Zusammenfassung
Die Manifestation einer Osteonekrose nach Arthroskopie des Kniegelenks ist eine seltene postoperative Komplikation. Ihre genaue Ätiologie ist unklar. Die wichtigste Differenzialdiagnose dieser postarthroskopisch diagnostizierten Osteonekrose ist die präarthroskopisch bestehende, nicht diagnostizierte spontane Osteonekrose des Kniegelenks. Dies ist von forensischer Bedeutung, denn die Arthroskopie könnte fälschlicherweise für eine erst postoperativ diagnostizierte Osteonekrose verantwortlich gemacht werden. Die Differenzialdiagnostik zur Unterscheidung der beiden Osteonekrosearten kann schwierig sein. Sowohl die postarthroskopisch diagnostizierte als auch die spontane Osteonekrose des Kniegelenks weisen hinsichtlich der bildgebenden Befunde und des phasenhaften klinischen Verlaufs große Gemeinsamkeiten auf.
Zur Beschreibung einer Osteonekrose nach Arthroskopie sollte der unverfängliche Begriff „Osteonekrose des postarthroskopischen Kniegelenks“ statt des forensisch bedeutsamen Ausdrucks der „postarthroskopischen Osteonekrose des Kniegelenks“ verwendet werden.
Abstract
Osteonecrosis of the knee is a rare complication following arthroscopic surgery. Little is known about its etiology. The most important differential diagnosis is preexisting and undiagnosed early-stage spontaneous osteonecrosis of the knee. Medicolegally, arthroscopic surgery could be wrongly regarded as the primary cause for postarthroscopic osteonecrosis. Orthopedic surgeons need to be aware of the diagnostic pitfalls in differentiating between these entities.
We suggest that the descriptive term “osteonecrosis in the postoperative knee” should be used rather than the captious term “postarthroscopic osteonecrosis.”
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Pape, D., Lorbach, O., Anagnostakos, K. et al. Die Osteonekrose des postarthroskopischen Kniegelenks. Orthopäde 37, 1099–1107 (2008). https://doi.org/10.1007/s00132-008-1303-8
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DOI: https://doi.org/10.1007/s00132-008-1303-8