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Intraoperative biologische Augmentation an Sehnen und Enthesen

Intraoperative biological augmentation of tendons and entheses

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Trotz technischer Weiterentwicklung in der Sehnenrekonstruktionschirurgie besteht postoperativ nach wie vor eine relativ hohe Rerupturrate. Ein Grund dafür ist die Tatsache, dass bei der Sehnenansatz- und Sehnenheilung, bedingt durch eine limitierte Regenerationskapazität, Narbengewebe anstelle von normalem Gewebe gebildet wird. Dieses Narbengewebe ist sowohl in funktioneller als auch struktureller Sicht dem normalen Gewebe unterlegen. Mehrere Strategien zur biologischen Augmentation von Sehnen- und Sehnenansatzläsionen wurden in den letzten Jahren entwickelt und getestet. Dieser Artikel bespricht die klinische Evidenzlage bezüglich der biologischen Augmentation von Sehnen und Enthesen mittels Wachstumsfaktoren in Form von Plättchenkonzentraten, zellbasierten Therapien bzw. biologischen Sehnengrafts.

Abstract

In spite of further developments in surgical techniques for tendon and entheses reconstruction procedures, the retearing rate after tendon and tendon-bone repair remains high. The reason is that instead of native tissue, scar tissue with reduced functional and structural quality forms at the reconstruction site. In order to improve tendon and enthesis healing several therapy strategies have been developed for biological improvement of the repair area. This article provides an overview of the current evidence of augmentation techniques for tendon and enthesis reconstruction using growth factors in the form of platelet concentrates, cell-based therapies and biological tendon grafts.

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Authors and Affiliations

  1. Schulter, Ellbogen und Sportorthopädie, Universitätsklinik für Orthopädische Chirurgie und Traumatologie, Inselspital, 3010, Bern, Schweiz

    M.O. Schär &  M.A. Zumstein

  2. Sports Medicine and Shoulder Service, Hospital for Special Surgery, Cornell University, New York, USA

    M.O. Schär & S.A. Rodeo

  3. Department of Orthopaedic Surgery and Sports Traumatology, L’Archet Hospital II, University of Nice-Sophia-Antipolis, Nice-Sophia-Antipolis, Frankreich

    P. Boileau

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  1. M.O. Schär
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  2. S.A. Rodeo
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  3. P. Boileau
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  4. M.A. Zumstein
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Corresponding authors

Correspondence to M.O. Schär or M.A. Zumstein.

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Schär, M., Rodeo, S., Boileau, P. et al. Intraoperative biologische Augmentation an Sehnen und Enthesen. Arthroskopie 26, 99–104 (2013). https://doi.org/10.1007/s00142-012-0735-7

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  • DOI: https://doi.org/10.1007/s00142-012-0735-7

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