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Symptomatische Partialrupturen des vorderen Kreuzbands

Diagnose und Therapie

Symptomatic partial tears of the anterior cruciate ligament

Diagnosis and therapy

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Das vordere Kreuzband (VKB) besteht aus zwei funktionellen Anteilen, dem anteromedialen (AM) und dem posterolateralen (PL) Bündel. Abhängig vom Verletzungsmechanismus existieren unterschiedliche Verletzungsmuster für das VKB mit einem breiten Spektrum unterschiedlicher Partialrupturen. Die isolierte Rekonstruktion des AM- oder PL-Bündels ist ein anspruchsvolles arthroskopisches Verfahren, welches die exakte Kenntnis der Kreuzbandanatomie, ein sorgfältiges Débridieren der verletzten Strukturen sowie eine exakte Bohrkanalanlage erfordert, ohne dabei intakte Kreuzbandfasern zu beschädigen.

Dieser Artikel erläutert das Konzept der VKB-Partialruptur sowie klinische, radiologische und arthroskopische Aspekte. Des Weiteren wird die Augmentation erörtert.

Abstract

The anterior cruciate ligament (ACL) consists of two anatomical and functional bundles, the anteromedial (AM) and posterolateral (PL) bundles. Different injury pattern demonstrate a wide spectrum of partial ACL tears. Clinical interest has recently focused on performing selective ACL augmentation according to the specific injury pattern. Theoretically, sparing the intact parts of the ACL may increase vascularization and proprioception, can optimize the accuracy of ACL reconstruction and result in better stability and improved clinical outcome for the patient. However, isolated reconstruction of the AM or PL bundle is an advanced arthroscopic procedure that requires precise preoperative and intraoperative diagnostic assessment of the injury pattern, exact anatomical definition of the insertion sites and careful debridement and bone tunnel placement while preserving the intact parts of the ACL.

This article presents the concept of partial ACL rupture, describes the clinical, radiological and arthroscopic assessment of partial tears as well as the arthroscopic reconstruction.

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Authors and Affiliations

  1. HKF: Zentrum für Spezielle Hüft-Knie-Fußchirurgie, Arthroskopie & Endoprothetik, ATOS Klinik Heidelberg, Bismarckstr. 9-15, 69115, Heidelberg, Deutschland

    R. Siebold & P. Schuhmacher

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  1. R. Siebold
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  2. P. Schuhmacher
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Correspondence to R. Siebold.

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Siebold, R., Schuhmacher, P. Symptomatische Partialrupturen des vorderen Kreuzbands. Arthroskopie 26, 47–51 (2013). https://doi.org/10.1007/s00142-012-0717-9

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  • DOI: https://doi.org/10.1007/s00142-012-0717-9

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