Zusammenfassung
Verkürzte und zu straffe laterale Strukturen am Femoropatellargelenk (laterales Retinakulum, Kapsel, Tractus iliotibialis, M. vastus lateralis) als Folge eines intraartikulären Problems können zu einem negativen Patellatilt mit lateraler Hyperkompression führen. Dabei entsteht eine verminderte Patellabeweglichkeit mit chronischen lateralen Schmerzen, die bei zunehmender Beugung noch verstärkt werden. Durch eine minimalinvasive laterale Retinakulumverlängerung können diese Beschwerden in Kombination mit einer arthroskopischen Therapie behoben werden. Der große Vorteil gegenüber der lateralen Retinakulumspaltung liegt bei gleichem therapeutischem Effekt in der Vermeidung einer sekundären medialen Patellainstabilität sowie der Möglichkeit der individuellen Spannungsanpassung (Weichteilbalancing).
Abstract
Increased pain in the lateral patellofemoral joint during loaded flexion may be caused by shortened and too tight lateral structures (e.g. retinacula, capsule, iliotibial tract, lateral vastus muscle) due to intraarticular pathologies, such as plicae, cartilage damage and osteoarthritis. The mobility of the patella is decreased and accentuated on the lateral side with a negative patella tilt, therefore creating lateral hypercompression and pain in the patellofemoral joint. In combination with the arthroscopic treatment for the intraarticular pathology, mini-open lengthening of the lateral retinaculum decreases the compression forces and normalizes the patellofemoral gliding mechanism. This procedure has the same therapeutic benefits as lateral retinacular release but the secondary medial patellar instability, as frequently seen after lateral retinacular release, can be avoided and individual soft tissue balancing is possible.
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Biedert, R. Laterale Retinakulumverlängerung bei arthroskopischen Eingriffen. Arthroskopie 23, 191–194 (2010). https://doi.org/10.1007/s00142-010-0569-0
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DOI: https://doi.org/10.1007/s00142-010-0569-0