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Die Unfallchirurgie

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01.06.2013 | Leitthema

Akute mediale Seitenbandverletzung am Kniegelenk

Diagnostik und Therapie

verfasst von: M. Heitmann, A. Preiss, A. Giannakos, Prof. Dr. K.-H. Frosch

Erschienen in: Die Unfallchirurgie | Ausgabe 6/2013

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Zusammenfassung

Die Verletzung des medialen Kollateralbandes („medial collateral ligament“, MCL) ist eine der häufigsten ligamentären Verletzungen des Kniegelenks. Anamnese, klinische Untersuchung und die Magnetresonanztomographie (MRT) gehören zum diagnostischen Algorithmus. Zu unterscheiden sind komplette Rupturen von Teilrupturen. Die exakte Klassifizierung der Verletzung sowie das Ausmaß der Begleitverletzungen sind für die Behandlung von Bedeutung. Teilrupturen (Grad-I- und -II-Läsionen) werden mittels konservativer Therapie behandelt und führen meist zu guten klinischen Ergebnissen. Kontrovers diskutiert wird die Therapie bei kompletten Innenbandverletzungen (Grad-III-Läsionen). Vollständige intraligamentäre Rupturen mit guter Annäherung der Bandstümpfe und Reststabilität (bei intakter dorsaler Kapsel) können ebenfalls erfolgreich konservativ therapiert werden. Ansatznahe Rupturen und Avulsionsverletzungen haben eine schlechtere Heilungstendenz, so dass neuere Arbeiten zur operativen Therapie raten. Die Dislokation oder Dehiszenz der Bandstümpfe in der MRT spricht ebenfalls für eine operative Versorgung. Auch bei Kombinationsverletzungen mit komplexen Instabilitäten wird von vielen Autoren die operative Stabilisierung empfohlen. Bei regelhafter Primärbehandlung kommt es nur selten zu chronischen Instabilitäten. Da chronische mediale Instabilitäten am Kniegelenk therapeutisch herausfordernd sein können, kommt der richtigen und adäquaten Akutbehandlung eine hohe Bedeutung zu.

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Titel: Akute mediale Seitenbandverletzung am Kniegelenk
Diagnostik und Therapie
verfasst von: M. Heitmann
A. Preiss
A. Giannakos
Prof. Dr. K.-H. Frosch
Publikationsdatum: 01.06.2013
Verlag: Springer-Verlag
Erschienen in: Die Unfallchirurgie / Ausgabe 6/2013
Print ISSN: 2731-7021
Elektronische ISSN: 2731-703X
DOI: https://doi.org/10.1007/s00113-013-2371-8

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