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Diagnostik und Management bei chronischer Instabilität des hinteren Kreuzbandes

Diagnosis and management of chronic posterior cruciate ligament instability

  • Leitthema
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Knie Journal Aims and scope

Zusammenfassung

Chronische Instabilitäten des hinteren Kreuzbandes (HKB) nach verzögerter Diagnostik oder insuffizienter Ausheilung einer hinteren Kreuzbandruptur stellen eine besondere Herausforderung dar. Kenntnisse der typischen Verletzungsmechanismen, anatomischen Verhältnisse sowie gezielte klinische und bildgebende Untersuchungen helfen, diese Instabilitäten zu erkennen und zu objektivieren. Die posteriore Tibiatranslation in seitenvergleichenden Röntgenstressaufnahmen ist eine hilfreiche Entscheidungsgrundlage der Therapie. Das Fundament der operativen Therapie chronischer hinterer Instabilitäten stellt die hintere Kreuzbandersatzplastik dar. Die standardisierte arthroskopische anatomische Rekonstruktion wird in diesem Artikel skizziert.

Abstract

Chronic posterior instabilities after delayed diagnosis or insufficient healing of a posterior cruciate ligament rupture are challenging. Knowledge of the typical injury mechanisms, the detailed anatomy as well as targeted clinical examinations and imaging modalities help to identify these instabilities. Determination of increased posterior tibial translation on stress x‑rays can objectify instability and guide treatment. The surgical approach to chronic instability is ligament reconstruction. Standardized arthroscopic anatomical reconstruction is outlined in this article.

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Authors and Affiliations

  1. Klinik für Orthopädie, Unfallchirurgie und Sporttraumatologie, Krankenhaus Köln-Merheim, Klinikum der Universität Witten/Herdecke, Köln, Deutschland, Ostmerheimer Str. 200, 51109

    Alexander Hundeshagen &  Daniel Günther MHBA, FACS

Authors
  1. Alexander Hundeshagen
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  2. Daniel Günther MHBA, FACS
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Correspondence to Daniel Günther MHBA, FACS.

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Interessenkonflikt

D. Günther erhält oder erhielt Honoraria/Reisekosten von Arthrex, Stryker, Smith and Nephew, Storz, Geistlich, Medical Magnesium, Rimasys, Codon, Medi und Telos. A. Hundeshagen gibt an, dass kein Interessenkonflikt besteht.

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

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Wolf Petersen, Berlin

Karl-Heinz Frosch, Hamburg

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Hundeshagen, A., Günther, D. Diagnostik und Management bei chronischer Instabilität des hinteren Kreuzbandes. Knie J. 5, 219–225 (2023). https://doi.org/10.1007/s43205-023-00229-4

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  • DOI: https://doi.org/10.1007/s43205-023-00229-4

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