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Patellaposition und Patellofemoralarthrose nach unikompartimentellem Kniegelenkersatz

Patella position and patellofemoral osteoarthritis after unicompartmental arthroplasty

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Zusammenfassung

Hintergrund

Veränderungen der Patellaposition (Höhe, Verkippung und Lateralisation) sowie die Patellofemoralarthrose können potentiell das Ergebnis nach Implantation einer unikompartimentellen Knieendoprothese beeinflussen.

Fragestellung

Der Beitrag evaluiert den Einflusses dieser Parameter auf das postoperative klinische Ergebnis.

Material und Methode

Es erfolgt eine Literaturanalyse über PubMed.

Ergebnisse

Es konnten 12 relevante Studien (3 über Patellahöhe, 2 über Verkippung und Lateralisation, 7 über Patellofemoralarthrose) identifiziert werden. Bezüglich der Patellahöhe zeigten 2 von 3 Studien eine postoperative Reduktion der Patellahöhe. Hinsichtlich der Patellaverkippung und -lateralisation konnte lediglich eine der beiden Studien die postoperative Patellalateralisation als Einflussparameter für ein schlechtes klinisches Ergebnis identifizieren. Die radiologisch manifeste Patellofemoralarthrose hat keinen Einfluss auf das funktionelle Ergebnis nach Schlittenprothesenimplantation, es sei denn, die laterale Patellafacette ist isoliert betroffen. Ein präoperativ bestehender vorderer Knieschmerz beeinflusst die postoperative Kniegelenkfunktion nicht.

Schlussfolgerungen

Die vorliegende Literaturlage erlaubt keine sicheren Aussagen über den Einfluss der Patellaposition auf das funktionelle Ergebnis nach unikompartimentellem Kniegelenkersatz. Bei korrekter Patientenselektion können trotz Patellofemoralarthrose gute Ergebnisse erreicht werden.

Abstract

Background

Changes of patellar position (height, tilt, and shift) and arthritis of the patellofemoral joint might potentially influence outcome after unicompartmental knee replacement.

Objectives

The purpose of this work is to evaluate the influence of the aforementioned parameters on postoperative outcome.

Methods

Literature analysis via PubMed.

Results

A total of 12 relevant studies (three about Patellar height, two about patellar tilt and shift, seven about patellofemoral osteoarthritis) could be identified. Regarding Patellar height, two out of three studies demonstrated a postoperative decrease. With regard to patellar tilt and shift, only one study identified postoperative lateralization of the patella to be a predictor for poor outcome. The radiological appearance of arthritis of the patellofemoral joint does not significantly influence postoperative knee function except for cases where only the lateral patellar facet is affected. Anterior knee pain has no influence on clinical outcome.

Conclusion

Literature data do not allow for a precise statement about the possible influence of patellar position on the outcome after unicompartmental knee replacement. With proper patient selection, good results can be achieved despite patellofemoral osteoarthritis.

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Einhaltung ethischer Richtlinien

Interessenskonflikt

K. Anagnostakos, O. Lorbach, D. Kohn, P. Orth geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Correspondence to PD Dr. med. K. Anagnostakos.

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Anagnostakos, K., Lorbach, O., Kohn, D. et al. Patellaposition und Patellofemoralarthrose nach unikompartimentellem Kniegelenkersatz. Orthopäde 43, 891–897 (2014). https://doi.org/10.1007/s00132-014-3004-9

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Schlüsselwörter

  • Patellahöhe
  • Patellalateralisation
  • Patellaverkippung
  • Patellofemoralarthrose
  • Unikompartimenteller Kniegelenkersatz

Keywords

  • Patellar height
  • Patellar tilt
  • Patellar shift
  • Patellofemoral arthritis
  • Unicompartmental knee replacement