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Leitfaden unikompartimenteller Gelenkknorpelschaden am Knie – Knorpelersatz, Osteotomie, Mini-Implantat oder Prothese?

Guidelines for the treatment of unicompartmental cartilage defects of the knee—Cartilage repair, osteotomy, mini-implant or arthroplasty?

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Zusammenfassung

Die Behandlung des unikompartimentellen Gelenkknorpelschadens am Knie bietet eine Reihe von Therapiemöglichkeiten. Mit Unterstützung durch einen Algorithmus wird eine Entscheidungshilfe bei der Vorgehensweise in der Behandlung von unikompartimentellen Gelenkknorpelschäden gegeben. Die Korrektur einer Achsabweichung stellt für eine erfolgreiche Therapie eine Grundvoraussetzung dar. Weiterhin spielen die Defektgröße und Kontextfaktoren wie z. B. das Alter und vorrausgegangene Therapien eine wichtige Rolle für die Wahl der geeignetsten operativen Vorgehensweise.

Abstract

The treatment of unicompartmental cartilage defects offers a large variety of therapeutic options. With help of an algorithm, decision-making for the most suitable treatment approach is supported. Correction of malalignment is key for successful treatment. Defect size, influencing factors such as “age” and prior treatments play an important role in choosing the most appropriate operative treatment option.

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Abbreviations

ACT:

Knorpelzelltransplantation

BMI :

Body-Mass-Index

CAD :

„Computer-aided design“

CAM :

„Computer-aided manufacturing“

DFO :

Distale Femurosteotomie

DGOU :

Deutsche Gesellschaft für Orthopädie und Unfallchirurgie

HTO :

Hohe tibiale valgisierende Osteotomie

MACT :

Matrixassoziierte Knorpelzelltransplantation

M‑BMS :

Matrixaugmentierte Knochenmarksstimulation

OA :

Osteoarthrose

UKE :

Unikompartimenteller Ersatz

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Authors and Affiliations

  1. IZO – Internationales Zentrum für Orthopädie, ATOS Klinik Heidelberg, Bismarckstr. 9–15, 69115, Heidelberg, Deutschland

    Christoph Becher

  2. Abteilung für Sportorthopädie, Klinikum rechts der Isar, Technische Universität München (TUM), München, Deutschland

    Andreas Imhoff

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Correspondence to Christoph Becher.

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C. Becher und A. Imhoff 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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Becher, C., Imhoff, A. Leitfaden unikompartimenteller Gelenkknorpelschaden am Knie – Knorpelersatz, Osteotomie, Mini-Implantat oder Prothese?. Orthopäde 50, 88–95 (2021). https://doi.org/10.1007/s00132-020-04051-y

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