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Vorderer Kreuzbandersatz mit Semitendinosus-Grazilis-Sehne 4fach vs. Lig. patellae vs. funktioneller Behandlung

Klinische Ergebnisse einer prospektiv randomisierten Studie nach vorderer Kreuzbandruptur

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Arthroskopie Aims and scope

Zusammenfassung

Eine Ruptur des vorderen Kreuzbands beim sportlich aktiven Patienten sollte mit einer Stabilisierungsoperation behandelt werden. Die beiden Operationsmethoden Semitendinosus-Grazilis-Sehnen-Plastik (SGSP) 4fach und Lig.-patellae-Plastik (LPP) führen zu guten Ergebnissen, wobei in unserer Untersuchung Vorteile für die SGSP 4fach vorhanden sind. Die funktionelle Therapie wurde von den Patienten wegen bestehender Auslassphänomene nicht akzeptiert. Die SGSP 4fach führt zu besseren Ergebnissen in der Sprungkraft, im OAK- und im IKDC-Score und zu weniger Problemen an der Transplantatentnahmestelle. Bezüglich der "passiven Stabilität", "Muskelmasse", "Maximalkraft", "range of motion—ROM", "subjektivem Beschwerdebild", und der "zyklischen Bewegungsschnelligkeit" konnte kein Unterschied zwischen den Operationsmethoden gezeigt werden. In der "Gleichgewichtsfähigkeit" zeigte sich ein signifikanter Unterschied zugunsten der LPP-Gruppe. Insgesamt hat bei uns die SGSP 4fach die LPP als "Goldstandard" abgelöst.

Abstract

We find that in general a rupture of the ACL in sportive active patients should be stabilized operatively. Both BTB and hamstring reconstruction technique show good results. The quadrouple-hamstring reconstruction however shows certain advantages in our study. Due to persistant instabillity functional treatment was not accepted by our patients. Hamstring reconstruction shows less donorsite morbidity and better restults in OAK and IKDC score and in jumping strength. No difference was noted in passive stability, musclemass, maximal strength, ROM, cyclic acceleration and patient content. The BTB group had a better balance activity level. Over all the hamstring reconstruction has become the "gold standard" for ACL reconstruction for us.

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Authors and Affiliations

  1. Unfallkrankenhaus Salzburg

    G. Oberthaler, W. Marth, C. Primavesi & A. Trost

  2. Sportuniversität Salzburg

    A. Aichner

  3. UKH Salzburg, Dr.-Franz-Rehrl-Platz 5, 5020, Salzburg, Österreich

    G. Oberthaler

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  1. G. Oberthaler
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  2. A. Aichner
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  3. W. Marth
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  4. C. Primavesi
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  5. A. Trost
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Correspondence to G. Oberthaler.

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Oberthaler, G., Aichner, A., Marth, W. et al. Vorderer Kreuzbandersatz mit Semitendinosus-Grazilis-Sehne 4fach vs. Lig. patellae vs. funktioneller Behandlung. Arthroskopie 16, 255–261 (2003). https://doi.org/10.1007/s00142-003-0225-z

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