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Remnant-Augmentation

Remnant augmentation

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Die Art der biologischen Einheilung nach vorderer Kreuzbandrekonstruktion ist ein möglicher Faktor, der Transplantatversagen durch Lockerung oder traumatische Rerupturen bewirken kann. Bei der Remnant-erhaltenden Augmentation sollen möglichst viele Fasern des ursprünglichen vorderen Kreuzbands (VKB) erhalten werden. Die gute Vaskularisierung und Besetzung mit Mechanorezeptoren der Remnants sollen sich bei dieser Technik auf das Sehnentransplantat übertragen und die Einheilung fördern. Physikalisch soll das Gewebe der Remnants die Bohrkanäle vor der Exposition mit Synovialflüssigkeit schützen. Neben einer reinen insertionserhaltenen Technik besteht auch die Möglichkeit der Rekonstruktion einer VKB-Teilruptur oder der Naht und Augmentation eines vollständigen, frisch gerissenen VKB.

Abstract

The process of biological healing after anterior cruciate ligament (ACL) reconstruction is a possible cause for postoperative insufficiency of the graft by loosening or traumatic rerupture. The fibers of the original torn ACL should be preserved during remnant augmentation ACL reconstruction techniques. The sufficient vascularization and the many mechanoreceptors of the remnants should grow into the new autogenous tendon graft to improve healing. The remnant tissue at the insertion sites cover the bone tunnels to avoid excessive filling with synovial fluid. Besides the technique for preservation of the insertion site, there are possibilities for partial ACL bundle reconstruction as well as a refixation of the freshly ruptured ACL in combination with an augmentation using an autogenous tendon graft.

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Authors and Affiliations

  1. Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Waldeyerstraße 1, 48149, Münster, Deutschland

    M. Herbort & C. Domnick

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  1. M. Herbort
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  2. C. Domnick
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Correspondence to M. Herbort.

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Interessenkonflikt

M. Herbort gibt Beraterätigkeiten für die Firmen Medacta, Conmed Linvatec, Karl Storz, DJO Global und Mathys an. C. Domnick gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Herbort, M., Domnick, C. Remnant-Augmentation. Arthroskopie 31, 201–206 (2018). https://doi.org/10.1007/s00142-018-0202-1

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  • DOI: https://doi.org/10.1007/s00142-018-0202-1

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