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Kniegelenkersatz des älteren Menschen

Total knee arthroplasty in the elderly

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Zusammenfassung

Hintergrund

Gemäß der demografischen Entwicklung nimmt der Anteil der endoprothetischen Versorgungen am Kniegelenk bei älteren Menschen zu.

Fragestellung

Es erfolgte eine Analyse zu der speziellen Situation beim älteren Menschen, alternativen Therapieoptionen, perioperativen Risiken, präoperativer Vorbereitung, intraoperativen Besonderheiten und Outcome.

Material und Methode

Die gegenwärtige wissenschaftliche Datenlage wurde ausgewertet und die eigenen wissenschaftlichen Studienergebnisse werden präsentiert.

Ergebnisse

Ältere Menschen haben ein erhöhtes perioperatives Risiko beim künstlichen Kniegelenkersatz. Eine gründliche interdisziplinäre Vorbereitung ist erforderlich, um Risiken zu reduzieren. Die Stabilität des Kapselbandapparates nimmt mit zunehmenden Alter nicht ab. Das postoperative Ergebnis nach künstlichen Kniegelenkersatz wird bei älteren Menschen von der präoperativen Funktion und psychosozialen Faktoren entscheidend beeinflusst.

Schlussfolgerungen

Der künstliche Kniegelenkersatz beim älteren Menschen ist eine besondere Herausforderung für den orthopädischen Chirurgen und bedarf einer engen interdisziplinären Zusammenarbeit.

Abstract

Background

The number of total knee arthroplasties in elderly patients is increasing in accordance with the demographic shift in the population.

Objective

Analysis of the special situation in the elderly, conservative treatment options, perioperative risk factors, preoperative preparation, special intraoperative features and outcome.

Methods

Analysis of currently available scientific data and presentation of own scientific study results.

Results

Total knee arthroplasty in elderly patients is related to an increased perioperative risk of complications. A thorough interdisciplinary preparation is required to reduce risk factors. Ligament stability of the knee does not correlate with age. The postoperative outcome after total knee arthroplasty in elderly patients is decisively influenced by the preoperative function and psychosocial parameters.

Conclusion

Total knee arthroplasty in elderly patients is particularly challenging for orthopedic surgeons and requires close interdisciplinary cooperation.

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Authors and Affiliations

  1. Orthopädische Abteilung der Universität Regensburg, Asklepios Klinikum Bad Abbach, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Deutschland

    M. Weber, F. Völlner, A. Benditz, T. Schwarz, M. Wörner, B. Craiovan, T. Renkawitz & J. Grifka

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  1. M. Weber
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  2. F. Völlner
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  3. A. Benditz
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  4. T. Schwarz
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  5. M. Wörner
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  6. B. Craiovan
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  7. T. Renkawitz
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  8. J. Grifka
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Corresponding author

Correspondence to M. Weber.

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Interessenkonflikt

M. Weber, F. Völlner, A. Benditz, T. Schwarz, M. Wörner, B. Craiovan, T. Renkawitz und J. Grifka geben an, dass kein Interessenkonflikt besteht.

Alle beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben.

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Weber, M., Völlner, F., Benditz, A. et al. Kniegelenkersatz des älteren Menschen. Orthopäde 46, 34–39 (2017). https://doi.org/10.1007/s00132-016-3363-5

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  • DOI: https://doi.org/10.1007/s00132-016-3363-5

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