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Erschienen in: Die Unfallchirurgie 1/2017

05.01.2017 | Konservative Therapie | CME

Verletzungen des hinteren Kreuzbands

verfasst von: K. F. Schüttler, E. Ziring, S. Ruchholtz, Prof. Dr. T. Efe

Erschienen in: Die Unfallchirurgie | Ausgabe 1/2017

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Zusammenfassung

Verletzungen des hinteren Kreuzbands (HKB) werden noch immer häufig übersehen, und die Therapie einer HKB-Ruptur unterscheidet sich grundsätzlich von der des verletzten vorderen Kreuzbands (VKB). Die konservative Behandlung ist für akute isolierte HKB-Verletzungen die Therapie der ersten Wahl, die mit guten klinischen und biomechanischen Ergebnissen einhergeht. Kombinationsverletzungen von HKB und anderen stabilisierenden Ligamenten, wie Kollateralbänder oder posterolaterale Gelenkecke, werden operativ versorgt. Dies gilt auch für die hochgradig chronische HKB-Insuffizienz. Die sorgfältige Einteilung der HKB-Verletzungen unter Berücksichtigung aller stabilisierenden Strukturen des Kniegelenks und der Zeit nach der HKB-Verletzung ist für die erfolgreiche Behandlung essenziell.
Literatur
1.
Zurück zum Zitat Sanders TL, Pareek A, Barrett IJ et al (2016) Incidence and long-term follow-up of isolated posterior cruciate ligament tears. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-016-4052-y Sanders TL, Pareek A, Barrett IJ et al (2016) Incidence and long-term follow-up of isolated posterior cruciate ligament tears. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-016-4052-y
2.
Zurück zum Zitat Owesen C, Sandven-Thrane S, Lind M et al (2015) Epidemiology of surgically treated posterior cruciate ligament injuries in Scandinavia. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-015-3786-2 PubMed Owesen C, Sandven-Thrane S, Lind M et al (2015) Epidemiology of surgically treated posterior cruciate ligament injuries in Scandinavia. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-015-3786-2 PubMed
3.
Zurück zum Zitat Fanelli GC, Edson CJ (1995) Posterior cruciate ligament injuries in trauma patients: Part II. Arthroscopy 11:526–529CrossRefPubMed Fanelli GC, Edson CJ (1995) Posterior cruciate ligament injuries in trauma patients: Part II. Arthroscopy 11:526–529CrossRefPubMed
4.
Zurück zum Zitat Yoon YC, Jeon SS, Sim JA et al (2016) Concomitant posterior cruciate ligament injuries with direct injury-related patellar fractures. Arch Orthop Trauma Surg 136:779–784CrossRefPubMed Yoon YC, Jeon SS, Sim JA et al (2016) Concomitant posterior cruciate ligament injuries with direct injury-related patellar fractures. Arch Orthop Trauma Surg 136:779–784CrossRefPubMed
5.
Zurück zum Zitat Emami Meybodi MK, Ladani MJ, Emami Meybodi T et al (2014) Concomitant ligamentous and meniscal knee injuries in femoral shaft fracture. J Orthop Traumatol 15:35–39CrossRefPubMed Emami Meybodi MK, Ladani MJ, Emami Meybodi T et al (2014) Concomitant ligamentous and meniscal knee injuries in femoral shaft fracture. J Orthop Traumatol 15:35–39CrossRefPubMed
6.
Zurück zum Zitat Strobel MJ, Weiler A, Eichhorn HJ (2000) Diagnosis and therapy of fresh and chronic posterior cruciate ligament lesions. Chirurg 71:1066–1081CrossRefPubMed Strobel MJ, Weiler A, Eichhorn HJ (2000) Diagnosis and therapy of fresh and chronic posterior cruciate ligament lesions. Chirurg 71:1066–1081CrossRefPubMed
7.
Zurück zum Zitat Amis AA, Bull AM, Gupte CM et al (2003) Biomechanics of the PCL and related structures: posterolateral, posteromedial and meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc 11:271–281CrossRefPubMed Amis AA, Bull AM, Gupte CM et al (2003) Biomechanics of the PCL and related structures: posterolateral, posteromedial and meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc 11:271–281CrossRefPubMed
8.
Zurück zum Zitat Amis AA, Gupte CM, Bull AM et al (2006) Anatomy of the posterior cruciate ligament and the meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc 14:257–263CrossRefPubMed Amis AA, Gupte CM, Bull AM et al (2006) Anatomy of the posterior cruciate ligament and the meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc 14:257–263CrossRefPubMed
9.
Zurück zum Zitat Gupte CM, Smith A, Jamieson N et al (2002) Meniscofemoral ligaments – structural and material properties. J Biomech 35:1623–1629CrossRefPubMed Gupte CM, Smith A, Jamieson N et al (2002) Meniscofemoral ligaments – structural and material properties. J Biomech 35:1623–1629CrossRefPubMed
10.
Zurück zum Zitat Yamamoto M, Hirohata K (1991) Anatomical study on the menisco-femoral ligaments of the knee. Kobe J Med Sci 37:209–226PubMed Yamamoto M, Hirohata K (1991) Anatomical study on the menisco-femoral ligaments of the knee. Kobe J Med Sci 37:209–226PubMed
11.
Zurück zum Zitat Covey DC, Sapega AA (1994) Anatomy and function of the posterior cruciate ligament. Clin Sports Med 13:509–518PubMed Covey DC, Sapega AA (1994) Anatomy and function of the posterior cruciate ligament. Clin Sports Med 13:509–518PubMed
12.
Zurück zum Zitat Rubinstein RA Jr., Shelbourne KD, Mccarroll JR et al (1994) The accuracy of the clinical examination in the setting of posterior cruciate ligament injuries. Am J Sports Med 22:550–557CrossRefPubMed Rubinstein RA Jr., Shelbourne KD, Mccarroll JR et al (1994) The accuracy of the clinical examination in the setting of posterior cruciate ligament injuries. Am J Sports Med 22:550–557CrossRefPubMed
13.
Zurück zum Zitat Fanelli GC, Giannotti BF, Edson CJ (1994) The posterior cruciate ligament arthroscopic evaluation and treatment. Arthroscopy 10:673–688CrossRefPubMed Fanelli GC, Giannotti BF, Edson CJ (1994) The posterior cruciate ligament arthroscopic evaluation and treatment. Arthroscopy 10:673–688CrossRefPubMed
14.
Zurück zum Zitat Noyes FR, Stowers SF, Grood ES et al (1993) Posterior subluxations of the medial and lateral tibiofemoral compartments. An in vitro ligament sectioning study in cadaveric knees. Am J Sports Med 21:407–414CrossRefPubMed Noyes FR, Stowers SF, Grood ES et al (1993) Posterior subluxations of the medial and lateral tibiofemoral compartments. An in vitro ligament sectioning study in cadaveric knees. Am J Sports Med 21:407–414CrossRefPubMed
15.
Zurück zum Zitat Wind WM, Bergfeld JA (2012) Evaluation and Treatment of Isolated and Combined PCL Injuries. In: Doral MN, Tandoğan RN, Mann G, Verdonk R (Hrsg) Sports Injuries. ISBN 9783642156304 Wind WM, Bergfeld JA (2012) Evaluation and Treatment of Isolated and Combined PCL Injuries. In: Doral MN, Tandoğan RN, Mann G, Verdonk R (Hrsg) Sports Injuries. ISBN 9783642156304
16.
Zurück zum Zitat Strauss EJ, Ishak C, Inzerillo C et al (2007) Effect of tibial positioning on the diagnosis of posterolateral rotatory instability in the posterior cruciate ligament-deficient knee. Br J Sports Med 41:481–485CrossRefPubMedPubMedCentral Strauss EJ, Ishak C, Inzerillo C et al (2007) Effect of tibial positioning on the diagnosis of posterolateral rotatory instability in the posterior cruciate ligament-deficient knee. Br J Sports Med 41:481–485CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Gross ML, Grover JS, Bassett LW et al (1992) Magnetic resonance imaging of the posterior cruciate ligament. Clinical use to improve diagnostic accuracy. Am J Sports Med 20:732–737CrossRefPubMed Gross ML, Grover JS, Bassett LW et al (1992) Magnetic resonance imaging of the posterior cruciate ligament. Clinical use to improve diagnostic accuracy. Am J Sports Med 20:732–737CrossRefPubMed
18.
Zurück zum Zitat Shelbourne KD, Jennings RW, Vahey TN (1999) Magnetic resonance imaging of posterior cruciate ligament injuries: assessment of healing. Am J Knee Surg 12:209–213PubMed Shelbourne KD, Jennings RW, Vahey TN (1999) Magnetic resonance imaging of posterior cruciate ligament injuries: assessment of healing. Am J Knee Surg 12:209–213PubMed
19.
Zurück zum Zitat Tewes DP, Fritts HM, Fields RD et al (1997) Chronically injured posterior cruciate ligament: magnetic resonance imaging. Clin Orthop Relat Res 335:224–232 Tewes DP, Fritts HM, Fields RD et al (1997) Chronically injured posterior cruciate ligament: magnetic resonance imaging. Clin Orthop Relat Res 335:224–232
20.
Zurück zum Zitat Jacobsen K (1976) Stress radiographical measurement of the anteroposterior, medial and lateral stability of the knee joint. Acta Orthop Scand 47:335–334CrossRefPubMed Jacobsen K (1976) Stress radiographical measurement of the anteroposterior, medial and lateral stability of the knee joint. Acta Orthop Scand 47:335–334CrossRefPubMed
21.
Zurück zum Zitat Hewett TE, Noyes FR, Lee MD (1997) Diagnosis of complete and partial posterior cruciate ligament ruptures. Stress radiography compared with KT-1000 arthrometer and posterior drawer testing. Am J Sports Med 25:648–655CrossRefPubMed Hewett TE, Noyes FR, Lee MD (1997) Diagnosis of complete and partial posterior cruciate ligament ruptures. Stress radiography compared with KT-1000 arthrometer and posterior drawer testing. Am J Sports Med 25:648–655CrossRefPubMed
22.
Zurück zum Zitat Kowalczuk M, Leblanc MC, Rothrauff BB et al (2015) Posterior tibial translation resulting from the posterior drawer manoeuver in cadaveric knee specimens: a systematic review. Knee Surg Sports Traumatol Arthrosc 23:2974–2982CrossRefPubMed Kowalczuk M, Leblanc MC, Rothrauff BB et al (2015) Posterior tibial translation resulting from the posterior drawer manoeuver in cadaveric knee specimens: a systematic review. Knee Surg Sports Traumatol Arthrosc 23:2974–2982CrossRefPubMed
23.
Zurück zum Zitat Schulz MS, Steenlage ES, Russe K et al (2007) Distribution of posterior tibial displacement in knees with posterior cruciate ligament tears. J Bone Joint Surg Am 89:332–338PubMed Schulz MS, Steenlage ES, Russe K et al (2007) Distribution of posterior tibial displacement in knees with posterior cruciate ligament tears. J Bone Joint Surg Am 89:332–338PubMed
24.
Zurück zum Zitat Strobel MJ, Weiler A, Schulz MS et al (2002) Fixed posterior subluxation in posterior cruciate ligament-deficient knees: diagnosis and treatment of a new clinical sign. Am J Sports Med 30:32–38PubMed Strobel MJ, Weiler A, Schulz MS et al (2002) Fixed posterior subluxation in posterior cruciate ligament-deficient knees: diagnosis and treatment of a new clinical sign. Am J Sports Med 30:32–38PubMed
25.
Zurück zum Zitat Harner CD, Hoher J (1998) Evaluation and treatment of posterior cruciate ligament injuries. Am J Sports Med 26:471–482PubMed Harner CD, Hoher J (1998) Evaluation and treatment of posterior cruciate ligament injuries. Am J Sports Med 26:471–482PubMed
26.
Zurück zum Zitat Fanelli GC, Stannard JP, Stuart MJ et al (2010) Management of complex knee ligament injuries. J Bone Joint Surg Am 92:2235–2246PubMed Fanelli GC, Stannard JP, Stuart MJ et al (2010) Management of complex knee ligament injuries. J Bone Joint Surg Am 92:2235–2246PubMed
27.
Zurück zum Zitat Fowler PJ, Messieh SS (1987) Isolated posterior cruciate ligament injuries in athletes. Am J Sports Med 15:553–557CrossRefPubMed Fowler PJ, Messieh SS (1987) Isolated posterior cruciate ligament injuries in athletes. Am J Sports Med 15:553–557CrossRefPubMed
28.
Zurück zum Zitat Shelbourne KD, Muthukaruppan Y (2005) Subjective results of nonoperatively treated, acute, isolated posterior cruciate ligament injuries. Arthroscopy 21:457–461CrossRefPubMed Shelbourne KD, Muthukaruppan Y (2005) Subjective results of nonoperatively treated, acute, isolated posterior cruciate ligament injuries. Arthroscopy 21:457–461CrossRefPubMed
29.
Zurück zum Zitat Ahn S, Lee YS, Song YD et al (2016) Does surgical reconstruction produce better stability than conservative treatment in the isolated PCL injuries? Arch Orthop Trauma Surg 136:811–819CrossRefPubMed Ahn S, Lee YS, Song YD et al (2016) Does surgical reconstruction produce better stability than conservative treatment in the isolated PCL injuries? Arch Orthop Trauma Surg 136:811–819CrossRefPubMed
30.
Zurück zum Zitat Skyhar MJ, Warren RF, Ortiz GJ et al (1993) The effects of sectioning of the posterior cruciate ligament and the posterolateral complex on the articular contact pressures within the knee. J Bone Joint Surg Am 75:694–699CrossRefPubMed Skyhar MJ, Warren RF, Ortiz GJ et al (1993) The effects of sectioning of the posterior cruciate ligament and the posterolateral complex on the articular contact pressures within the knee. J Bone Joint Surg Am 75:694–699CrossRefPubMed
31.
Zurück zum Zitat Song JG, Kim HJ, Han JH et al (2015) Clinical outcome of posterior cruciate ligament reconstruction with and without remnant preservation. Arthroscopy 31:1796–1806CrossRefPubMed Song JG, Kim HJ, Han JH et al (2015) Clinical outcome of posterior cruciate ligament reconstruction with and without remnant preservation. Arthroscopy 31:1796–1806CrossRefPubMed
32.
Zurück zum Zitat Jain V, Goyal A, Mohindra M et al (2016) A comparative analysis of arthroscopic double-bundle versus single-bundle posterior cruciate ligament reconstruction using hamstring tendon autograft. Arch Orthop Trauma Surg 136:1555–1561CrossRefPubMed Jain V, Goyal A, Mohindra M et al (2016) A comparative analysis of arthroscopic double-bundle versus single-bundle posterior cruciate ligament reconstruction using hamstring tendon autograft. Arch Orthop Trauma Surg 136:1555–1561CrossRefPubMed
33.
Zurück zum Zitat Milles JL, Nuelle CW, Pfeiffer F et al (2016) Biomechanical comparison: single-bundle versus double-bundle posterior cruciate ligament reconstruction techniques. J Knee Surg. doi:10.1055/s-0036-1588014 Milles JL, Nuelle CW, Pfeiffer F et al (2016) Biomechanical comparison: single-bundle versus double-bundle posterior cruciate ligament reconstruction techniques. J Knee Surg. doi:10.​1055/​s-0036-1588014
34.
Zurück zum Zitat Nuelle CW, Milles JL, Pfeiffer FM et al (2016) Biomechanical comparison of five posterior cruciate ligament reconstruction techniques. J Knee Surg. doi:10.1055/s-0036-1593625 Nuelle CW, Milles JL, Pfeiffer FM et al (2016) Biomechanical comparison of five posterior cruciate ligament reconstruction techniques. J Knee Surg. doi:10.​1055/​s-0036-1593625
Metadaten
Titel
Verletzungen des hinteren Kreuzbands
verfasst von
K. F. Schüttler
E. Ziring
S. Ruchholtz
Prof. Dr. T. Efe
Publikationsdatum
05.01.2017
Verlag
Springer Medizin
Erschienen in
Die Unfallchirurgie / Ausgabe 1/2017
Print ISSN: 2731-7021
Elektronische ISSN: 2731-703X
DOI
https://doi.org/10.1007/s00113-016-0292-z

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