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Anatomie der lateralen und medialen Stabilisatoren des Kniegelenks

Anatomy of the lateral and medial stabilizers of the knee

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Am Bandapparat des Kniegelenks wird der zentrale Pfeiler mit vorderem und hinterem Kreuzband von den peripheren Strukturen (medial und lateral) abgegrenzt. Am peripheren Bandapparat lassen sich 3 verschiedene Schichten identifizieren: Faszie und Tractus iliotibialis (Schicht 1), laterales Kollateralband (LCL), Popliteussehne und oberflächliches mediales Kollateralband (Schicht 2), Kapselbänder (Schicht 3). Die posteromedialen Strukturen werden von den meisten Autoren in das oberflächliche und tiefe mediale Kollateralband (sMCL und dMCL), das hintere Schrägband (POL) und die posteromediale Gelenkkapsel (PMC) unterteilt. Die anteromediale Kapsel besteht aus den meniskofemoralen und meniskopatellaren Bändern sowie dem Retinaculum longitudinale patellae mediale. Die Verbindung zwischen Meniskus und Tibia wird als Ligamentum coronarium bezeichnet. Lateral entspringt das LCL am Epicondylus lateralis des Femur und zieht schräg nach distal-hinten zur Seiten- und Vorderfläche des Fibulakopfes. Die wichtigsten Strukturen der posterolateralen Gelenkecke sind die Ansatzsehne des M. popliteus und das Lig. popliteofibulare (LPF), welches vom Fibulakopf in die Popliteussehne einstrahlt. Die anterolateralen Strukturen bestehen aus der anterolateralen Gelenkkapsel mit den meniskopatellaren Faszikeln, dem Reservestreckapparat, dem anterolateralen Ligament (ALL) und dem Tractus iliotibialis. Der periphere Bandapparat ist primärer Stabilisator gegen Valgus- und Varusstress sowie gegen Innen- oder Außenrotation. Seine Strukturen sind jedoch auch wichtige sekundäre Stabilisatoren gegen die anteriore und posteriore tibiale Translation.

Abstract

At the knee joint the central ligaments with the anterior and posterior cruciate ligaments are differentiated from the peripheral ligamentous structures (medial and lateral). Among the peripheral ligaments three different layers can be identified: the fascia and iliotibial tract (layer 1), the lateral collateral ligament (LCL), popliteal tendon and superficial medial collateral ligament (sMCL, layer 2) and capsular ligaments (layer 3). Most authors divide the posteromedial structures into the sMCL and the deep medial collateral ligament (dMCL), the posterior oblique ligament (POL) and the posteromedial joint capsule (PMC). The anteromedial capsule consists of the meniscofemoral ligament, the medial longitudinal retinaculum of the patella and the meniscopatellar ligament. The connection between the medial meniscus and the tibia is known as the coronary ligament. Laterally, the LCL inserts at the lateral epicondyle of the femur and runs obliquely posterodistal to the side and front surfaces of the fibular head. The main structures of the posterolateral corner are the popliteal tendon and the popliteofibular ligament (LPF), which radiates from the fibular head into the popliteal tendon. The anterolateral structures consist of the anterolateral joint capsule with the meniscopatellar fibers, the anterolateral ligament (ALL) and the iliotibial tract. The peripheral ligaments are the primary stabilizers against valgus and varus strain and against internal or external rotation; however, its structures are also important secondary stabilizers against anterior and posterior tibial translation.

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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. Sporthopaedicum Straubing, Straubing, Deutschland

    Thore Zantop

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  1. Wolf Petersen
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  2. Thore Zantop
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Correspondence to Wolf Petersen.

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Interessenkonflikt

W. Petersen gibt folgenden Interessenskonflikt an: Beratertätigkeit für Otto Bock Helath Care, Karl Storz un AAP Implantate, Vortragshonorar von Plasmaconcept. T. Zantop gibt folgenden Interessenskonflikt an: Beratertätigkeit für Otto Bock Helath Care und Karl Storz.

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

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Petersen, W., Zantop, T. Anatomie der lateralen und medialen Stabilisatoren des Kniegelenks. Arthroskopie 30, 4–13 (2017). https://doi.org/10.1007/s00142-016-0112-z

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