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Die Versorgung der frischen und der veralteten Kreuzbandruptur mit kombiniertem autologem und alloplastisch verstärktem Sehnentransplantat (Polypropylen-Band)

Treatment of the recent and inveterate cruciate ligament rupture by means of a combined autologous tendon graft with alloplastic splicing (polypropylene stripe)

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Zusammenfassung

Nach Besprechung grundsätzlicher Probleme bei der Versorgung frischer und alter Verletzungen des vorderen Kreuzbandes wird auf die eigene Operationstechnik eigegangen, die sich modifiziert an die Kennedy-MacIntosh-Methode anlehnt Zur temporären Überbrückung der operationsbedingten Schwächung des Quadrizeps-Patellarsehnen-Transplantates wird dieses mit einem 8 mm breiten Polypropylenband mit sehr guten biologischen und mechanischen Eigenschaften verstärkt. Die “biologische Fixierung” distal an der Sehne und proximal am Knochen verhindert “stress-shielding” underlaubt den Kraftfluß auf das autologe Transplantat als formativen Reiz. Frische Rupturen werden genäht oder reinseriert, zusätzlich fibrin-geklebt und mit einem kombinierten Semitendinosus-6-mm-Polypropylenband-Transplantat in gleicher Weise verstärkt. Wichtige operationstechnische Einzelheiten werden dargestellt. Auch auf Details der Nachbehandlung wird eingegangen. Frühergebnisse und Komplikationen werden abschließend besprochen.

Abstract

After discussing basic problems in repair and reconstruction of acute as well as secondary anterior cruciate ligament-lesions authors present a modified Kennedy-MacIntosh technique of acl-reconstruction. Temporary compensation of loss in tensile strength of the autograft (quadriceps-patellar-tendon) is achieved by an 8 mm Polypropylene band with excellent biocompatibility and mechanical characteristics. “Biological fixation” of the distal part of the tendon-graft avoids “stress shielding” and physiological applied stress may lead to remodelling and structuring in the sense of functional adaptation. Acute acl-ruptures are sutured or reinserted and treated with fibrine-tissue-glue. Furthermore a semitendinosus-autograft combined with a 6 mm Polypropylene band is added. Details of the operations-procedure are presented as well as steps in postoperative treatment. Early results and complications are finally discussed.

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  1. P. Bernett

    Present address: Sporttraumatologie, Ismaninger Str. 22, D-8000, München 80

Authors and Affiliations

  1. Poliklinik für Sportverletzungen, Klinikum rechts der Isar, TU München, München, Deutschland

    P. Bernett, H. Seesko & Ch. Feldmeier

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Bernett, P., Seesko, H. & Feldmeier, C. Die Versorgung der frischen und der veralteten Kreuzbandruptur mit kombiniertem autologem und alloplastisch verstärktem Sehnentransplantat (Polypropylen-Band). Unfallchirurgie 11, 251–258 (1985). https://doi.org/10.1007/BF02587973

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