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Arthroskopische Rekonstruktion superiorer und postero-superiorer Rotatorenmanschettenrupturen

Übersicht über operative Techniken

Arthroscopic repair of superior and postero-superior rotator cuff tears

Overview of current surgical techniques

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Arthroskopie Aims and scope

Zusammenfassung

Im Verlauf der letzten Jahre kam es zu einer rasanten Weiterentwicklung der arthroskopischen Techniken im Bereich der Rotatorenmanschettenrekonstruktion sowie der zur Verfügung stehenden technischen Hilfsmittel. Zudem wurde durch aktuelle biomechanische und klinische Arbeiten ein erheblicher Verständnisgewinn der Pathologien der Rotatorenmanschette erzielt. Die durch die Arthroskopie vereinfachte Beurteilung der exakten Rissgeometrie und Retraktion legte den Grundstein für das optimale operationstechnische Vorgehen. Die Refixationstechnik der Sehne mit verschiedenen Ankersystemen sowie die Rekonstruktion des Footprints in Single- oder Double-Row-Technik sind eine Gratwanderung zwischen der erzielten Reißfestigkeit bzw. Auflagefläche und der Affektion des bereits degenerierten Sehnengewebes. Eine besondere Herausforderung stellen retrahierte Massenrupturen dar, die durch spezielle Techniken arthroskopisch versorgt werden können. Dieser Artikel gibt einen Überblick über aktuelle Konzepte und Operationstechniken der arthroskopischen postero-superioren Rotatorenmanschettenrekonstruktion.

Abstract

The last years have seen rapid development in arthroscopic technical devices and techniques for rotator cuff surgery, and the results of current biomechanical and clinical studies offer better understanding of rotator cuff pathologies. With arthroscopic techniques, evaluation of the exact tear shape has been simplified, providing the basis for a successful reconstructive procedure. Different anchor systems and footprint reconstruction using single- or double-row technique offer various reconstruction methods, but the combination of the achieved stability and the contact area, as well as the extent of the degenerated tendon tissue, are critical. Massive retracted tears to be repaired by arthroscopic techniques offer a particular challenge. This article summarizes the current concepts and surgical techniques in arthroscopic rotator cuff repair.

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  1. Abteilung und Poliklinik für Sportorthopädie, Klinikum Rechts der Isar, Technische Universität München, 80809 , Connollystraße 32, München, Deutschland

    S. Buchmann & A. Imhoff

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  1. S. Buchmann
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  2. A. Imhoff
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Correspondence to S. Buchmann.

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Buchmann, S., Imhoff, A. Arthroskopische Rekonstruktion superiorer und postero-superiorer Rotatorenmanschettenrupturen. Arthroskopie 20, 40–46 (2007). https://doi.org/10.1007/s00142-006-0373-z

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  • DOI: https://doi.org/10.1007/s00142-006-0373-z

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