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Vordere Kreuzbandruptur

Anterior cruciate ligament rupture

  • Standards in der Unfallchirurgie
  • Published:
Trauma und Berufskrankheit

Zusammenfassung

Rupturen des vorderen Kreuzbandes (VKB) stellen nach Verletzungen des Sprunggelenks die zweithäufigste Sportverletzung dar und führen verglichen mit allen Sportverletzungen am häufigsten zu einer operativen Therapie. Eine Ruptur des vorderen Kreuzbandes führt zu einer vermehrten anteromedialen Rotationstranslation des Unterschenkels gegenüber dem Oberschenkel. Die Folge ist ein subjektives Instabilitätsgefühl sowie eine objektive Instabilität in der klinischen Testung. Die VKB-Ersatzplastik hat sich zum Goldstandard der operativen Therapie entwickelt. Hier bestehen trotz der vorhandenen umfangreichen Literatur Kontroversen hinsichtlich des Operationszeitpunktes, Techniken der operativen Versorgung, Wahl des geeigneten Transplantates und Fixation. Dieser Beitrag soll anhand der aktuellen Literatur die Evidenz der genannten Punkte aufzeigen und eine Hilfestellung zur optimalen Therapie jedes einzelnen Patienten unter Berücksichtigung der individuellen Kontextfaktoren geben.

Abstract

Anterior cruciate ligament (ACL) ruptures are the second most common sports injury after ankle injuries and most commonly lead to surgical treatment compared to all sports injuries. Rupture of the ACL is accompanied by increased anteromedial rotational translation of the lower leg relative to the upper leg. The consequence is a subjective sense of instability as well as an objective instability in clinical testing. The ACL reconstruction procedure has become the gold standard of surgical treatment. Despite the substantial literature available, there is controversy regarding the timing of the operation, techniques of surgical treatment, choice of suitable graft and fixation. Based on the current literature, this article aims to demonstrate the evidence of these points and to provide guidance on the optimal treatment of each individual patient considering the individual context factors.

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Correspondence to J. von Recum.

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T. Schalk, P. von der Linden, M. Schnetzke und J. von Recum geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Schalk, T., von der Linden, P., Schnetzke, M. et al. Vordere Kreuzbandruptur. Trauma Berufskrankh 21, 111–120 (2019). https://doi.org/10.1007/s10039-019-0426-y

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  • DOI: https://doi.org/10.1007/s10039-019-0426-y

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