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Isolierte Arthrose des Patellofemoralgelenks beim jüngeren Patienten (<50 Jahre)

Isolated arthrosis of the patellofemoral joint in younger patients (<50 years)

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Zusammenfassung

In den meisten Fällen ist die Arthrose des Patellofemoralgelenks (PFG) mit einer Arthrose der femorotibialen Kompartments kombiniert und steht dadurch etwas im Hintergrund. Trotzdem kann sie auch isoliert auftreten, insbesondere auf der Außenseite. In mehreren radiologischen Studien fanden sich isolierte degenerative Veränderungen im PFG bei einer Altersgruppe von >55 Jahren (13,6–24,0% bei Frauen und 11,0–15,4% bei Männern). Bei jüngeren Patienten ist die Häufigkeit geringer und steht v. a. im Zusammenhang mit einer Patellainstabilität oder mit einer posttraumatischen Arthrose. Trotzdem ist die Auswahl der richtigen Therapie bei diesen Patienten schwieriger. Beim älteren und weniger aktiven Patienten kann eine Totalprothese empfohlen werden. Beim jüngeren und aktiveren Patienten hingegen stehen dem Chirurgen verschiedene konservative Therapieformen und anspruchsvollere operativeTechniken zur Vermeidung einer Arthroplastik zur Verfügung. In diesem Beitrag beschreiben wir verschiedene therapeutische Möglichkeiten in der Behandlung der Arthrose des PFG beim Patienten <50 Jahren.

Abstract

In the majority of cases, arthrosis of the patellofemoral joint (PFJ) is combined with arthrosis of the femorotibial compartment and thus assumes a somewhat secondary role. Nevertheless, it can occur as an isolated entity. Several radiological studies evidenced isolated degenerative alterations in the PFJ in the age group >55 years (13.6–24.0% in women and 11.0–15.4% in men). In younger patients the incidence is lower and is mainly associated with patellar instability or post-traumatic arthrosis. Just the same, the choice of appropriate treatment for these patients is challenging. Total replacement can be recommended for older and less active patients. In contrast, for younger and more active patients, various conservative treatment options and more demanding operative techniques are available to the surgeon to avoid arthroplasty. This article describes the different therapeutic possibilities for managing arthrosis of the PFJ in patients aged <50 years.

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  1. Hôpital de la Croix-Rousse, Grande Rue de la Croix-Rousse 103, F-69317, Lyon, France

    S. Lustig, E. Servien, R. Biedert & P. Neyret

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  1. S. Lustig
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  2. E. Servien
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  3. R. Biedert
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  4. P. Neyret
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Correspondence to P. Neyret.

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Lustig, S., Servien, E., Biedert, R. et al. Isolierte Arthrose des Patellofemoralgelenks beim jüngeren Patienten (<50 Jahre). Orthopäde 37, 848–857 (2008). https://doi.org/10.1007/s00132-008-1291-8

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