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Obere Extremität
Erschienen in: Obere Extremität 4/2016

15.11.2016 | Übersicht

Management von Redefekten der Rotatorenmanschette

verfasst von: Dr. med. C. Gwinner, PD Dr. med. P. Moroder, Dr. med. C. Gerhardt, Univ.-Prof. Dr. med. M. Scheibel

Erschienen in: Obere Extremität | Ausgabe 4/2016

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Zusammenfassung

Auch wenn die konsequente Weiterentwicklung aktueller Operationstechniken immer stabilere Rekonstruktionen erlaubt, stellen Redefekte der Rotatorenmanschette nach wie vor die Hauptkomplikation nach Rotatorenmanschettenrekonstruktionen dar. Diese strukturellen Redefekte unterliegen vornehmlich einer multifaktoriellen Genese. Für das therapeutische Management ist eine dezidierte Ursachenanalyse obligat. Zudem ist es abhängig vom subjektiven Beschwerdebild des Patienten, dem objektiven Funktionszustand, den pathomorphologischen Veränderungen der muskulotendinösen Einheit und ossären Veränderungen des Glenohumeralgelenks. Neben einem „skilfull neglect“ bzw. konservativen Therapiemaßnahmen kommt bei entsprechender Indikation der arthroskopischen Re-Rekonstruktion ein zunehmender Stellenwert hinzu. Irreparable Defektsituationen können je nach Beschwerdebild und Ausdehnung der Ruptur mit einem Sehnentransfer (Latissimus-dorsi- oder Pectoralis-major-Transfer) bzw. der Implantation einer inversen Endoprothese therapiert werden. Insgesamt sind die Ergebnisse einer Revisionsoperation denen eines Primäreingriffs unterlegen, so dass der Patient entsprechend aufgeklärt werden muss.
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Metadaten
Titel
Management von Redefekten der Rotatorenmanschette
verfasst von
Dr. med. C. Gwinner
PD Dr. med. P. Moroder
Dr. med. C. Gerhardt
Univ.-Prof. Dr. med. M. Scheibel
Publikationsdatum
15.11.2016
Verlag
Springer Medizin
Erschienen in
Obere Extremität / Ausgabe 4/2016
Print ISSN: 1862-6599
Elektronische ISSN: 1862-6602
DOI
https://doi.org/10.1007/s11678-016-0384-y

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