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Einzelbündeltechnik

Quadrizepssehne in Portaltechnik

Single bundle technique

Quadriceps tendon in the portal technique

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Die Quadrizepssehne (QS) ist in der Kniebandchirurgie ein in ihrer Qualität oft unterschätztes Transplantat. Sie ist in ihren Dimensionen sehr flexibel und mit oder ohne Knochenblock verwendbar. Während die QS heute von einigen Kniechirurgen als Revisionstransplantat favorisiert wird, konnte sie sich bis dato nicht als Standardtransplantat für die primäre Rekonstruktion des vorderen Kreuzbands (VKB) durchsetzen, obwohl die klinischen Ergebnisse in der Literatur sehr gut sind.

Ein wesentlicher Grund, der die weite Verbreitung der QS als Primärtransplantat bis dato verhindert hat, ist die aufwendigere Entnahmetechnik sowie die kosmetisch oft schlechten Ergebnisse. Mit der Entwicklung einer standardisierten, minimal-invasiven Entnahmetechnik lassen sich diese Nachteile jedoch deutlich verringern. Zudem kann mit einer der Sehnenmorphologie entsprechend veränderten Geometrie der Bohrkanäle (rechteckig statt rund) eine Verbesserung der Biomechanik erreicht werden. Die QS erscheint unserer Meinung nach daher auch zunehmend als Primärtransplantat für die VKB-Rekonstruktion interessant.

Abstract

While many knee surgeons use the quadriceps tendon (QT) as a graft for anterior cruciate ligament (ACL) revision surgery, it has never achieved universal acceptance for primary ACL reconstruction. The main reason in our opinion is that QT graft harvest is technically more demanding and a scar on the thigh cosmetically less favorable, despite excellent clinical results in the literature.

With the use of a minimally invasive harvesting technique these issues can be markedly reduced. Adapting the geometry of the bone tunnel (squared tunnels versus round tunnels) the biomechanics of the reconstruction can be further improved. Therefore we think that QT may become an increasingly attractive graft for primary ACL reconstruction in the future.

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Authors and Affiliations

  1. OSM Research Foundation, Sportsclinic Austria, Olympiastr. 39, 6020, Innsbruck, Österreich

    C. Fink & C. Hoser

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  1. C. Fink
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  2. C. Hoser
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Correspondence to C. Fink.

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Fink, C., Hoser, C. Einzelbündeltechnik. Arthroskopie 26, 35–41 (2013). https://doi.org/10.1007/s00142-012-0715-y

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  • DOI: https://doi.org/10.1007/s00142-012-0715-y

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