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Z Orthop Unfall 2024; 162(03): 316-328
DOI: 10.1055/a-2091-4681
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Therapie von Verletzungen des hinteren Kreuzbandes

Treatment of Injuries to the Posterior Cruciate Ligament
Alexander Korthaus
,
Sofia Hansen
,
Matthias Krause
,
Karl-Heinz Frosch
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Im Vergleich zu der vorderen Kreuzbandverletzung stellt die Ruptur des hinteren Kreuzbandes (HKB) die seltenere Erkrankung dar. Dem HKB wird in der Literatur ein hohes Heilungspotenzial zugeschrieben, daher wird neben der operativen Therapie auch der konservativen Therapie ein Stellenwert eingeräumt. Die hintere Kreuzbandruptur ist häufig mit Begleitverletzungen assoziiert. Unter anderem sind in bis zu 70% der Fälle Verletzungen der posterolateralen Ecke begleitend vorhanden. Die Detektion der Begleitverletzungen hat maßgeblichen Einfluss auf das Outcome, da in diesen Fällen die isolierte operative HKB-Stabilisierung nicht zu zufriedenstellenden Ergebnissen führt.

Abstract

Compared to the anterior cruciate ligament injury, the rupture of the posterior cruciate Ligament (PCL) is the rarer condition. A high healing potential is attributed to the PCL in the literature, which is why conservative therapy is also considered important in addition to surgical treatment [1]. Posterior cruciate ligament rupture is often associated with concomitant injuries. Among other things, up to 70% of cases are associated with accompanying injuries to the posterolateral corner [2]. The detection of concomitant injuries has a significant influence on the outcome, as isolated surgical PCL stabilization does not lead to satisfactory results in these cases.

Kernaussagen

  • Die konservative Therapie hat einen hohen Stellenwert bei isolierten Verletzungen des hinteren Kreuzbandes (HKB).

  • Die Detektion von Begleitverletzungen ist essenziell für einen Therapieerfolg.

  • Auch Avulsionsverletzungen des hinteren Kreuzbandes können abhängig von der Dislokation des Fragmentes mit guten klinischen Ergebnissen konservativ therapiert werden.

  • Die Rekonstruktion in Doppelbündeltechnik bietet keinen Outcome-Vorteil gegenüber der Einzelbündeltechnik.

  • Bei operativer Therapie der akuten HKB-Verletzung stellt das Ligament Bracing eine gute Alternative zur HKB-Plastik dar.

  • Die Indikation zur Slope-Korrektur mit Erhöhung des Slope sollte insbesondere bei chronischen Instabilitäten und versagter operativer Therapie in Betracht gezogen werden.

Schlüsselwörter

HKB-Ruptur - Kreuzbandruptur - Knieverletzung - hinteres Kreuzband

Keywords

cruciate ligament rupture - knee injury - posterior cruciate ligament


Publication History

Article published online:
04 June 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
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