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Arthroskopie

, Volume 32, Issue 5, pp 308–316 | Cite as

Lösungen für häufige Komplikationen bei vorderer Kreuzbandoperation

  • Wolf PetersenEmail author
  • Thore Zantop
Leitthema
  • 215 Downloads

Zusammenfassung

Die arthroskopische vordere Kreuzbandplastik mit einem autologen Sehnentransplantat gilt heute als Standardverfahren zur Behandlung akuter und chronischer vorderer Instabilitäten. Für dieses operative Verfahren sind in großen Kollektiven Komplikationsraten zwischen 1,1 und 1,35 % beschrieben. Die häufigste Frühkomplikation nach Rekonstruktion des vorderen Kreuzbands (VKB) ist die tiefe Venenthrombose, gefolgt von der Infektion und der Lungenembolie. Ein wesentlicher Risikofaktor hierfür ist die Operationszeit. Ansätze zur Prophylaxe dieser Komplikationen sind der postoperative Einsatz niedermolekularer Heparine und das Einlegen der Transplantate in Vancomycin. Weitere Komplikationen nach VKB-Plastik sind die Arthrofibrose, die Tunnelfehlplatzierung, das Versagen des Fixationssystems, die Patellafraktur, das zu Boden gefallene Transplantat oder abgebrochene Instrumente. Auch das Risiko für diese selteneren Komplikationen lässt sich mit prophylaktischen Maßnahmen minimieren. Für die meisten beschriebenen Komplikationen sind Lösungsansätze bekannt.

Schlüsselwörter

Thrombose Lungenembolie Infektion Fixation Arthrofibrose 

Solutions for frequent complications of anterior cruciate ligament surgery

Abstract

Arthroscopic anterior cruciate ligament (ACL) reconstruction with an autologous tendon graft is currently considered to be the standard procedure for the treatment of acute and chronic anterior instability. For this surgical procedure complication rates between 1.2% and 1.35% have been described in large collectives. The most common early complication after ACL reconstruction is deep vein thrombosis, followed by infections and pulmonary embolism. A major risk factor for these complications is the duration of surgery. Further approaches for prevention of these complications include the postoperative use of low molecular weight heparins and soaking the graft in vancomycin. Other complications of ACL reconstruction include arthrofibrosis, tunnel misplacement, fixation system failure, patellar fracture, transplants that have been dropped on the floor or broken instruments. The risk of these rare complications can also be minimized with prophylactic measures and solutions are known for all the described complications.

Keywords

Thrombosis Lung embolism Infection Fixation Arthrofibrosis 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

T. Zantop und W. Petersen erhalten Beraterhonorare von der Firma Karl Storz. W. Petersen erhält Beraterhonorare von der Firma Otto Bock. W. Petersen erhält Vortragshonorare von der Firma Plasmaconceptm, AAP Implantate und dem Deutschen Institut für Zell und Gewegbetransplantation.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Klinik für Orthopädie und UnfallchirurgieMartin Luther Krankenhaus, Berlin, GrunewaldBerlinDeutschland
  2. 2.Sporthopaedicum StraubingStraubingDeutschland

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