Rekonstruktion des hinteren Kreuzbands View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2009-08

AUTHORS

J.D. Agneskirchner, M. Tröger, H. Hosseini, P. Lobenhoffer

ABSTRACT

Das hintere Kreuzband (HKB) ist der primäre hintere Stabilisator des Kniegelenks. Sein Verlust induziert eine in Beugung zunehmende Subluxation des Kniegelenks, die muskulär oft gut kompensiert wird. Deshalb sind Instabilitätsbeschwerden selten, und der Spontanverlauf ist relativ günstig. Durch den dauerhaft verkürzten Hebelarm der Quadrizepsmuskulatur kommt es jedoch zu einer erhöhten Belastung des medialen und retropatellaren Kompartiments mit gehäuftem Auftreten einer Arthrose nach 10–20 Jahren. Transossäre HKB-Ausrisse haben bei adäquater Therapie eine gute Prognose. Die Naht des Ligaments beim isolierten Substanzriss ist hingegen obsolet, und für isolierte HKB-Rupturen ist der langfristige Effekt durch eine Operation nicht gesichert. Bei einer von den Autoren entwickelten speziellen arthroskopischen Technik für den primären HKB-Ersatz werden die autologen Sehnentransplantate mittels resorbierbarer Crosspins gelenknah fixiert. Bei den komplexen chronischen Instabilitäten müssen sowohl knöcherne als auch ligamentäre Faktoren berücksichtigt werden. Liegt ein Varusmorphotyp vor, muss meist zunächst eine knöcherne Achskorrektur durchgeführt werden. Bei zusätzlicher posterolateraler Instabilität ist eine Rekonstruktion der posterolateralen Kapsel-Band-Ecke indiziert. More... »

PAGES

140-145

References to SciGraph publications

Journal

TITLE

Trauma und Berufskrankheit

ISSUE

Suppl 2

VOLUME

11

Author Affiliations

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10039-008-1466-x

DOI

http://dx.doi.org/10.1007/s10039-008-1466-x

DIMENSIONS

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