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Erweiterte Indikationen für die Rekonstruktion des medialen patellofemoralen Ligaments

Extended indications for reconstruction of the medial patellofemoral ligament

  • Leitthema
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Arthroskopie Aims and scope

Zusammenfassung

Das mediale patellofemorale Ligament (MPFL) ist der Hauptstabilisator des patellofemoralen Gelenks (PFG) in strecknaher Gelenkstellung. Bei subakuten bzw. chronischen Patellaluxationen stellt sich die Indikation zur Sehnentransplantation (MPFL-Rekonstruktion) zur Stabilisierung des PFGs sowie zur Wiederherstellung einer physiologischen Kinematik. Dies wird durch eine anatomische Platzierung des Transplantats sowie eine Zweibündelstruktur gewährleistet. Aufgrund der multifaktoriellen Genese der patellofemoralen Instabilität (PFI) sollte die alleinige MPFL-Rekonstruktion erst nach Ausschluss weiterer Pathomorphologien erfolgen.

Jedoch ist die Rekonstruktion des MPFL auch in Kombinationseingriffen bei Trochleaplastiken, Derotationsosteotomien und Prothesenimplantationen ein wesentlicher Faktor für eine erfolgreiche operative Therapie der PFI.

Abstract

The medial patellofemoral ligament (MPFL) is the main restraint of the patellofemoral joint against lateral patella dislocation in the extended knee. The indications to reconstruct the MPFL are subacute and/or chronic dislocations of the patella to regain stability and physiological joint kinematics, which is achieved by placing the graft anatomically and using a two-bundle technique. Due to the multifactorial genesis of patellofemoral instability, the exclusive reconstruction of the MPFL should only be done after exclusion of further pathomorphologies. Nevertheless, reconstruction of the MPFL in combined surgical interventions, such as trochleaplasty, derotation osteotomy and implantation of prostheses is an essential part of the successful operative treatment of patellofemoral instability.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 3471 Fifth Avenue, Suite 1011, 15213, Pittsburgh, USA

    D. Hensler

  2. Orthopädie am Zürichberg, Klinik Bethanien, Zürich, Schweiz

    P.B. Schöttle

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  1. D. Hensler
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  2. P.B. Schöttle
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Correspondence to D. Hensler.

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Hensler, D., Schöttle, P. Erweiterte Indikationen für die Rekonstruktion des medialen patellofemoralen Ligaments. Arthroskopie 23, 184–190 (2010). https://doi.org/10.1007/s00142-010-0568-1

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  • DOI: https://doi.org/10.1007/s00142-010-0568-1

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