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Z Orthop Unfall 2015; 153(05): 553-566
DOI: 10.1055/s-0035-1557834
Refresher Orthopädie und Unfallchirurgie
Georg Thieme Verlag KG Stuttgart · New York

Die mediale Gonarthrose

Arthritis of the Medial Knee Joint Compartment
G. Matziolis
Orthopädische Klinik, Friedrich-Schiller-Universität, Campus Eisenberg
,
E. Röhner
Orthopädische Klinik, Friedrich-Schiller-Universität, Campus Eisenberg
› Author Affiliations
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Publication History

Publication Date:
09 October 2015 (online)

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Zusammenfassung

Die Arthrose des Kniegelenks ist mit einer Lebenszeitprävalenz von 23 % bei den über 65-Jährigen eine häufige orthopädische Erkrankung [1]. Aufgrund der demografischen Entwicklung ist mit einer weiteren Zunahme der Anzahl betroffener Patienten zu rechnen. Das mediale Gelenkkompartiment ist dabei aufgrund der Biomechanik und Kinematik des Kniegelenks erheblich häufiger betroffen als das laterale. Erst das Verständnis der funktionellen Anatomie und Pathologie ermöglicht die kritische Wertung der unterschiedlichen zur Verfügung stehenden konservativen und operativen Therapieansätze. Dieser Artikel soll einen Überblick über die diagnostischen und therapeutischen Verfahren der medialen Gonarthrose geben. Dabei sollen insbesondere die medial öffnende tibiale Korrekturosteotomie (HTO), der unikondyläre Gelenkersatz (UNI) und die Totalendoprothese (TEP) als die am häufigsten durchgeführten operativen Maßnahmen vergleichend dargestellt werden. Die aktuelle wissenschaftliche Datenlage wird mit dem Ziel einer evidenzbasierten Diagnostik und einer dem Stadium und der Pathologie angemessenen Therapie der medialen Gonarthrose dargestellt.

Abstract

23 % of all persons older than 65 years suffer from osteoarthritis of the medial compartment of the knee joint, a very common situation in orthopaedic practice [1]. As a result of the demographic trend the number of patients is expected to increase in the future. Based on specific joint biomechanics and kinematics the medial knee joint compartment is more frequently affected than the lateral. Only an understanding of the functional anatomy and underlying pathology allows a critical evaluation of different available conservative and operative treatment options. This article gives an overview of diagnostic and therapeutic strategies of osteoarthritis of the medial knee joint. Frequently performed surgeries, e.g. high tibial osteotomy (HTO), unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) will be presented in a comparative manner. The actual scientific evidence will be given with the goal of an evidence based therapy that is adopted to stage and pathology of osteoarthritis of the medial compartment of the knee joint.

Key words

Gonarthrose - Korrekturosteotomie (HTO) - unikondyläre Endoprothese (UNI) - Totalendoprothese (TEP)

Key words

knee joint arthritis - corrective osteotomy - high tibial osteotomy (HTO) - unicompartmental knee arthroplasty (UKA) - total knee arthroplasty (TKA)
 

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