Zusammenfassung
Komplette Knorpeldefekte an der Patella sind problematische Verletzungen und führen häufig auf Grund der ausgeprägten Schmerzsymptomatik zu einer Einschränkung der Aktivitäten des täglichen Lebens. Eine Therapie der Wahl ist bisher nicht entwickelt worden. Es ist bekannt, dass in der Kambiumschicht des Periosts pluripotente Zellen vorliegen, die zu einer Differenzierung und Produktion von hyalinem oder hyalinähnlichem Knorpel in der Lage sind. Dies gilt im Besonderen im Gelenk und unter Einfluss von kontinuierlicher passiver Bewegung (CPM). In nur wenigen klinischen Studien sind alleinige Periosttransplantate, autologe Chondrozyten/Periost-transplantate für die Behandlung von kompletten Knorpeldefekten der Patella benutzt worden. Diese Untersuchungen erbrachten unterschiedliche Ergebnisse. Autologe Periostlappentransplantate alleine haben in Verbindung mit postoperativer kontinuierlicher passiver Bewegung (CPM) in der frühen postoperativen Phase und unter einer Entlastung für 3 Monate erfolgversprechende klinische Resultate erbracht. Die besten klinischen Ergebnisse wurde in der Behandlung von traumatischen Knorpeldefekten (Frakturen, Kontusionen und Dislokationen) erreicht. Die Behandlung von nicht traumatischen Knorpeldefekten erscheint allerdings weniger erfolgversprechend. Bei den klinischen Ergebnissen der autologen Periosttrans-plantationen zur Deckung von kompletten Knorpeldefekten ist die postoperative Rehabilitation von großer Bedeutung.
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Alfredson, H., Lorentzon, R. (2000). Autologe Periosttransplantation zur Behandlung von Knorpeldefekten der Patella. In: Wirth, C.J., Rudert, M. (eds) Das patellofemorale Schmerzsyndrom. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-57717-8_24
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DOI: https://doi.org/10.1007/978-3-642-57717-8_24
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