Zusammenfassung
Zur Behandlung von traumatischen Gelenkknorpeldefekten sind unterschiedliche, regenerativ
ausgerichtete Therapieverfahren entwickelt worden. Die Auswahl des geeigneten Therapieverfahrens
für den einzelnen Patienten hängt ab von einer genauen Patientenevaluation unter Berücksichtigung
des Knorpelschadens an sich (u. a. Defektgröße, Defekttiefe) sowie von eventuell vorliegenden
Komorbiditäten wie Bandinstabilitäten, Meniskuseinrissen und Achsabweichungen der
mechanischen Beinachse oder des Streckapparates. Diese Komorbiditäten müssen im Sinne
einer multimodalen Therapie mit korrigiert werden, um ein erfolgreiches Outcome für
das jeweilige Knorpeltherapieverfahren zu ermöglichen. Aus der Fülle an vorhandenen
regenerativen Knorpeltherapieverfahren soll in diesem Artikel auf die „Knochenmark-stimulierenden
Techniken“ und die „osteochondrale Transplantation“ fokussiert werden.
Abstract
Surgical procedures designed to treat focal chondral lesions by regenerating the cartilage
surface have been evolving in the last few years. Selecting the proper treatment algorithm
for a particular chondral defect depends on careful patient evaluation, including
the defect morphology (e.g. defect size, depth) and the recognition of comorbidities
such as ligamentous instability, deficient menisci, or misalignment of the mechanical
limb axis or extensor mechanism. These comorbidities may need to be treated in conjunction
with symptomatic chondral injuries to achieve the desired outcome. Among the various
surgical treatment options for focal articular lesions, this article focuses on marrow
stimulating techniques and osteochondral transplantation.
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Peter Angele
Abteilung für Unfallchirurgie
Universitätsklinik Regensburg
Franz-Josef-Strauß-Allee 11
93053 Regensburg
Phone: 0941/9446805
Fax: 0941/9446806
Email: peter.angele@klinik.uni-regensburg.de
