Subscribe to RSS
DOI: 10.1055/a-1699-3403
Sport mit Knieprothese – Wieviel Sport ist möglich und was gilt es zu beachten ?
Article in several languages: deutsch | English
Zusammenfassung
Mit dem demografischen Wandel der Patientenpopulation, die einen Kniegelenkersatz erhält, verändern sich die Ansprüche der Patienten. Jüngere Patienten möchten sich nach Implantation einer Knietotalendoprothese (K-TEP) sportlich betätigen und zählen auf die Langlebigkeit des Implantates. Die Literatur zeigt, dass Patienten sowohl prä- als auch postoperativ vorwiegend Sportarten der Kategorie Low Impact ausüben. Ein gewisser Prozentsatz praktiziert mit entsprechender Vorerfahrung auch High-Impact-Sportarten. In der operativen Versorgung kann durch konforme Implantate die Punktbelastung der Polyethylenoberfläche verringert werden, durch eine adäquate Komponentenausrichtung erhöhter Stress an der medialen Knochen-Implantat-Schnittstelle vermieden und durch die Vermeidung eines Retropatellarersatzes eine stärkere Belastung in tiefer Kniebeuge ermöglicht werden.
Eine K-TEP sollte heutzutage kein absolutes Hindernis für High-Impact-Sportarten wie Tennis, Golf oder Skifahren sein. Viel mehr als implantatspezifische Faktoren scheinen jedoch patientenspezifische Faktoren ausschlaggebend zu sein, insbesondere das präoperative Aktivitätslevel und die präoperativen Sportgewohnheiten. Die vorliegende Übersichtsarbeit gibt Einblick in das tatsächliche Sportverhalten von K-TEP-Patienten, beschreibt die biomechanischen Belastungsmuster am Kniegelenk bei diversen Sportarten und fasst die wichtigsten Aspekte in der Versorgung von sportlich aktiven Patienten mit einer K-TEP zusammen.
Publication History
Received: 22 March 2021
Accepted after revision: 12 November 2021
Article published online:
23 February 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
Literatur
- 1 Cohrdes C, Mensink GBM, Hölling H. How you live is how you feel? Positive associations between different lifestyle factors, cognitive functioning, and health-related quality of life across adulthood. Qual Life Res 2018; 27: 3281-3292
- 2 Healy WL, Iorio R, Lemos MJ. Athletic activity after total knee arthroplasty. Clin Orthop Relat Res 2000; (380) 65-71
- 3 Lange T, Schmitt J, Kopkow C. et al. What Do Patients Expect From Total Knee Arthroplasty? A Delphi Consensus Study on Patient Treatment Goals. J Arthroplasty 2017; 32: 2093-2099.e1
- 4 Bourne RB, Chesworth BM, Davis AM. et al. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?. Clin Orthop Relat Res 2010; 468: 57-63
- 5 Rupp M, Lau E, Kurtz SM. et al. Projections of Primary TKA and THA in Germany From 2016 Through 2040. Clin Orthop Relat Res 2020; 478: 1622-1633
- 6 Grimberg A, Jansson V, Lützner J, Melsheimer O, Morlock M, Steinbrück A. Endoprothesenregister Deutschland (EPRD) – Jahresbericht 2021. https://www.eprd.de/fileadmin/user_upload/Dateien/Publikationen/Berichte/Jahresbericht2021_2021–10–25_F.pdf
- 7 Witjes S, van Geenen RC, Koenraadt KL. et al. Expectations of younger patients concerning activities after knee arthroplasty: are we asking the right questions?. Qual Life Res 2017; 26: 403-417
- 8 Witjes S, Gouttebarge V, Kuijer PP. et al. Return to Sports and Physical Activity After Total and Unicondylar Knee Arthroplasty: A Systematic Review and Meta-Analysis. Sports Med 2016; 46: 269-292
- 9 Huch K, Müller KA, Stürmer T. et al. Sports activities 5 years after total knee or hip arthroplasty: the Ulm Osteoarthritis Study. Ann Rheum Dis 2005; 64: 1715-1720
- 10 Vu-Han TL, Gwinner C, Perka C. et al. Recommendations for Patients with High Return to Sports Expectations after TKA Remain Controversial. J Clin Med 2020; 10: 54
- 11 Crawford DA, Adams JB, Hobbs GR. et al. Higher Activity Level Following Total Knee Arthroplasty Is Not Deleterious to Mid-Term Implant Survivorship. J Arthroplasty 2020; 35: 116-120
- 12 Jones DL, Cauley JA, Kriska AM. et al. Physical activity and risk of revision total knee arthroplasty in individuals with knee osteoarthritis: a matched case-control study. J Rheumatol 2004; 31: 1384-1390
- 13 Mont MA, Marker DR, Seyler TM. et al. Knee arthroplasties have similar results in high- and low-activity patients. Clin Orthop Relat Res 2007; 460: 165-173
- 14 Bock P, Schatz K, Wurnig C. Physical activity after total knee replacement. Z Orthop Ihre Grenzgeb 2003; 141: 272-276
- 15 Healy WL, Sharma S, Schwartz B. et al. Athletic activity after total joint arthroplasty. J Bone Joint Surg Am 2008; 90: 2245-2252
- 16 Hanreich C, Martelanz L, Koller U. et al. Sport and Physical Activity Following Primary Total Knee Arthroplasty: A Systematic Review and Meta-Analysis. J Arthroplasty 2020; 35: 2274-2285.e1
- 17 Jassim SS, Tahmassebi J, Haddad FS. et al. Return to sport after lower limb arthroplasty – why not for all?. World J Orthop 2019; 10: 90-100
- 18 Hepperger C, Gfoller P, Abermann E. et al. Sports activity is maintained or increased following total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2018; 26: 1515-1523
- 19 Vielgut I, Leitner L, Kastner N. et al. Sports Activity after Low-contact-stress Total Knee Arthroplasty – A long term follow-up study. Sci Rep 2016; 6: 24630
- 20 Ho JC, Stitzlein RN, Green CJ. et al. Return to Sports Activity following UKA and TKA. J Knee Surg 2016; 29: 254-259
- 21 Chang MJ, Kim SH, Kang YG. et al. Activity levels and participation in physical activities by Korean patients following total knee arthroplasty. BMC Musculoskelet Disord 2014; 15: 240
- 22 Lefevre N, Rousseau D, Bohu Y. et al. Return to judo after joint replacement. Knee Surg Sports Traumatol Arthrosc 2013; 21: 2889-2894
- 23 Hopper GP, Leach WJ. Participation in sporting activities following knee replacement: total versus unicompartmental. Knee Surg Sports Traumatol Arthrosc 2008; 16: 973-979
- 24 Wylde V, Blom A, Dieppe P. et al. Return to sport after joint replacement. J Bone Joint Surg Br 2008; 90: 920-923
- 25 Walton NP, Jahromi I, Lewis PL. et al. Patient-perceived outcomes and return to sport and work: TKA versus mini-incision unicompartmental knee arthroplasty. J Knee Surg 2006; 19: 112-116
- 26 Chatterji U, Ashworth MJ, Lewis PL. et al. Effect of total knee arthroplasty on recreational and sporting activity. ANZ J Surg 2005; 75: 405-408
- 27 Bradbury N, Borton D, Spoo G. et al. Participation in sports after total knee replacement. Am J Sports Med 1998; 26: 530-535
- 28 Bauman S, Williams D, Petruccelli D. et al. Physical activity after total joint replacement: a cross-sectional survey. Clin J Sport Med 2007; 17: 104-108
- 29 Panzram B, Bertlich I, Reiner T. et al. Cementless unicompartmental knee replacement allows early return to normal activity. BMC Musculoskelet Disord 2018; 19: 18
- 30 Schneider BL, Ling DI, Kleebad LJ. et al. Comparing Return to Sports After Patellofemoral and Knee Arthroplasty in an Age- and Sex-Matched Cohort. Orthop J Sports Med 2020; 8: 2325967120957425
- 31 Waldstein W, Kolbitsch P, Koller U. et al. Sport and physical activity following unicompartmental knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc 2017; 25: 717-728
- 32 Plassard J, Masson JB, Malatray M. et al. Factors lead to return to sports and recreational activity after total knee replacement – A retrospective study. SICOT J 2020; 6: 11
- 33 Kleeblad LJ, van der List JP, Zuiderbaan HA. et al. Larger range of motion and increased return to activity, but higher revision rates following unicompartmental versus total knee arthroplasty in patients under 65: a systematic review. Knee Surg Sports Traumatol Arthrosc 2018; 26: 1811-1822
- 34 Jones DL, Bhanegaonkar AJ, Billings AA. et al. Differences between actual and expected leisure activities after total knee arthroplasty for osteoarthritis. J Arthroplasty 2012; 27: 1289-1296
- 35 Mont MA, Marker DR, Seyler TM. et al. High-impact sports after total knee arthroplasty. J Arthroplasty 2008; 23: 80-84
- 36 Mayr HO, Reinhold M, Bernstein A. et al. Sports activity following total knee arthroplasty in patients older than 60 years. J Arthroplasty 2015; 30: 46-49
- 37 Van Rossom S, Wesseling M, Smith CR. et al. The influence of knee joint geometry and alignment on the tibiofemoral load distribution: A computational study. Knee 2019; 26: 813-823
- 38 Halder A, Kutzner I, Graichen F. et al. Influence of limb alignment on mediolateral loading in total knee replacement: in vivo measurements in five patients. J Bone Joint Surg Am 2012; 94: 1023-1029
- 39 Heinlein B, Kutzner I, Graichen F. et al. ESB Clinical Biomechanics Award 2008: Complete data of total knee replacement loading for level walking and stair climbing measured in vivo with a follow-up of 6–10 months. Clin Biomech (Bristol, Avon) 2009; 24: 315-326
- 40 D’Lima DD, Steklov N, Patil S. et al. The Mark Coventry Award: in vivo knee forces during recreation and exercise after knee arthroplasty. Clin Orthop Relat Res 2008; 466: 2605-2611
- 41 Kutzner I, Heinlein B, Graichen F. et al. Loading of the knee joint during ergometer cycling: telemetric in vivo data. J Orthop Sports Phys Ther 2012; 42: 1032-1038
- 42 Ericson M. On the biomechanics of cycling. A study of joint and muscle load during exercise on the bicycle ergometer. Scand J Rehabil Med Suppl 1986; 16: 1-43
- 43 Lynch JT, Perriman DM, Scarvell JM. et al. The influence of total knee arthroplasty design on kneeling kinematics: a prospective randomized clinical trial. Bone Joint J 2021; 103-B: 105-112
- 44 Sharma A, Dennis DA, Zingde SM. et al. Femoral condylar contact points start and remain posterior in high flexing patients. J Arthroplasty 2014; 29: 945-949
- 45 Sharma A, Leszko F, Komistek RD. et al. In vivo patellofemoral forces in high flexion total knee arthroplasty. J Biomech 2008; 41: 642-648
- 46 Courtney PM, Lee GC. Early Outcomes of Kinematic Alignment in Primary Total Knee Arthroplasty: A Meta-Analysis of the Literature. J Arthroplasty 2017; 32: 2028-2032.e1
- 47 Zhang Z, Liu C, Li Z. et al. Residual Mild Varus Alignment and Neutral Mechanical Alignment Have Similar Outcome after Total Knee Arthroplasty for Varus Osteoarthritis in Five-Year Follow-Up. J Knee Surg 2020; 33: 200-205
- 48 Klasan A, de Steiger R, Holland S. et al. Similar Risk of Revision After Kinematically Aligned, Patient-Specific Instrumented Total Knee Arthroplasty, and All Other Total Knee Arthroplasty: Combined Results From the Australian and New Zealand Joint Replacement Registries. J Arthroplasty 2020; 35: 2872-2877
- 49 Ritter MA, Davis KE, Meding JB. et al. The effect of alignment and BMI on failure of total knee replacement. J Bone Joint Surg Am 2011; 93: 1588-1596
- 50 Howell SM, Papadopoulos S, Kuznik K. et al. Does varus alignment adversely affect implant survival and function six years after kinematically aligned total knee arthroplasty?. Int Orthop 2015; 39: 2117-2124
- 51 Streit MR, Streit J, Walker T. et al. Minimally invasive Oxford medial unicompartmental knee arthroplasty in young patients. Knee Surg Sports Traumatol Arthrosc 2017; 25: 660-668
- 52 Wong J, Steklov N, Patil S. et al. Predicting the effect of tray malalignment on risk for bone damage and implant subsidence after total knee arthroplasty. J Orthop Res 2011; 29: 347-353
- 53 Berend ME, Ritter MA, Meding JB. et al. Tibial component failure mechanisms in total knee arthroplasty. Clin Orthop Relat Res 2004; (428) 26-34
- 54 Julin J, Jämsen E, Puolakka T. et al. Younger age increases the risk of early prosthesis failure following primary total knee replacement for osteoarthritis. A follow-up study of 32,019 total knee replacements in the Finnish Arthroplasty Register. Acta Orthop 2010; 81: 413-419
- 55 Currier JH, Van Citters DW. Knee Wear. In: Scott WN. Insall & Scott Surgery of the Knee. Philadelphia, Pa.: Elsevier Churchill Livingstone; 2018: 323-328
- 56 Nam D, Lawrie CM, Salih R. et al. Cemented Versus Cementless Total Knee Arthroplasty of the Same Modern Design: A Prospective, Randomized Trial. J Bone Joint Surg Am 2019; 101: 1185-1192
- 57 Papas PV, Congiusta D, Cushner FD. Cementless versus Cemented Fixation in Total Knee Arthroplasty. J Knee Surg 2019; 32: 596-599
- 58 Brown TE, Harper BL, Bjorgul K. Comparison of cemented and uncemented fixation in total knee arthroplasty. Orthopedics 2013; 36: 380-387
- 59 Sharkey PF, Lichstein PM, Shen C. et al. Why are total knee arthroplasties failing today--has anything changed after 10 years?. J Arthroplasty 2014; 29: 1774-1778
- 60 Baker-LePain JC, Lane NE. Role of bone architecture and anatomy in osteoarthritis. Bone 2012; 51: 197-203
- 61 Newman JM, Sodhi N, Dekis JC. et al. Survivorship and Functional Outcomes of Cementless versus Cemented Total Knee Arthroplasty: A Meta-Analysis. J Knee Surg 2020; 33: 270-278
- 62 Zahiri CA, Schmalzried TP, Szuszczewicz ES. et al. Assessing activity in joint replacement patients. J Arthroplasty 1998; 13: 890-895
- 63 Krug S, Jordan S, Mensink GB. et al. Physical activity: results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56: 765-771
- 64 Bercovy M, Langlois J, Beldame J. et al. Functional Results of the ROCC(R) Mobile Bearing Knee. 602 Cases at Midterm Follow-Up (5 to 14 Years). J Arthroplasty 2015; 30: 973-979