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Ausrichtungstechniken zur Implantation einer Knietotalendoprothese mit besonderem Fokus auf die kinematische Ausrichtung

Alignment techniques for implantation of a total knee endoprosthesis with particular focus on kinematic alignment

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Zusammenfassung

Hintergrund

Diese Übersichtsarbeit stellt verschiedene Techniken der Implantation einer Knie-TEP vor, und hinterfragt die „mechanische Ausrichtung“ einer Knietotalendoprothese, hierbei sollen die verschiedenen Ausrichtungsphilosophien untersucht werden. Im Besonderen soll hierbei die kinematische Ausrichtung, in Bezug auf ihren Stellenwert, die einzelnen Schritte der Implantationstechnik und die damit erhobenen Daten eingehender untersucht werden.

Technik

Eine Verbesserung der klinischen Ergebnisse nach Implantation einer Knie-TEP kann durch eine personalisierte, individualisierte und physiologische Implantation erzielt werden, welche die einzigartigen anatomischen Merkmale jedes Patienten respektiert. In den letzten Jahren wurden viele alternative Ausrichtungstechniken entwickelt, einige zeigten vielversprechenden Ansätze.

Ergebnisse

Die kinematische Implantationstechnik kann zuverlässig und kostengünstig durchgeführt werden, und zeigte gute biomechanische Resultate. Auch wenn die ersten klinischen Ergebnisse ermutigend sind, sollten die weiterführende Studien erfolgen um Grenzen einer optimalen Ausrichtung festzulegen.

Abstract

Background

This review introduces various techniques for implantation of a total knee endoprosthesis and scrutinizes the “mechanical alignment” of a total knee endoprosthesis, whereby the various alignment concepts are examined. In particular, kinematic alignment, in terms of its significance, the individual steps of the implantation technique and the data collected, will be examined in more detail.

Methods

Improvement in the clinical results after implantation of a total knee endoprosthesis can be achieved by a personalized, individualized, physiological implantation that respects the unique anatomical characteristics of each patient. In recent years, many alternative alignment techniques have been developed, some of them showing promising approaches.

Results

The kinematic implantation technique can be performed reliably and inexpensively, and shows good biomechanical results. Although the first clinical results are encouraging, further studies should be carried out to determine the limits of optimal alignment.

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Abbreviations

aA:

Anatomische Ausrichtung

amA :

Angepasste mechanische Ausrichtung

fA :

Funktionelle Ausrichtung

kA :

Kinematische Ausrichtung

mA :

Mechanische Ausrichtungstechnik

rkA:

„Restricted-kA“-Technik

TEP :

Totalendoprothese

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Author information

Authors and Affiliations

  1. Endoprothetikzentrum, Theresienkrankenhaus, Mannheim, Deutschland

    Yann Wiart, Johannes Kuntz & Christian Bergdolt

  2. Centre de l’arthrose, Clinique du Sport, Mérignac, Frankreich

    Loïc Villet & Charles Rivière M.D., Ph.D.

  3. South West London Elective Orthopaedic Centre, Epsom General Hospital, MSK Lab – Imperial College London, KT18 7EG, Epsom, Surrey, Großbritannien

    Charles Rivière M.D., Ph.D.

Authors
  1. Yann Wiart
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  2. Johannes Kuntz
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  3. Christian Bergdolt
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  4. Loïc Villet
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  5. Charles Rivière M.D., Ph.D.
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Corresponding author

Correspondence to Charles Rivière M.D., Ph.D..

Ethics declarations

Interessenkonflikt

C. Rivière erklärt, Berater für Medacta zu sein. Y. Wiart, J. Kuntz, C. Bergdolt und L. Villet geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Wiart, Y., Kuntz, J., Bergdolt, C. et al. Ausrichtungstechniken zur Implantation einer Knietotalendoprothese mit besonderem Fokus auf die kinematische Ausrichtung. Orthopäde 49, 578–583 (2020). https://doi.org/10.1007/s00132-020-03930-8

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  • DOI: https://doi.org/10.1007/s00132-020-03930-8

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