Zusammenfassung
Der Stellenwert der Arthroskopie bei manifester Gonarthrose stellt ein komplexes Thema dar, welches in den letzten Jahren Gegenstand kontroverser Debatten war. Auch wenn die ursprüngliche Idee durch eine Spülung des Gelenks ohne gezieltes Adressieren einer spezifischen Pathologie heute auf Basis der vorhanden Literatur kritisch zu sehen ist und nicht mehr empfohlen werden kann, existieren relevante Begleitpathologien, die auch heute bei manifester Arthrose des Kniegelenks ein arthroskopisches Vorgehen rechtfertigen. Der vorliegende Artikel soll einen Überblick über die therapeutischen Ansätze arthroskopischer Chirurgie bei manifester Arthrose des Kniegelenks geben.
Abstract
The relevance of arthroscopic surgery in patients with advanced osteoarthritis of the knee has been discussed controversially in recent years. Even though the idea of joint lavage in order to reduce the inflammatory component of the affected joint has not been proven to provide sufficient long-term effects, there are a variety of copathologies that can efficiently be addressed by arthroscopic surgery. The present article summarizes the indications for arthroscopic surgery in patients with osteoarthritis of the knee joint and discusses the scientific literature available on this controversial topic.
Literatur
AAOS (2002) Arthroscopic surgery and osteoarthritis of the knee. A Report for the Centers for Medicare and Medicaid Services
Aaron RK, Skolnick AH, Reinert SE, Ciombor DM (2006) Arthroscopic Débridement for osteoarthritis of the knee. J Bone Joint Surg Am 88:936–943
Becker R, Ropke M, Krull A et al (2008) Surgical treatment of isolated patellofemoral osteoarthritis. Clin Orthop Relat Res 466:443–449
Campbell MK, Skea ZC, Sutherland AG et al (2010) Effectiveness and cost-effectiveness of arthroscopic lavage in the treatment of osteoarthritis of the knee: a mixed methods study of the feasibility of conducting a surgical placebo-controlled trial (the KORAL study). Health Technol Assess 14:1–180
Chang RW, Falconer J, Stulberg SD et al (1993) A randomized, controlled trial of arthroscopic surgery versus closed-needle joint lavage for patients with osteoarthritis of the knee. Arthritis Rheum 36:289–296
Dandy DJ (1991) Arthroscopic Débridement of the knee for osteoarthritis. J Bone Joint Surg Br 73:877–878
Dervin GF, Stiell IG, Rody K, Grabowski J (2003) Effect of arthroscopic Débridement for osteoarthritis of the knee on health-related quality of life. J Bone Joint Surg Am 85-A:10–19
Englund M, Guermazi A, Lohmander LS (2009) The meniscus in knee osteoarthritis. Rheum Dis Clin North Am 35:579–590
Fond J, Rodin D, Ahmad S, Nirschl RP (2002) Arthroscopic Débridement for the treatment of osteoarthritis of the knee: 2- and 5-year results. Arthroscopy 18:829–834
Kalunian KC, Moreland LW, Klashman DJ et al (2000) Visually-guided irrigation in patients with early knee osteoarthritis: a multicenter randomized, controlled trial. Osteoarthritis Cartilage 8:412–418
Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502
Kirkley A, Birmingham TB, Litchfield RB et al (2008) A randomized trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med 359:1097–1107
Kornaat PR, Ceulemans RY, Kroon HM et al (2005) MRI assessment of knee osteoarthritis: Knee Osteoarthritis Scoring System (KOSS)–inter-observer and intra-observer reproducibility of a compartment-based scoring system. Skeletal Radiol 34:95–102
Kuzmanova SI (2003) Treatment of knee osteoarthritis by arthroscopic synovectomy and Débridement of cartilage lesions–late results. Folia Med (Plovdiv) 45(3):66–72
Laskin RS, Ohnsorge JA (2005) The role of arthroscopy: beneficial, placebo, or worse? Orthopedics 28:975–976
Laupattarakasem W, Laopaiboon M, Laupattarakasem P, Sumananont C (2008) Arthroscopic Débridement for knee osteoarthritis. Cochrane Database Syst Rev 23(1):CD005118
Moseley JB, O’Malley K, Petersen NJ et al (2002) A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med 347:81–88
Ohnsorge JA, Maus U, Weisskopf M, Laskin RS (2006) Arthroscopy and knee osteoarthritis: only a placebo effect? Z Orthop Ihre Grenzgeb 144:241–243
Pearse EO, Craig DM (2003) Partial meniscectomy in the presence of severe osteoarthritis does not hasten the symptomatic progression of osteoarthritis. Arthroscopy 19:963–968
Pierzchala A, Kusz D, Widuchowski J (2003) Complication of arthroscopy of the knee. Wiad Lek 56:460–467
Ravaud P, Moulinier L, Giraudeau B et al (1999) Effects of joint lavage and steroid injection in patients with osteoarthritis of the knee: results of a multicenter, randomized, controlled trial. Arthritis Rheum 42:475–482
Reigstad O, Grimsgaard C (2006) Complications in knee arthroscopy. Knee Surg Sports Traumatol Arthrosc 14:473–477
Sanchis-Alfonso V, Rosello-Sastre E (2000) Immunohistochemical analysis for neural markers of the lateral retinaculum in patients with isolated symptomatic patellofemoral malalignment. A neuroanatomic basis for anterior knee pain in the active young patient. Am J Sports Med 28:725–731
Smith GD, Richardson JB, Brittberg M et al (2003) Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. J Bone Joint Surg Am 85-A:2487–2488, author reply 2488
Spahn G, Muckley T, Kahl E, Hofmann GO (2006) Factors affecting the outcome of arthroscopy in medial-compartment osteoarthritis of the knee. Arthroscopy 22:1233–1240
Steadman JR, Ramappa AJ, Maxwell RB, Briggs KK (2007) An arthroscopic treatment regimen for osteoarthritis of the knee. Arthroscopy 23:948–955
Wai EK, Kreder HJ, Williams JI (2002) Arthroscopic Débridement of the knee for osteoarthritis in patients fifty years of age or older: utilization and outcomes in the Province of Ontario. J Bone Joint Surg Am 84-A:17–22
Widuchowski J, Koczy B, Widuchowski W (2003) Intra- and postoperative complications in the arthroscopy of the knee joint. Chir Narzadow Ruchu Ortop Pol 68:105–108
Wu CC (2011) Combined lateral retinacular release with drilling chondroplasty for treatment of patellofemoral osteoarthritis associated with patellar malalignment in elderly patients. Knee 18:24–29
:http://www.aerzteblatt.de/nachrichten/33667. [Letzter Zugriff am 04.07.2012]
http://www.spiegel.de/spiegel/print/d-79974031.html. [Letzter Zugriff am 04.07.2012]
http://www.spiegel.de/wissenschaft/mensch/0,1518,577622,00.html. [Letzter Zugriff am 04.07.2012]
http://www.g-ba.de/downloads/39-261-1333/2011-05-05_SN-135-1_137c_Gonarthrose_BAnz.pdf. [Letzter Zugriff am 04.07.2012]
Interessenkonflikt
Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Niemeyer, P., Zantop, T., Südkamp, N. et al. Stellenwert der Arthroskopie bei Gonarthrose. Arthroskopie 25, 170–176 (2012). https://doi.org/10.1007/s00142-012-0695-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00142-012-0695-y