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Arthroskopie

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01.02.2014 | Leitthema

Ursachen und Versagensmuster für Redefekte nach Rekonstruktion der Rotatorenmanschette

verfasst von: C. Gwinner, K. Hug, C. Gerhardt, Prof. Dr. M. Scheibel

Erschienen in: Arthroskopie | Ausgabe 1/2014

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Zusammenfassung

Hintergrund

Strukturelle Redefekte stellen eine häufige Komplikation nach der operativen Rekonstruktion der Rotatorenmanschette dar.

Fragestellung

Ziel der vorliegenden Arbeit ist es, die zugrundeliegenden pathomorphologischen Veränderungen sowie patientenspezifische Faktoren und implantat- bzw. rekonstruktionsspezifische Risikofaktoren darzustellen.

Material und Methoden

Systematisches Review der Onlinedatenbanken PubMed, EMBASE und Cochrane Library.

Ergebnisse

Auch wenn der stetige Fortschritt der Operationsverfahren und Innovationen in der Implantattechnologie immer robustere Rekonstruktionen möglich machen, die den orginären Sehnenfootprint reproduzierbar wiederherstellen können, verbleibt eine vergleichbar hohe Anzahl an Redefekten. Diese sind multifaktorieller Genese. Es können jedoch Risikofaktoren identifiziert werden, welche die osteofibroblastische Integration negativ beeinflussen.

Schlussfolgerungen

Pathomorphologische Veränderungen der muskulotendinösen Einheit (fettige Infiltration ≥ Grad II nach Goutallier, fortgeschrittene Atrophie oder Retraktion), patientenspezifische Faktoren (Alter > 65 Jahre, Knochenqualität, Nikotinabusus, AHA < 7 mm), die Wahl des Implantats und der Rekonstruktionstechnik sowie die postoperative Rehabilitation (Applikation von NSAIR, Patientencompliance) sind für das klinische Ergebnis der Sehnenrekonstruktion ausschlaggebend.

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Titel: Ursachen und Versagensmuster für Redefekte nach Rekonstruktion der Rotatorenmanschette
verfasst von: C. Gwinner
K. Hug
C. Gerhardt
Prof. Dr. M. Scheibel
Publikationsdatum: 01.02.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Arthroskopie / Ausgabe 1/2014
Print ISSN: 0933-7946
Elektronische ISSN: 1434-3924
DOI: https://doi.org/10.1007/s00142-013-0767-7

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