Patellofemorale Inlay-Implantate – ein Fortschritt in der patellofemoralen Endoprothetik?

Patellofemoral inlay implants—an innovation in patellofemoral joint arthroplasty?

Der Orthopäde (2020)Cite this article

Zusammenfassung

Die isolierte Arthrose des Patellofemoralgelenkes stellt eine seltene und komplexe Erkrankung dar. Nach Ausschöpfen der konservativen Therapie stehen dem Orthopäden diverse weichteilige und knöcherne rekonstruktive Verfahren sowie knorpelregenerative Verfahren zur Verfügung. Bei fehlgeschlagener oder unbefriedigender Therapie wird die Patellofemoralprothese als Therapiealternative weiterhin kontrovers diskutiert. Bei genauerer Betrachtung der Studien zeigen sich vielversprechende Ergebnisse bei korrekter Indikationsstellung und Patientenselektion. Die unterschiedlichen Prothesendesigns liefern gute postoperative Ergebnisse bei Beachtung von generellen und spezifischen Risiken. Die aktuelle Generation der patellofemoralen Inlay-Prothesen zeigt eine hohe Patientenzufriedenheit mit signifikanten Verbesserungen der Kniefunktion und Schmerzlinderung in mittelfristen Ergebnissen, bei allerdings nicht unerheblicher Revisionsrate.

Abstract

Isolated arthrosis of the patellofemoral joint is a rare and complex disease. After conservative therapy has been exhausted, the orthopedist has various soft-tissue and bone reconstructive procedures as well as cartilage regenerative procedures at his hands. In cases of failed or unsatisfactory therapy, patellofemoral arthroplasty continues to be controversially discussed as an alternative therapy. A closer look at these studies reveals promising results with the correct indication and patient selection. The different prosthesis designs provide good postoperative results while considering general and specific risks. The current generation of patellofemoral inlay prostheses shows high patient satisfaction with significant improvements in knee function and pain relief in mid-term outcomes. However, a relatively high revision rate must be considered.

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Abbreviations

BMI:

Body-Mass-Index

KTEP :

Knietotalendoprothese

MPFL :

Mediales patellofemorales Ligament

PFTE :

Patellofemoraler Teilersatz

VAS :

Visuelle Analogskala

WOMAC :

Western Ontario and McMaster Universities Osteoarthritis Index

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  1. Abteilung für Sportorthopädie, Klinikumrechts der Isar, TU München, Ismaninger Str. 22, 81675, München, Deutschland

    Hannes Degenhardt, Prof. Dr. med. Andreas B. Imhoff, apl. Prof. Dr. med. Matthias J. Feucht & PD Dr. Jonas Pogorzelski MHBA

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  1. Hannes Degenhardt
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  2. Prof. Dr. med. Andreas B. Imhoff
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  3. apl. Prof. Dr. med. Matthias J. Feucht
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Correspondence to PD Dr. Jonas Pogorzelski MHBA.

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Interessenkonflikt

A.B. Imhoff gibt an, dass er eine beratende Funktion für die Firma Arthrosurface (Franklin, MA, USA) hat. H. Degenhardt, M.J. Feucht und J. Pogorzelski geben an, dass kein Interessenkonflikt besteht. Die Firma Arthrosurface (Franklin, MA, USA) hat keinen Einfluss auf Design, Datenerhebung und Ergebnisinterpretation dieser Arbeit.

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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Degenhardt, H., Imhoff, A.B., Feucht, M.J. et al. Patellofemorale Inlay-Implantate – ein Fortschritt in der patellofemoralen Endoprothetik?. Orthopäde (2020). https://doi.org/10.1007/s00132-020-04059-4

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Schlüsselwörter

  • Knorpel
  • Gelenkersatz
  • Knie
  • Arthrose
  • Patellofemoralgelenk

Keywords

  • Cartilage
  • Joint replacement
  • Knee
  • Osteoarthritis
  • Patellofemoral joint