Zusammenfassung
Die Arthrose betrifft eine größere Anzahl von Patienten als jede andere muskuloskeletale Erkrankung [1-4]. Bei diesem komplexen Prozess verlieren die Proteoglykanmoleküle des hyalinen Gelenkknorpels zunehmend ihre Fähigkeit, Wasser zu binden, die Kollagenarchitektur wird fortschreitend zerstört, während die Chondrozyten eine nicht hinreichende Reparaturreaktion ausführen [5,6]. Das daraus resultierende Ersatzgewebe vermag den normalen Belastungen des Gelenkes nicht auf Dauer standzuhalten, und die Oberflächenzerstörung schreitet weiter fort. Die Ziele einer operativen Behandlung sind die Verminderung von Schmerz und die Verbesserung der Gelenkfunktion. Der große Erfolg der Endoprothetik in den letzten Jahrzehnten [7] hat dazu geführt, dass der endoprothetische Oberflächenersatz heute als einziges Mittel zur definitiven Behandlung der Arthrose angesehen wird [8]. Alternativen zur Endoprothetik sind für eine große Gruppe von Patienten wünschenswert. Hierzu zählen Patienten mit wenig fortgeschrittener Arthrose, junge Patienten und sehr aktive Patienten [9,10]. Das Spektrum derartiger operativer Methoden beinhaltet u. a. subchondrale Bohrungen [11], die Abrasionsarthroplastik [12], Mikrofrakturierungen [13] und periostale [14], perichondriale [15] bzw. osteochondrale [16,17] Transplantate. In diesem Beitrag soll die subchondrale Knorpelanbohrung dargestellt werden.
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Madry, H., Kohn, D. (2004). Pridie-Bohrung. In: Fuchs, S. (eds) Arthrose. Münsteraner Streitgespräche. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-7985-1928-2_14
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DOI: https://doi.org/10.1007/978-3-7985-1928-2_14
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