Z Orthop Unfall 2014; 152(2): 182-187
DOI: 10.1055/s-0033-1360353
Aus den Sektionen
Georg Thieme Verlag KG Stuttgart · New York

Patellofemoraler Ersatz – welche Datenlage haben wir?

Arthroplasty of the Femoropatellar Joint – What Data are Available?
B. Fink
Klinik für Endoprothetik, Allgemeine und Rheumaorthopädie, Orthopädische Klinik Markgröningen
,
C. Schwenninger
Klinik für Endoprothetik, Allgemeine und Rheumaorthopädie, Orthopädische Klinik Markgröningen
› Author Affiliations
Further Information

Publication History

Publication Date:
28 February 2014 (online)

Zusammenfassung

Hintergrund: Bei fortgeschrittener isolierter Arthrose des Femoropatellargelenks stellt der endoprothetische Femoropatellarersatz eine Therapieoption dar. Um hiermit ein gutes Ergebnis erzielen zu können, bedarf es der korrekten Patientenauswahl mit isolierter Arthrose ohne Fehllauf und Instabilität der Patella, moderner Prothesen mit femoraler Onlay-Komponente und einer korrekten Implantationstechnik mit korrekter Orientierung der Komponenten und Vermeidung eines Overstuffings der Patella. Patienten und Methoden: 53 Vanguard-Prothesen (Biomet GmbH, Warsaw, IL) wurden in einem Nachuntersuchungszeitraum von 3,7 ± 2,8 (1–8) Jahren untersucht. Ergebnisse: Der Knee Society Score stieg von 117,3 präoperativ auf 181,2 zum Nachuntersuchungszeitraum. Eine Revision erfolgte aufgrund neuropathischer Schmerzen, und es traten 2 periprothetische Patellafrakturen nach Sturz auf. Schlussfolgerung: Bei strenger Indikationsstellung einer isolierten Femoropatellararthrose sind gute Ergebnisse mit modernen Femoropatellarprothesen zu erwarten.

Abstract

Background: Osteoarthritis of the knee joints is rarely seen only in the femoropatellar joint. In isolated severe osteoarthritis of the femoropatellar joint an isolated prosthetic joint replacement of this joint is indicated. To achieve good results, correct patient selection with no arthritis in the femorotibial joint and absence of maltracking and instability of the patella are crucial. Modern prostheses with a femoral onlay component and a proper surgical technique with correct alignment of the prosthetic component and prevention of an overstuffing of the patella are essential. Patients and Methods: Fifty-three Vanguard Prostheses (Biomet GmbH, Warsaw, IL) were examined after a follow-up of 3.7 ± 2.8 (1–8) years. Results: The Knee Society score increased from 117.3 points preoperative to 181.2 points at the follow-up. One knee was revised because of neuropathic pain. Two patients suffered from periprosthetic patellar fractures after falling. Conclusion: In well indicated cases with isolated osteoarthritis of the femoropatellar joint, good clinical results with a femoropatellar prosthesis can be expected.

 
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