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Therapie der isolierten Femoropatellararthrose

Gibt es evidenzbasierte Verfahren?

Therapy of isolated arthritis in the patellofemoral joint

Are there evidence-based options?

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Zusammenfassung

Hintergrund

Die isolierte Femoropatellararthrose tritt bei ca. 9% der Patienten über 40 Jahren auf und betrifft häufig Frauen. Die Therapieoptionen sind vielfältig und bisher nicht ausreichend durch die Literatur abgesichert.

Material und Methodik

Anhand verschiedener Schlüsselwörter aus dem Bereich der Femoropatellararthrose erfolgte eine Literaturrecherche in den einschlägigen Datenbanken. Die Studien wurden gemäß der untersuchten Therapieform eingeteilt und deren Aussage analysiert.

Ergebnisse

Insgesamt gibt es kaum Level-I-Studien, um die verschiedenen Therapieoptionen mit guter Evidenz vergleichen zu können. In der vorhanden Literatur finden sich Hinweise auf Beschwerdebesserung durch konservative Therapie, arthroskopische Chirurgie, knorpeladressierende Maßnahmen und endoprothetischen Ersatz. Beim Studiendesign fehlen jedoch meist Kontrollgruppen oder ein prospektives randomisiertes Design.

Schlussfolgerung

Kaum eine der untersuchten Therapieoptionen erreicht einen hohen Empfehlungsgrad, daher fehlt nach wie vor ein klarer Goldstandard zur Therapie der isolierten Retropatellararthrose.

Abstract

Background

Isolated osteoarthritis of the patellofemoral joint occurs in 9% of patients over 40 years of age and women are more often affected. Options of treatment are varied and not sufficiently justified by the literature.

Materials and methods

A literature research with keywords in the field of femoropatellar osteoarthritis was carried out in the relevant databases. Studies were categorized into different treatment options and analyzed.

Results

There are almost no level I studies comparing the different treatment options. In the literature there are indications that relief of pain can be achieved by conservative treatment, arthroscopic surgery, cartilage conserving surgery and isolated arthroplasty.

Conclusion

In view of the fact that there are almost no prospective randomized controlled trials, none of the options for treatment can be highly recommended. There is still no gold standard for the treatment of isolated patellofemoral osteoarthritis.

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Lüring, C., Tingart, M., Drescher, W. et al. Therapie der isolierten Femoropatellararthrose. Orthopäde 40, 902–906 (2011). https://doi.org/10.1007/s00132-011-1777-7

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  • DOI: https://doi.org/10.1007/s00132-011-1777-7

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