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Anatomische und biomechanische Überlegungen zur Sprunggelenkprothetik

Anatomical and biomechanical aspects of total ankle replacement

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Zusammenfassung

Der Erfolg des prothetischen Ersatzes des oberen Sprunggelenks (OSG) dürfte wesentlich davon abhängen inwieweit die physiologischen Verhältnisse des Gelenks erhalten bleiben, respektive wiederhergestellt wurden. Je mehr das Design der Prothese der physiologischen Anatomie entspricht, je korrekter die Achsenstellung des Rückfußes und je ausgeglichener die Bandspannung ist, desto besser werden die normalen kinematischen Verhältnisse des OSG nachgeahmt. Dadurch können unphysiologische Kräfte vermindert werden, die zu Schmerzen, Verschleiß und zu einem frühen Implantatversagen führen können.

In diesem Artikel sind die zur Sprunggelenkprothetik notwendigen anatomischen und biomechanischen Grundlagen zusammengestellt.

Abstract

The success of total ankle replacement highly depends on how successfully the physiological kinematics are maintained or reconstructed. Normal kinematics of the ankle joint can be replicated by designing an implant that is as close as possible to the normal bony anatomy, aligning the ankle and balancing the ligaments. Mimicking normal kinematics and kinetics of a healthy ankle joint will consequently decrease damaging joint contact stress forces and stress forces on the surrounding soft tissue, which may cause wear, implant failure, and pain.

This article summarizes the anatomical and biomechanical basics that are required in total ankle replacement.

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  1. Orthopädische Universitätsklinik, Universitätsspital, CH-4031, Basel, Schweiz

    M. Knupp, V. Valderrabano &  B. Hintermann

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  1. M. Knupp
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  2. V. Valderrabano
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  3. B. Hintermann
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Correspondence to B. Hintermann.

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Knupp, M., Valderrabano, V. & Hintermann, B. Anatomische und biomechanische Überlegungen zur Sprunggelenkprothetik. Orthopäde 35, 489–494 (2006). https://doi.org/10.1007/s00132-006-0935-9

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