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Minimal-invasive Implantation unikondylärer Prothesen

Minimally invasive implantation in unicondylar arthroplasty

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Zusammenfassung

Die Knieendoprothetik hat sich zu einem der erfolgreichsten Standardverfahren in der orthopädischen Chirurgie entwickelt. Durch die Implantation bei immer jüngeren Patienten gewinnt die knochensparende Implantation von Prothesen zunehmende Bedeutung, um im Falle eines Prothesenwechsels eine bestmögliche ossäre Situation zu erreichen. Hierfür bietet der Hemischlitten alle Voraussetzungen. Mit zunehmend verbesserten Instrumentationen und minimal-invasiven Operationstechniken lassen sich sehr gute Langzeitergebnisse und eine beschleunigte Rehabilitation erreichen. Die operative Technik mit ausschließlicher Kapselinzision und extramedullärer Technik wird beschrieben.

In einer prospektiven Studie wurden mit dem ZUK-Hemischlitten sehr gute frühfunktionelle Ergebnisse erreicht. Der Einsatz ist durch die begrenzte Indikation limitiert und bedarf einer exakten Differentialindikation und Operationstechnik. Die minimal-invasive Implantation von Hemischlitten trägt aber bei richtiger Indikation zusätzlich zu den sehr guten frühfunktionellen Ergebnissen erheblich zum Erhalt autogener Knochensubstanz bei und ist somit eine sinnvolle Therapieoption in der Behandlung der Einkompartmentkrankheit des Kniegelenks.

Abstract

Knee arthroplasty has become one of the most successful standard procedures in orthopaedic surgery. With a more frequent use in young and active patients bone-saving procedures have become more important. The goal is to save good bone stock for the revision procedure. Therefore, unicompartmental knee arthroplasty is a good example. Instrumentation and minimally invasive surgical techniques have been improved so very good long-term results and early functional results are achieved. The paper describes the surgical technique with true capsule incision and extramedullary alignment technique.

In a prospective study, the early functional results with the ZUK implant were excellent. The implant may not be indicated for every knee situation and an exact differential indication and sound surgical technique are necessary. Its use, however, in cases with unicompartmental knee arthritis, contributes to excellent early rehabilitation and to maintaining autologous bone. Therefore, the minimally invasive unicompartmental knee arthroplasty is a sensible alternative to other options.

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  1. Orthopädische Chirurgie, OCM-Klinik GmbH, Steiner Straße 6, 81369, München, Deutschland

    R. Hube & M. Keim

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  1. R. Hube
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  2. M. Keim
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Correspondence to R. Hube.

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Hube, R., Keim, M. Minimal-invasive Implantation unikondylärer Prothesen. Orthopäde 36, 1093–1099 (2007). https://doi.org/10.1007/s00132-007-1168-2

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