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Aktuelle Traumatol 2007; 37(1): 31-40
DOI: 10.1055/s-2006-955865
Originalarbeit

Georg Thieme Verlag KG Stuttgart · New York

Knorpelschaden und Gonarthrose, Teil V

Osteotomie und GelenkersatzCartilage Lesions and Gonarthritis, Part VOsteotomies and ArthroplastyG. Spahn1
  • 1Praxisklinik für Unfallchirurgie und Orthopädie, Eisenach
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
22. Mai 2007 (online)

    Lizenzen und Reprints

Zusammenfassung

Die Achskorrektur des Beines durch eine Umstellungsosteotomie sowie der endoprothetische Gelenkersatz sind heute bei der Behandlung der Gonarthrose nicht mehr wegzudenken. Das Ziel der valgisierenden Umstellungsosteotomie, die in zunehmendem Maße als medial-öffnende Osteotomie durchgeführt wird, ist es, die Tragelinie des Beines aus dem durch die Varusarthrose geschädigten Gelenkkompartiment in das nicht betroffene laterale Kompartiment zu verlagern. Von dieser Operation profitieren vor allem jüngere und aktive Patienten mit einer unikompartimentellen Arthrose. Durch verbesserte Implantationstechniken sind durch die Endoprothese exzellente oder gute Langzeitergebnisse möglich geworden. Methode der Wahl ist die Implantation der zumindest teilweise (tibial) zementierten Semiconstrained-Prothese. Die Standzeit der Prothese beträgt durchschnittlich 10 Jahre. Daneben kommt bei älteren und inaktiven Patienten die unikondyläre Prothesenimplantation bei auf ein Gelenkkompartiment beschränkten Arthrosen in Betracht.

Abstract

Axial realignment by osteotomy and arthroplasty are important methods in treatment of gonarthritis today. The osteotomies are purposed to transfer the mean bearing line of the leg from the destructed knee compartment into the non-affected area. The osteotomies are performed by the medial-opening techniques in a high frequency today. This operation is optimal in younger patients who suffering from unicompartimental gonarthritis. Arthroplasty also produces excellent or good long-term results, today. The implantation of semiconstrained cemented or partially cemented (tibial) bicondular endoprosthesis is method of choice in the mostly cases. The survival after arthroplasty amounts meanly 10 years. The unicondular joint replacement is only indicated in cases of unilateral gonarthritis in older and inactive patients.

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Dr. med. Gunter Spahn

Praxisklinik für Unfallchirurgie und Orthopädie

Sophienstraße 16

99817 Eisenach

Telefon: 0 36 91/7 35 00

Fax: 0 36 91/73 50 11

eMail: spahn@pk-eisenach.de