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Rekonstruktion des medialen Kollateralbandkomplexes

Reconstruction of the medial collateral ligament complex

  • Leitthema
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Arthroskopie Aims and scope

Zusammenfassung

Das Prinzip der posteromedialen Rekonstruktion ist der Ersatz der insuffizienten Strukturen (hinteres Schrägband [POL] und oberflächliches mediales Kollateralband [sMCL]) mit einem Sehnentransplantat. Da die Beugesehnen des Pes anserinus superficialis (Ansatzsehne der Mm. semitendinosus und gracilis) als aktive mediale Stabilisatoren dienen, erscheint es sinnvoll, diese entweder von der Gegenseite oder von einem Körperspender zu nehmen. Im Bereich der tibialen Insertionen werden Knochentunnel angelegt, in welche die beiden Transplantatschenkel für das POL und sMCL eingezogen werden. Die Schlaufe des Transplantats wird in einen gemeinsamen Knochentunnel im Bereich des medialen Epikondylus, der femoralen Innenbandinsertion, gezogen. Die Fixation im Knochentunnel erfolgt über Interferenzschrauben und/oder extrakortikal mit Kippankern bzw. durch Verknoten über der Knochenbrücke.

Abstract

The principle of posteromedial reconstruction is replacement of the insufficient structures, the posterior oblique ligament (POL) and the superficial medial collateral ligament (sMCL), with a tendon graft. As the flexor tendons of the superficial pes anserinus (insertion tendon of the semitendinosus and gracilis muscles) serve as active medial stabilizers, it appears to be reasonable to harvest them from the contralateral side or from a body donor (allograft). Bone tunnels are drilled at the tibial insertions of the sMCL and the POL. The loop of the graft is pulled into the tunnel at the medial epicondyle, the femoral insertion of the medial collateral complex. The graft is fixed in the bone tunnel with resorbable interference screws or/and by extracortical fixation using a flip toggle or tying a knot over the bone bridge.

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Authors and Affiliations

  1. Klinik für Orthopädie und Unfallchirurgie, Martin Luther Krankenhaus, Berlin Grunewald, Caspar-Theyss-Straße 27–31, 14193, Berlin, Deutschland

    Wolf Petersen

  2. Abteilung für Sportorthopädie, TU München, München, Deutschland

    Andrea Achtnich

Authors
  1. Wolf Petersen
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  2. Andrea Achtnich
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Correspondence to Wolf Petersen.

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Interessenkonflikt

W. Petersen ist als Berater für die Firmen Karl Storz, Otto Bock und AAP Implantate tätig. A. Achtnich gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Petersen, W., Achtnich, A. Rekonstruktion des medialen Kollateralbandkomplexes. Arthroskopie 30, 38–43 (2017). https://doi.org/10.1007/s00142-016-0115-9

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  • DOI: https://doi.org/10.1007/s00142-016-0115-9

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