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Proximales Realignment bei patellofemoralen Erkrankungen: Indikationen, Einschränkungen und Ergebnisse

  • Chapter
Das patellofemorale Schmerzsyndrom

Zusammenfassung

Bevor ein operatives Verfahren zur Korrektur der Patellaführung angewandt wird, muss ein Abweichen der Führung der Patella von der Norm definiert werden. Für die vorliegende Präsentation wird dies als eine messbare Abnormalität des Streckapparates, die mit Symptomen verbunden ist, beschrieben. Häufige Fehlstellungen beinhalten eine vermehrte laterale Kippung der Kniescheibe (Tilt) und eine übermäßige laterale Positionierung der Patella (Subluxation). Kippung und Subluxation können unabhängig von einander auftreten [34]. Es erscheint wichtig, hier anzumerken, dass die Bildgebung einer pathologischen Patellaposition alleine niemals eine Indikation für einen operativen Eingriff darstellt. Operative Verfahren zur proximalen Zügelung der Kniescheibe (proximales Realignment) beeinhal-ten das laterale Release, alleine oder in Kombination mit einer medialen Raffung. Distale Verfahren beeinhalten den medialen Transfer des Ansatzes der Kniescheibensehne, bei Erwachsenen normalerweise durch die mediale Transposition der Tuberositas tibiae. Dieses Kapitel wird eine Diskussion der Indikationen und verschiedenen Techniken für das proximale Realignment beinhalten. Insbesondere werden Patienten mit Schmerzen von solchen mit rezidivierenden Episoden nach einer Patellainstabilität getrennt betrachtet. Zuerst muss festgestellt werden, ob es einen tatsächlichen Hinweis dafür gibt, dass die Instabilität oder der Schmerz sekundär zur fehlerhaften Zügelung der Patella auftreten.

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  1. W. R. Post
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  1. Orthopädische Klinik der Medizinischen Hochschule, Hannover im Annastift e.V., Heimchenstr. 1-7, 30625, Hannover, Germany

    Carl Joachim Wirth  & Maximilian Rudert  & 

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© 2000 Springer-Verlag Berlin Heidelberg

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Post, W.R. (2000). Proximales Realignment bei patellofemoralen Erkrankungen: Indikationen, Einschränkungen und Ergebnisse. In: Wirth, C.J., Rudert, M. (eds) Das patellofemorale Schmerzsyndrom. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-57717-8_16

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  • DOI: https://doi.org/10.1007/978-3-642-57717-8_16

  • Publisher Name: Steinkopff, Heidelberg

  • Print ISBN: 978-3-642-63334-8

  • Online ISBN: 978-3-642-57717-8

  • eBook Packages: Springer Book Archive

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