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Operative Behandlungsstrategien bei posteromedialen oder -lateralen Kombinationsverletzungen des hinteren Kreuzbandes

Stellenwert fadenaugmentierter Bandnähte („ligament bracing“) in der akuten Versorgung

Surgical treatment strategies for combined posteromedial or posterolateral knee injuries

Anatomic repair and suture augmentation (ligament bracing) as a new treatment option in acute care

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  • Published:
Knie Journal Aims and scope

Zusammenfassung

Rupturen des hinteren Kreuzbandes (HKB) sind häufig assoziiert mit posterolateralen oder posteromedialen Begleitverletzungen. Derartige Kombinationsverletzungen zeigen schlechte funktionelle Resultate nach konservativer Behandlung. Daher gewinnt das für Knieluxationen etablierte Konzept des „ligament bracing“ auch bei akuten kombinierten HKB-Verletzungen sowohl für den zentralen Pfeiler (HKB) als auch die peripheren Strukturen an Bedeutung. Während auf der posteromedialen Seite die fadenaugmentierten Bandnähte vielversprechende Ergebnisse zeigen, ist die Rate an Therapieversagern posterolateral deutlich höher. Daher wird dort aktuell eine Hybridtechnik aus Naht der verletzten Strukturen mit primärer Sehnenaugmentation in anatomischer Technik favorisiert.

Abstract

Combined posteromedial or posterolateral posterior cruciate ligament (PCL) tears are associated with poor functional outcome. Due to the promising clinical results of anatomic repair and suture augmentation (ligament bracing) in knee dislocations, this technique has become more important in the surgical treatment of combined PCL injuries. While ligament bracing techniques show promising results in cases of posteromedial injuries, posterolateral injuries are associated with higher failure rates and inferior outcome. Thus, in patients with posterolateral injuries, hybrid procedures involving anatomic repair and additional reconstruction of primary posterolateral corner (PLC) structures are preferred.

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Authors and Affiliations

  1. Klinik für Arthroskopische Chirurgie, Sporttraumatologie und Sportmedizin, BG Klinikum Duisburg, Duisburg, Deutschland

    T. J. Gensior &  C. Schoepp

  2. Orthopädische Praxisklinik Neuss-Düsseldorf (OPND), Breite Straße 96, 41460, Neuss, Deutschland

    T. J. Gensior

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Correspondence to T. J. Gensior.

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Interessenkonflikt

T.J. Gensior und C. Schoepp 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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A. Achtnich, München

K.-H. Frosch, Hamburg

M. Herbort, München

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Gensior, T.J., Schoepp, C. Operative Behandlungsstrategien bei posteromedialen oder -lateralen Kombinationsverletzungen des hinteren Kreuzbandes. Knie J. 2, 186–195 (2020). https://doi.org/10.1007/s43205-020-00055-y

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  • DOI: https://doi.org/10.1007/s43205-020-00055-y

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