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Hohe Tibiakopfumstellungsosteotomie vs. unikondyläre Schlittenprothese

High tibial osteotomy versus unicondylar knee arthroplasty

  • Leitthema
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Arthroskopie Aims and scope

Zusammenfassung

Die valgisierende Tibiakopfumstellungsosteotomie (HTO) und die unikondyläre Schlittenprothese (UKA) besitzen einen festen Stellenwert zur Behandlung der medialen Gonarthrose. Trotz der gemeinsamen Indikation muss aufgrund prinzipieller Unterschiede beider operativer Verfahren für den Patienten individuell das richtige gewählt werden. Die Vorteile der HTO liegen bei jüngeren, aktiven Patienten mit deutlicher Varusfehlstellung oder Knieinstabilität. Die Vorteile der UKA liegen in der deutlich kürzeren Rehabilitationszeit, von der v. a. ältere Patienten profitieren. Durch die Verbesserung der Instrumente und Implantate erreichen beide Methoden heute Standzeiten von weit über 10 Jahren bei gleichzeitig guten klinischen Resultaten in über 80% der Fälle. Wegen des erhöhten Lockerungsrisikos und der z. T. aufwendigen Revisionseingriffe sollte dennoch vor dem Unischlitten bei jüngeren aktiven Patienten gewarnt werden.

Abstract

High tibial osteotomy (HTO) and unicondylar knee arthroplasty (UKA) are of great value in the treatment of medial knee osteoarthritis. Despite the common indications for HTO and UKA the correct approach has to be selected individually for each patient due to general differences between both operative procedures. The advantages of HTO are related to young and active patients with significant varus deformity of the tibia or knee ligament instability. The advantages of UKA are related to a considerably shorter rehabilitation period with benefits especially for older patients. Through the improvements of instruments and implants both methods now achieve survival rates of over 10 years with good clinical results in over 80% of the cases. Because of a higher risk of loosening and to some extent extensive revision arthroplasty the implantation of UKA should be avoided in young and active persons.

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Abbreviations

UKA:

unikompartimentelle Kniearthroplastik, unikondyläre Schlittenprothese

TKA:

totale Kniegelenkendoprothese

HTO:

hohe Tibiakopfumstellungsosteotomie

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Der korrespondierende Autor weist auf folgende Beziehungen hin: Referententätigkeit für Aesculap, Stryker.

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  1. Orthopädie Harthausen, Dr.-Wilhelm-Knarr-Weg 1-3, 83043, Bad Aibling, Deutschland

    V. Martinek

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Martinek, V. Hohe Tibiakopfumstellungsosteotomie vs. unikondyläre Schlittenprothese. Arthroskopie 22, 193–198 (2009). https://doi.org/10.1007/s00142-008-0483-x

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  • DOI: https://doi.org/10.1007/s00142-008-0483-x

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