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Meniskuswurzelläsionen: Klinische Relevanz und Therapie

Meniscal root lesions: clinical relevance and treatment

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Zusammenfassung

Die Meniskuswurzeln spielen eine wichtige Rolle für die Aufnahme der tibiofemoralen Last. Aus diesem Grund sind Läsionen der Meniskuswurzeln schwerwiegende Verletzungen für das Knie, die den Knorpel signifikant erhöhten Belastungen aussetzen. Dabei wird die akute Meniskuswurzelverletzung, die häufig die posterolaterale Wurzel betrifft und mit einer vorderen Kreuzbandruptur einhergeht, von der chronischen, häufig die posteromediale Wurzel betreffende Läsion unterschieden. Zur Diagnosestellung spielen für beide Verletzungen die Anamnese, die klinische Untersuchung und insbesondere die Magnetresonanztomographie eine wichtige Rolle. Die Therapie der Wahl ist die transtibiale Wurzelrefixation, die zu einer signifikanten Verbesserung der klinischen Symptome und zu einer Verlangsamung der Arthroseprogression führt.

Abstract

Meniscal roots play an important role in load distribution of the tibiofemoral knee joint. Thus, meniscal root tears are severe injuries of the knee, which significantly expose cartilage to increased stress. Two entities are distinguished: (i) acute root tears that mainly affect the posterolateral root and often occur with ruptures of the anterior cruciate ligament; and (ii) chronic, degenerative root tears that mainly affect the posteromedial root. For diagnosis of both entities, the patient’s medical history, a knee examination and especially MRI play key roles. The treatment of choice is in general transtibial fixation of the torn root, which leads to an increased clinical improvement and a decrease of the progression of arthritis.

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Abbreviations

BMI:

Body-Mass-Index

HSS:

Hospital for Special Surgery

ICRS:

International Cartilage Repair Society

LCA:

Ligamentum cruciatum anterius

LCP:

Ligamentum cruciatum posterius

NSAR:

nichtsteroidale Antirheumatika

ROM:

range of motion

TEP:

Totalendoprothese

VKB:

vorderes Kreuzband

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Authors and Affiliations

  1. Zentrum für Orthopädie und Unfallchirurgie, Hochschulklinikum Brandenburg, Medizinische Hochschule Theodor Fontane, Brandenburg an der Havel, Deutschland

    S. Kopf & R. Becker

  2. Orthopädische Universitätsklinik, Otto-von-Guericke Universität, Magdeburg, Deutschland

    C. Stärke

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  1. S. Kopf
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Correspondence to S. Kopf.

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Interessenkonflikt

S. Kopf, C. Stärke und R. Becker geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Kopf, S., Stärke, C. & Becker, R. Meniskuswurzelläsionen: Klinische Relevanz und Therapie. Orthopäde 46, 839–845 (2017). https://doi.org/10.1007/s00132-017-3460-0

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