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Patellaluxation im Kindes- und Jugendalter

Aktuelle Entwicklung bei Diagnostik und Therapie
  • C. ObermeyerEmail author
  • D. B. Hoffmann
  • M. M. Wachowski
Übersichten

Zusammenfassung

Hintergrund

In den letzten Jahren haben klinische Studien zu einer Verbesserung des Verständnisses des Krankheitsbilds der kindlichen Patellaluxation geführt. Diese Erkenntnisse haben jedoch noch keinen flächendeckenden Einzug in die klinische Praxis gehalten.

Ziel der Arbeit

Überprüfung und Darstellung notwendiger diagnostischer und therapeutischer Schritte.

Material und Methoden

Systematische Medline-Recherche zu den Stichworten „patellar instability“ und „patellar dislocation“. Alle Abstracts der Trefferliste (3302 Treffer) wurden überprüft und 147 relevante Artikel im Original ausgewertet.

Ergebnisse

Erkenntnisse aus der Erwachsenenmedizin sind weitgehend übertragbar auf Kinder und Jugendliche. Das Reluxationsrisiko kann auch bei Kindern anhand etablierter Parameter eingeschätzt werden. Es besteht ein zunehmender Trend zur primären operativen Versorgung bei erhöhtem Risiko für eine Reluxation. Fugenschonende Operationsverfahren mit MPFL-Plastik sind sicher und zeigen ein gutes Outcome.

Diskussion

Bei hohem Risiko für eine Rezidivluxation sollten Kinder und Jugendliche nach Erstluxation operativ stabilisiert werden. Das erforderliche Operationsverfahren ist anhand des individuellen Risikoprofils zu wählen.

Schlüsselwörter

Kind Epiphysenfuge Gelenkinstabilität Kniescheibe Mediales patello-femorales Ligament (MPFL) 

Abkürzungen

CT

Computertomographie

MPFL

Mediales patellofemorales Ligament

MRT

Magnetresonanztomographie

PIS

Patellar Instability Severity

ROM

„Range of motion“

TG

„Trochlea groove“

TT

Tuberositas tibiae

Patellar dislocation in children and adolescents

Current developments in diagnostics and treatment

Abstract

Background

The latest results concerning patellar instability in children and adolescents lead to a better understanding of the underlying pathology.

Objectives

Determination of necessary diagnostic procedures and treatment of patellar instability in children and adolescents.

Material and methods

Analysis of available literature based on a systematic MEDLINE analysis.

Results

Diagnostics, risk factors und treatment of adult patellar instability are applicable in the treatment of children. A trend towards early surgical stabilization after primary dislocation was identified. Growth plate-preserving methods for autologous MPFL reconstruction can safely be used in children.

Conclusions

For children with a high risk of redislocation, primary surgical intervention should be performed. The necessary method must be determined by individual risk factor analysis.

Keywords

Child Epiphyseal plate Joint instability Kneecap Medial patello-femoral ligament (MPFL) 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

C. Obermeyer, D.B. Hoffmann und M.M. Wachowski geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • C. Obermeyer
    • 1
    Email author
  • D. B. Hoffmann
    • 2
  • M. M. Wachowski
    • 2
  1. 1.IMB KasselKasselDeutschland
  2. 2.Universitätsmedizin GöttingenGöttingenDeutschland

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