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Z Orthop Ihre Grenzgeb 2002; 140(1): 27-31
DOI: 10.1055/s-2002-22087
Knieendoprothetik

© Georg Thieme Verlag Stuttgart · New York

Einflussfaktoren auf die Patellaführung in der Knieendoprothetik und operatives Weichteilmanagement

Influencing factors of the patella alignment in TKR and operative soft tissue managementK.  Büttner-Janz1 , A.  Ekkernkamp2
  • 1Orthopädische Klinik, Klinikum Hellersdorf, Vivantes Netzwerk für Gesundheit GmbH, Berlin
  • 2Abteilung Unfallchirurgie, Ernst-Moritz-Arndt-Universität, Greifswald
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Publication History

Publication Date:
15 March 2002 (online)

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Zusammenfassung

Fragestellung: Nach der Implantation von Knieendoprothesen hat die Patella entscheidenden Anteil am Behandlungsergebnis, wie Komplikationsstatistiken dies zeigen. Welche Faktoren beeinflussen den Patellalauf und durch welche Operationsschritte kann die Patella zentriert werden? Methodik: Aus Ergebnissen einer Literaturrecherche der Jahre 1983 bis 2000 und eigenen Operationserfahrungen sollten alle Faktoren zur gezielten Beeinflussung der Patellaführung in der Knieendoprothetik festgestellt werden. Ergebnisse: Es wird eine komplexe Übersicht zur Abhängigkeit des Patellalaufs durch die Endoprothesenkonstruktion, die Weichteil- und Knochenpräparation sowie die Implantationstechnik gegeben mit Empfehlungen zum intraoperativen Management für die Patellazentrierung. Schlussfolgerung: Zur Vermeidung jeglicher Patellapathologie ist die umfassende Kenntnis und gezielte Anwendung der dargestellten Operationsschritte zur Zentrierung der Patella inklusive des Streckapparats von hoher Bedeutung für eine zufriedenstellende Funktion der Knieendoprothese.

Abstract

The patella has a crucial effect on the postoperative result after TKR, as complication statistics demonstrate. What factors influence the patella alignment and through which surgical steps can it be centred? Method: Reviewing the findings from publications ranging from 1983 to 2000 and our own operative experience, we tried to establish all factors that could influence patella alignment after TKR. Results: A complex overview is given about the dependency of the patella alignment on the design of the prosthesis, the soft tissue and bone preparation and the implantation technique, together with suggestions for intraoperative management for patella centralisation. Conclusion: To avoid any patella pathologies, it is of crucial importance to have comprehensive knowledge and to follow the described surgical steps strictly for patella centralisation, including the extensor mechanism. This is essential to achieve a satisfying functional result after TKR.

Schlüsselwörter

Knieendoprothese - Patella - Alignment

Key words

TKR - patella - alignement

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Priv.-Doz. Dr. K. Büttner-Janz

Vivantes Klinikum Berlin-Hellersdorf

Myslowitzer Straße 45

12621 Berlin

Phone: 030/5651-2180

Fax: 030/5651-2678

Email: orthopaedie@kh-hellersdorf.de

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