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Arthroskopie

, Volume 32, Issue 1, pp 15–21 | Cite as

Innovationen der Rotatorenmanschettenchirurgie

  • S. GreinerEmail author
  • L. Achenbach
Leitthema
  • 64 Downloads

Zusammenfassung

Der vorliegende Beitrag präsentiert eine Übersicht zu den Innovationen in der Rotatorenmanschettenchirurgie der letzten Jahre. Hierbei werden die multifaktorielle Pathogenese von Läsionen der Rotatorenmanschette (RM), die Genetik und die unterschiedliche klinische Vorstellung dargestellt. Durch neue Studien werden die konservativen und operativen Behandlungsmöglichkeiten dem Therapieverlauf gegenübergestellt und Gründe für ein Nahtversagen aufgezeigt. Neue operative Behandlungsmöglichkeit bei irreparablen RM-Massenrupturen, wie die Implantation eines biodegradierbaren Spacers in den Subakromialraum und die superiore Kapselrekonstruktion sowie Erkenntnisse hinsichtlich der postoperativen Rehabilitationsphase werden beschrieben. Die Zusammenschau der aktuellen Studienlage ermöglicht eine Optimierung der individualisierten Behandlung von Patienten aller Altersklassen mit RM-Läsionen verschiedener Schweregrade.

Schlüsselwörter

Schulter Pathophysiologie Heilungsversagen Reruptur 

Abkürzungen

AI

Akromionindex

CSA

„Critical shoulder angle“

MOON

Multicenter Orthopaedic Outcomes Network

PRP

Plättchenreiches Plasma („platelet-rich plasma“)

RM

Rotatorenmanschette

ROM

Range-of-motion

SCR

Superiore Kapselrekonstruktion („superior capsular reconstruction“)

SNP

Einzelnukleotid-Polymorphismen

VAS

Visueller Analogskala

Innovations in rotator cuff surgery

Abstract

This article presents an overview of the innovations in rotator cuff (RC) surgery in recent years. The multifactorial pathogenesis, genetics and differing clinical presentations of RC lesions are presented. With the help of new studies conservative versus operative treatment options are compared and reasons for suturing failure are highlighted. New operative treatment options for irreparable massive RC tears, such as the implantation of a biodegradable subacromial spacer and superior capsular reconstruction as well as new study results regarding the rehabilitation process after surgery are presented. All information described here can help physicians to improve the individualized patient-based treatment regimen for patients of all ages presenting with RC lesions of all degrees of severity.

Keywords

Shoulder Pathophysiology Healing failure Rerupture 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

S. Greiner ist Berater der Firma Arthrex. L. Achenbach gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Sporthopaedicum RegensburgRegensburgDeutschland

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