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Der laterale Monoschlitten – „seltener aber gut?“

Lateral unicompartimental knee arthroplasty—“rare but good”

  • Leitthema
  • Published:
Knie Journal Aims and scope

Zusammenfassung

Die isolierte Arthrose des lateralen femorotibialen Kompartiments gilt als seltener als die des medialen Kompartiments. Eine differenzierte Betrachtung des Kniegelenkersatzes in Deutschland zeigt generell einen steigenden Trend zur unikompartimentellen Knieendoprothese. Indikationen für die laterale unikompartimentelle Knieendoprothese sind die schmerzhafte, auf das laterale Kompartiment des Knies begrenzte Arthrose, die Osteonekrose oder die posttraumatische Arthrose, die mit einem vollständigen Verlust des Gelenkspalts auf den Röntgenbildern einhergeht. Die Röntgendiagnostik mittels „Rosenberg-Aufnahme“ ist hier besonders aussagekräftig, da sie aufgrund der Anatomie des lateralen Kompartiments eine vorhandene Arthrose am ehesten detektiert. Insgesamt zeigen die Langzeitstudien gute klinische Ergebnisse und eine gute Überlebensrate der Implantate. Der Anstieg der Überlebensrate und der Rückgang der Revisionsraten bei der lateralen Schlittenprothesen kann auf besser definierte Kriterien für die Patientenauswahl, Verbesserungen der Operationstechniken und Änderungen des Implantatdesigns zur besseren Anpassung an die Anatomie des lateralen Kompartiments zurückgeführt werden.

Abstract

Isolated osteoarthritis (OA) of the lateral femorotibial compartment is considered to occur less often than that of the medial compartment. Analysis of knee joint replacement in Germany generally shows an increasing trend for unicompartmental knee arthroplasty (UKA). Indications for lateral unicompartmental knee arthroplasty are painful OA limited to the lateral compartment of the knee, osteonecrosis or posttraumatic OA associated with a complete loss of the joint space on the radiographs. X‑ray diagnosis by means of a “Rosenberg view” is particularly informative in this case, as it is most likely to detect the presence of arthrosis due to the anatomy of the lateral compartment. Overall, long-term studies show good clinical results and implant survivorship. The increase in survival and decrease in revision rates for lateral UKA can be attributed to better defined patient selection criteria, improvements in surgical techniques, and changes in implant design to better fit the anatomy of the lateral compartment.

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Authors and Affiliations

  1. Klinik für Orthopädie und Unfallchirurgie, Krankenhaus Barmherzige Brüder München, Romanstr. 93, 80639, München, Deutschland

    F. Wilken &  Johannes Beckmann

  2. Zentrum für den Bewegungsapparat, Klinik für Orthopädie und Traumatologie des Bewegungsapparates, Kantonsspital Baselland, Bruderholz, Schweiz

    M. Koch & M. T. Hirschmann

  3. Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Regensburg, Regensburg, Deutschland

    M. Koch

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  4. Johannes Beckmann
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Correspondence to Johannes Beckmann.

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F. Wilken, M. Koch, M. T. Hirschmann und J. Beckmann geben 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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Johannes Beckmann, Stuttgart

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Der Verlag bleibt in Hinblick auf geografische Zuordnungen und Gebietsbezeichnungen in veröffentlichten Karten und Institutsadressen neutral.

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Wilken, F., Koch, M., Hirschmann, M.T. et al. Der laterale Monoschlitten – „seltener aber gut?“. Knie J. 6, 11–16 (2024). https://doi.org/10.1007/s43205-023-00248-1

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