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Rehabilitation nach kniegelenksnaher Umstellungsosteotomie

  • C. Ihle
  • J. Merk
  • S. SchröterEmail author
  • M.-D. Ahrend
Leitthema
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Zusammenfassung

Kniegelenksnahe Umstellungsosteotomien gehören zu den häufigsten kniegelenkserhaltenden Eingriffen bei medialer Gonarthrose in Deutschland. Basierend auf unterschiedlichen operativen Techniken mit öffnenden und schließenden Verfahren, unterschiedlichen Füllmöglichkeiten des Osteotomiespaltes sowie verschiedenen zur Verfügung stehenden Implantaten existiert eine Vielzahl an publizierten Nachbehandlungsmöglichkeiten. Ein allgemeingültiges Schema ist daher nicht zu empfehlen. Vielmehr sollte die Nachbehandlung an die verwendete operative Technik angepasst werden. Die vorliegende Arbeit soll einen Überblick über wissenschaftlich belegte Nachbehandlungskonzepte geben, um praktische Handlungsempfehlungen für die tägliche klinische Arbeit anzubieten. Ergänzend werden Möglichkeiten der physiotherapeutischen Nachbehandlung dargestellt. Im Unterschied zur „closed wedge“ hohen Tibiakopfumstellungsosteotomie (HTO) sowie bei Verwendung nichtwinkelstabiler Implantate oder Spacer-Implantaten kann bei der Open-wedge-HTO in Kombination mit einem Plattenfixateur auch ohne Auffüllung des Osteotomiespaltes eine frühe Vollbelastung erfolgen.

Schlüsselwörter

Plattenfixateur  Nachbehandlung Kniegelenk Hohe Tibiakopfumstellungsosteotomie Distale Femurosteotomie 

Rehabilitation after osteotomies around the knee

Abstract

Osteotomies around the knee are the most frequent knee preservation procedures for medial knee osteoarthritis in Germany. There are several rehabilitation protocols depending on the surgical techniques with opening vs. closing procedures, different gap filling possibilities and a variety of available implants. Therefore, a general scheme is not recommended. Aftercare should be adapted to the surgical technique. This article gives an overview of scientifically confirmed aftercare concepts, in order to provide practical recommendations and options for physiotherapy are presented. In contrast to closed wedge high tibial osteotomy (HTO) as well as the use of non-locking plates or spacer plates, an early full-weight bearing can be achieved by open wedge HTO combined with a plate fixator even without gap filling.

Keywords

Plate fixator Aftercare Knee joint High tibial plateau corrective osteotomy Distal femoral osteotomy 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

C. Ihle, J. Merk, S. Schröter und M.-D. Ahrend geben an, dass kein Interessenkonflikt besteht.

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 2019

Authors and Affiliations

  1. 1.Berufsgenossenschaftliche Unfallklinik TübingenTübingenDeutschland

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