Artikel
Operative treatment of complex knee instabilities
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Veröffentlicht: | 13. Juni 2005 |
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Gliederung
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The diagnosis and surgical treatment of complex knee instabilities remain a challenge to the surgeon because of ist complexity.
The incidence for PCL ruptures is estimated in literature to be 4000 - 5000 per year in Germany.
Our present study shows preliminary results of three different arthroscopically treated groups all including PCL ruptures.
Group 1 consists of PCL injuries which were primarily treated with a conservative approach with individualized K-COM orthosis (Fa. Ortema) in PCL version and failed. Subsequently, they were treated arthroscopic autologous hamstring stabilization.
Group 2 includes PCL and lateral collateral ligament lesions.
Group 3 consists of PCL, LCL and ACL injuries.
The latter two groups were treated in a two step approach. First, conservative therapy with a knee orthesis followed by arthroscopic surgery with PCL and LCL - or PCL, LCL and ACL reconstruction
The clinical evaluation includes the reverse pivot shift test, the posterolateral drawer test, measurements with the Rolimeter (Fa.Aircast), conventional x-rays including stress x-rays in 90° of flexion and MRI.
We present the clinical diagnosis, surgical technique, rehabilitation program and preliminary results of all three groups.