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Die zuklappende Tibiakopfosteotomie in der Behandlung der unikompartimentären Arthrose

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Zusammenfassung

Die zuklappende valgisierende Tibiakopfosteotomie ist eine effiziente Methode zur Behandlung der medialen Gonarthrose. Die korrekte Indikationsstellung und Planung setzen das Verständnis der Biomechanik und der Pathophysiologie voraus und sind Grundlage für eine erfolgreiche Therapie. Die Art der Osteotomie (Lokalisation, aufklappend oder zuklappend) richtet sich nach der Fehlstellung und den Begleitpathologien.

Die Operationstechnik erfordert eine hohe Präzision, um die geplante Achsenkorrektur zu verwirklichen und um Komplikationen zu vermeiden. Die Winkelstabilität der Implantate bietet Vorteile gegenüber konventionellen Fixationstechniken. Bei geeigneter Indikation und Technik behalten die Patienten eine hohe Kniefunktion, die im Idealfall über 10 Jahre anhält. Der Effekt auf die Langzeitprognose beim jungen Patienten mit Knorpelschäden ist noch unklar.

Abstract

Closing wedge high tibial osteotomy is an efficient method for the treatment of medial osteoarthritis of the knee. Prerequisites of successful surgery are proper indication and planning as well as the understanding of biomechanics and pathophysiology. The technique of osteotomy to choose (opening or closing wedge) depends on the type of malalignment and on additional pathologies.

The surgical technique demands high precision to realize the planned correction and to avoid complications. Implants with angular stability provide advantages compared to traditional implants. Correct indication and surgical technique results in a desirable follow-up, which often lasts for at least 10 years. The effect on the prognosis of the young patient with cartilage damage is still unclear.

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  1. Kantonsspital Fribourg, Schweiz

    R. P. Jakob & M. Jacobi

  2. Orthopädische Abteilung, Kantonsspital Fribourg, Rue de Bertigny, 1700, Fribourg, Schweiz

    R. P. Jakob

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Jakob, R.P., Jacobi, M. Die zuklappende Tibiakopfosteotomie in der Behandlung der unikompartimentären Arthrose. Orthopäde 33, 143–152 (2004). https://doi.org/10.1007/s00132-003-0600-5

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