Zusammenfassung.
Wir präsentieren einen Verlauf nach Karbonstiftimplantation am Kniegelenk. Innerhalb eines halben Jahres kam es wegen dauerhafter Beschwerden zum Einbau eines Oberflächenersatzes an dem arthrotischen Gelenk. Neben der intraoperativen deutlichen Sklerosierung um die Karbonfaserstiftbohrlöcher und einer synovialen Gewebsreaktion fand sich histopathologisch eine ausgeprägte granulomatöse Fremdkörperreaktion um die Karbonfasern. Experimentelle Daten weisen auf einen negativen Einfluss von Fremdkörperreaktionen bei Knorpelheilungsprozessen hin. Die Implantation von Karbonfaserstiften erscheint unter diesen Gesichtspunkten weder unter biomechanischen noch unter pathophysiologischen Aspekten empfehlenswert. Bevor diese Therapieform allgemein empfohlen werden kann, sollten die Ergebnisse prospektiv vergleichender Untersuchungen abgewartet werden.
We present the clinical radiological and pathological data of a patient who underwent carbon fiber implantation of the right knee. Within half a year a total knee replacement had to be performed due to persistent pain. Apart from the intraoperative, macroscopically visible, massive sclerosis around the drill holes and an obvious synovial reaction, we histopathologically found a severe granulomatous foreign body reaction around the carbon fibers. Experimental data point toward a negative influence of a foreign body reaction on attempted cartilage repair. The implantation of carbon fibers can be recommended neither for biomechanical nor for pathophysiological reasons. Before this treatment can be recommended, prospective randomized trials are mandatory.
Schlüsselwörter:
Karbonfasern - Knorpelschaden - Arthrose - Fremdkörperreaktion
Key words:
Carbon Fiber - Cartilage Damage - Arthrosia - Foreign Body Reaction
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