Zusammenfassung
In einer Reihe unterschiedlicher Studien konnte gezeigt werden, dass Knorpeldefekte des Kniegelenks auch bei jüngeren Patienten relativ häufig auftreten und dass mit zunehmender Defektgröße das sekundäre Arthroserisiko zunimmt. Eine begleitende Verletzung protektiver Gelenkbinnenstrukturen erhöht diese Gefahr zusätzlich. Darüber hinaus weist der Knorpel des Kniegelenks im Vergleich zum Knorpel des Sprunggelenks eine geringere Regenerationsfähigkeit auf. Von den großen Gelenken ist das Kniegelenk am häufigsten von einer Arthrose betroffen. Um der Arthroseentstehung vorzubeugen, sollten klinisch symptomatische Knorpelschäden möglichst frühzeitig biologisch rekonstruiert und bestehende Achsfehlstellungen, Band- oder Meniskusverletzungen saniert werden. Für die biologische Rekonstruktion der Gelenkoberfläche stehen seit mehreren Jahren verschiedene operative Verfahren zur Verfügung. Technik, Vor- und Nachteile sowie die mittel- bis langfristigen Ergebnisse der derzeit gängigsten Methoden werden in der vorliegenden Übersichtsarbeit dargestellt, um so deren geeignetes Indikationsspektrum aufzuzeigen.
Abstract
Several studies have shown that articular cartilage defects often occur in the knee, even in younger patients. There is also evidence that the risk of secondary osteoarthritis increases accordingly to the primary defect size. An attendant meniscus and/or ligament tear raises this hazard additionally. Furthermore chondrocytes of the knee have lower regenerative properties, compared to chondrocytes of the ankle. Among the large joints the knee is most frequently affected by osteoarthritis (OA). In order to avoid OA, symptomatic articular cartilage defects should undergo a biological reconstruction as early as possible. Additional meniscus or ligament tears or malalignements should be treated moreover. For the biological reconstruction of the articular cartilage surface certain different surgical procedures are available to date. The paper shows current techniques, their pros and cons and their mid- and long-term results in order to figure out their appropriate indications.
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Dr. med. Jürgen Fritz
BG-Unfallklinik
Eberhard-Karls-Universität Tübingen
Schnarrenbergstraße 95
72076 Tübingen
Phone: 07071/606-1001
Fax: 07071/606-1002
Email: jfritz18@email.de
