Zusammenfassung
Therapieoptionen bei Gonarthrose beinhalten Selbstmanagement (u. a. Anpassung des Lebensstils, Gewichtsreduktion, Bewegungsübungen), konservative Maßnahmen (z. B. Analgetika, Physiotherapie) und letztendlich operative Verfahren. Die Implantation einer Knieendoprothese gehört dabei zu den weltweit häufigsten Routineeingriffen. Im Rahmen der S2k-Leitlinie „Indikation Knieendoprothese: Evidenz- und konsensbasierte Indikationsstellung in der Knieendoprothetik“ wurden Mindestanforderungen (Hauptkriterien), weitere wichtige Aspekte (Nebenkriterien) sowie absolute und relative Kontraindikationen für die Indikationsstellung zur Knieendoprothese festgelegt. Folgende Hauptkriterien wurden konsentiert: Knieschmerz, Nachweis eines Strukturschadens (Arthrose, Osteonekrose), Versagen konservativer Therapiemaßnahmen, auf die Kniegelenkerkrankung bezogene Einschränkung der Lebensqualität und subjektiver Leidensdruck. Bei Risikofaktoren oder komplexer Ausgangssituation (z. B. posttraumatisch) ist eine besonders sorgfältige Indikationsstellung und Besprechung mit dem Patienten erforderlich.
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Literatur
Australian Orthopaedic Association (2020) Australian Orthopaedic Association National Joint Replacement Registry. Hip, knee & shoulder arthroplasty. Annual report 2017. AOA, Adelaide. https://aoanjrr.sahmri.com/de/annual-reports-2020
Bedard NA, Dowdle SB, Anthony CA, DeMik DE, McHugh MA, Bozic KJ, Callaghan JJ (2017) The AAHKS clinical research award: what are the costs of knee osteoarthritis in the year prior to total knee arthroplasty? J Arthroplast 32:S8–S10.e1
Brinkman JM, Lobenhoffer P, Agneskirchner JD, Staubli AE, Wymenga AB, van Heerwaarden RJ (2008) Osteotomies around the knee: patient selection, stability of fixation and bone healing in high tibial osteotomies. J Bone Joint Surg Br 90:1548–1557
Carr AJ, Robertsson O, Graves S, Price AJ, Arden NK, Judge A, Beard DJ (2012) Knee replacement. Lancet 379:1331–1340
Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, Bridgett L, Williams S, Guillemin F, Hill CL, Laslett LL, Jones G, Cicuttini F, Osborne R, Vos T, Buchbinder R, Woolf A, March L (2014) The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 73:1323–1330
Daigle ME, Weinstein AM, Katz JN, Losina E (2012) The cost-effectiveness of total joint arthroplasty: a systematic review of published literature. Best Pract Res Clin Rheumatol 26:649–658
Dexel J, Beyer F, Lützner C, Kleber C, Lützner J (2016) TKA for posttraumatic osteoarthritis is more complex and needs more surgical resources. Orthopedics 39:S36–S40
Dowsey MM, Spelman T, Choong PFM (2016) Development of a prognostic nomogram for predicting the probability of nonresponse to total knee arthroplasty 1 year after surgery. J Arthroplasty 31:1654–1660
El-Galaly A, Nielsen PT, Jensen SL, Kappel A (2018) Prior high tibial osteotomy does not affect the survival of total knee arthroplasties: results from the Danish Knee Arthroplasty Registry. J Arthroplast 33:2131–2135.e1
Giori NJ, Amanatullah DF, Gupta S, Bowe T, Harris AHS (2018) Risk reduction compared with access to care: quantifying the trade-off of enforcing a body mass index eligibility criterion for joint replacement. J Bone Joint Surg Am 100:539–545
IQTIG (2019) Qualitätsreport 2017. https://iqtig.org/qs-berichte/qualitaetsreport/
Lange T, Schmitt J, Kopkow C, Rataj E, Günther KP, Lützner J (2017) What do patients expect from total knee arthroplasty? A Delphi consensus study on patient treatment goals. J Arthroplast 32:2093–2099.e1
Lange T, Ramos AL, Albrecht K, Günther KP, Jacobs H, Schmitt J, Hoffmann F, Goronzy J, Postler A (2018) Verordnungshäufigkeit physikalischer Therapien und Analgetika vor dem Einsatz einer Hüft- bzw. Kniegelenks-Endoprothese. Orthopade 47:1015–1023
Lützner C, Lange T, Lützner J (2017) Grundlagen patientenberichteter Ergebnisse (Patient-reported outcome – PRO). Orthop Unfall up2date 12:661–676
Lützner J, Lange T, Schmitt J, Kopkow C, Aringer M, DGRh, Bohle E, ZVK, Bork H, DGOU, Dreinhofer K, DNVF, Friederich N, Deutsche Arthrose-Hilfe e V, Gravius S, DGOOC, Heller KD, BVOU, Hube R, DKG, Gromnica-Ihle E, Deutsche Rheuma-Liga Bundesverband e V, Kirschner S, AE, Kladny B, DGOU, Kremer M, DGU, Linke M, Deutsche Gesellschaft fur Medizinische P, Malzahn J, Bundesverband AOK, Sabatowski R, Deutsche Schmerzgesellschaft e V, Scharf HP, Stove J, Wagner R, DGORH, Günther KP (2018) The S2k guideline: indications for knee endoprosthesis: evidence and consent-based indications for total knee arthroplasty. Orthopade 47:777–781
Lützner C, Postler A, Beyer F, Kirschner S, Lützner J (2019) Fulfillment of expectations influence patient satisfaction 5 years after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 27(7):2061–2070. https://doi.org/10.1007/s00167-018-5320-9. [Epub 2018 Dec 13]
McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, Hawker GA, Henrotin Y, Hunter DJ, Kawaguchi H, Kwoh K, Lohmander S, Rannou F, Roos EM, Underwood M (2014) OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthr Cartil 22:363–388
Moskowitz RW (2009) The burden of osteoarthritis: clinical and quality-of-life issues. Am J Manag Care 15:S223–S229
National Joint Register (2020) 14th annual report 2017. National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. https://reports.njrcentre.org.uk/downloads
Niemeyer P, Feucht MJ, Fritz J, Albrecht D, Spahn G, Angele P (2016) Cartilage repair surgery for full-thickness defects of the knee in Germany: indications and epidemiological data from the German Cartilage Registry (KnorpelRegister DGOU). Arch Orthop Trauma Surg 136:891–897
Niemeyer P, Becher C, Brucker PU, Buhs M, Fickert S, Gelse K, Gunther D, Kaelin R, Kreuz P, Lutzner J, Nehrer S, Madry H, Marlovits S, Mehl J, Ott H, Pietschmann M, Spahn G, Tischer T, Volz M, Walther M, Welsch G, Zellner J, Zinser W, Angele P (2018) Significance of matrix-augmented bone marrow stimulation for treatment of cartilage defects of the knee: a consensus statement of the DGOU Working Group on tissue regeneration. Z Orthop Unfall 156:513–532
Noble PC, Conditt MA, Cook KF, Mathis KB (2006) The John Insall Award: patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 452:35–43
Palazzo C, Nguyen C, Lefevre-Colau MM, Rannou F, Poiraudeau S (2016) Risk factors and burden of osteoarthritis. Ann Phys Rehabil Med 59:134–138
Paley D, Pfeil J (2000) Prinzipien der kniegelenknahen Deformitätenkorrektur. Orthopade 29:18–38
Ponnusamy KE, Marsh JD, Somerville LE, McCalden RW, Vasarhelyi EM (2018) Ninety-day costs, reoperations, and readmissions for primary total knee arthroplasty patients with varying body mass index levels. J Arthroplast 33:S157–SS61
Schmitt J, Lange T, Gunther KP, Kopkow C, Rataj E, Apfelbacher C, Aringer M, Bohle E, Bork H, Dreinhofer K, Friederich N, Frosch KH, Gravius S, Gromnica-Ihle E, Heller KD, Kirschner S, Kladny B, Kohlhof H, Kremer M, Leuchten N, Lippmann M, Malzahn J, Meyer H, Sabatowski R, Scharf HP, Stoeve J, Wagner R, Lutzner J (2017) Indication criteria for total knee arthroplasty in patients with osteoarthritis – a multi-perspective consensus study. Z Orthop Unfall 155:539–548
Siljander MP, McQuivey KS, Fahs AM, Galasso LA, Serdahely KJ, Karadsheh MS (2018) Current trends in patient-reported outcome measures in total joint arthroplasty: a study of 4 major orthopaedic journals. J Arthroplast 33:3416–3421
Skou ST, Rasmussen S, Laursen MB, Rathleff MS, Arendt-Nielsen L, Simonsen O, Roos EM (2015) The efficacy of 12 weeks non-surgical treatment for patients not eligible for total knee replacement: a randomized controlled trial with 1-year follow-up. Osteoarthr Cartil 23:1465–1475
Spahn G, Hofmann GO, von Engelhardt LV, Li M, Neubauer H, Klinger HM (2013) The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 21:96–112
The Swedish Knee Arthroplasty Register (2020) Annual report 2018. http://myknee.se/en/
Waimann CA, Fernandez-Mazarambroz RJ, Cantor SB, Lopez-Olivo MA, Zhang H, Landon GC, Siff SJ, Suarez-Almazor ME (2014) Cost-effectiveness of total knee replacement: a prospective cohort study. Arthritis Care Res 66:592–599
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Lützner, J., Lange, T., Schmitt, J., Günther, KP. (2023). Knieendoprothetik: Indikationskriterien. In: Wirtz, D.C., Reichel, H., Matziolis, G., Pfitzner, T. (eds) Endoprothetik des Kniegelenkes. AE-Manual der Endoprothetik. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-65175-9_4
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