Summary
Degeneration of the medial meniscus is the result of a partial overload due to the lateralization of the leg's axis and is the first sign of arthrosis of the medial compartment. Meniscectomy increases the pressure exerted on the cartilage and causes dynamic shearing movements. Furthermore, lubrication by the synovial fluid is reduced. Therapy must take these causes into consideration. Not the meniscus, but the faulty biomechanical situation causing its “degeneration” should be the main target. Arthroscopy alone is not enough to base planning on; radiography of the knee in the standing position is essential. These findings prompted us in 30 patients to correct the axis by valgization osteotomy through the tibial head. Ninety percent of these patients feel that there has been an improvement in their condition. Of those treated by a meniscectomy without taking the static situation into consideration, 60% were judged worse off both subjectively and objectively.
Zusammenfassung
Die sog. Meniscusdegeneration ist eine durch Achsenfehlstellung induzierteÜberlastung und erstes Indiz einer Kompartmentarthrose. Die Meniscektomie erhöht den Articulations-druck, erzeugt dynamische, knorpelschädigende Querbelastungen und vermindert die Synovialfunktion. Zur OP-Planung ist die Röntgenaufnahme im Einbeinstand unerlässlich, der arthroskopische Detailbefund ist nicht ausreichend. Bei Varusfehlstellung muss die Beinachse korrigiert werden. Bei 30 Patienten 90% Besserung, bei fehlindizierter Meniscektomie 60% objektiv und subjektiv Verschlimmerung.
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Labitzke, R., Witzel, U. & Upmeyer, M. 162. Behandlung des “degenerativen” Meniscusschadens durch valgisierende Tibiakopf-Umstellungs-Osteotomie. Langenbecks Arch Chiv 372, 826 (1987). https://doi.org/10.1007/BF01297946
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DOI: https://doi.org/10.1007/BF01297946