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Sportverletz Sportschaden 2021; 35(04): 227-233
DOI: 10.1055/a-1523-9937
Übersicht

Wenn nichts mehr geht: Der patellofemorale Gelenkersatz

When nothing else works: patellofemoral joint arthroplasty
Christian Benignus
  Sportklinik Stuttgart GmbH, Stuttgart
,
Malin Meier
  Sportklinik Stuttgart GmbH, Stuttgart
,
Raymond Best
  Sportklinik Stuttgart GmbH, Stuttgart
,
Johannes Beckmann
  Sportklinik Stuttgart GmbH, Stuttgart
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Zusammenfassung

Der patellofemorale Gelenkersatz stellt die beste verfügbare Therapieoption bei isolierter patellofemoraler Arthrose dar. Vor allem junge Patienten sollten mit möglichst knochensparender Technik unter Erhalt der Weichteile operiert werden, da sie mit hoher Wahrscheinlichkeit im Verlauf des Lebens revidiert werden. Die korrekte Patientenselektion ist wichtig für den Operationserfolg und sollte sowohl eine gründliche klinische Untersuchung als auch Bildgebung beinhalten. Hier ist vor allem auf zusätzliche Pathologien zu achten, die eventuell ebenfalls adressiert werden müssen. Für die Trochlea gibt es mit dem Inlay- und Onlay-System 2 verschiedene moderne Möglichkeiten der Versorgung. Ein Ersatz der retropatellaren Fläche sollte regelhaft erfolgen. Der patellofemorale Gelenkersatz wird immer noch selten durchgeführt, sodass eine Behandlung in spezialisierten Zentren empfohlen wird. Daten aus Endoprothesenregistern zeigen hohe Revisionsraten, während Daten aus Zentren vielversprechende Ergebnisse aufweisen.

Abstract

Patellofemoral joint replacement is the best treatment option available for isolated patellofemoral arthritis. Especially young patients should be operated on with bone-sparing techniques that also preserve the soft tissues, since these patients are very likely to be revised at some point in their lifetime. Correct patient selection is important for the success of surgery and should include a meticulous clinical examination and imaging. Special attention should be paid to additional pathologies that may also need to be addressed. For the trochlea, there are two different options for treatment with the inlay and onlay system. The retropatellar surface should be replaced. Patellofemoral joint replacement is still rarely performed, so treatment in specialised centres is recommended. National joint registry data show high revision rates, while data from centres show promising results.

Schlüsselwörter

Endoprothetik - Kniegelenk - patellofemorale Instabilität - Patellofemoralgelenk - patellofemorale Arthrose

Key words

arthroplasty - knee joint - patellofemoral instability - patellofemoral joint - patellofemoral arthritis


Publication History

Article published online:
09 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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