with a high burden for the patient. The number of revisions a patient can undergo is restricted by the substance of the hip bone. The mean age of the patient is about 65 years. It is important to reduce the burden of the patient to a minimum. The prosthesis is fixed either by cement (cemented prosthesis) or by ingrowth (cementless prosthesis). A cementless prosthesis bears advantages according to protection of the bone substance. In the last five years problems with the stability of cementless prostheses have been solved. The proportion of primary cementless implants is growing since 5 years. In the near future the number of revisions of cementless implants will increase. Nevertheless all old cemented prostheses still have to be revised.

THE SWISS ORTHOCLAST^® SYSTEM CAN BE USED TO

> REMOVE AND SHAPE PARTS OF THE BONE > REMOVE THE CEMENT MANTLE > PREPARE THE BEARING OF THE REVISION PROSTHESIS > DISRUPT THE TISSUE BETWEEN A CEMENTLESS STEM AND THE BONE

THE SWISS ORTHOSCOPE^® CAN BE USED TO

> INSPECT THE OLD CEMENT MANTLE AFTER EXTRACTION OF THE OLD STEM > VISUALLY CONTROL CEMENT REMOVAL WITH THE SWISS ORTHOCLAST® > CONTROL SUCCESS OF CEMENT REMOVAL > VISUALLY INSPECT THE NEW PROSTHESIS JOINT