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Positive und negative Prädiktoren für das Langzeitresultat nach kniegelenknaher Osteotomie

Positive and negative predictors of long-term results after an osteotomy around the knee joint

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Zusammenfassung

Eine häufig gestellte Frage im Zusammenhang mit jeglichem operativem Eingriff, so auch mit einer kniegelenknahen Osteotomie, ist: „Welche Parameter sprechen in diesem speziellen Fall für einen therapeutischen Erfolg?“ Wenn die Analyse der Beingeometrie für eine Osteotomie spricht, dann gilt es den Patienten weiter einzuschätzen, und zwar unter Berücksichtigung des Zustands sowohl des Gelenks als auch des Menschen. Positive Prognosefaktoren für einen langfristigen Erfolg einer kniegelenknahen Osteotomie, in diesem Fall v. a. für die valgisierende hohe Tibiaosteotomie (HTO), sind: konstitutioneller tibialer Varuswinkel (TBVA) >3–5°, Kniegelenkbeweglichkeit >100° Flexion, männliches Geschlecht und BMI <30. Es ist unklar, ob der Arthrosegrad des betroffenen (medialen) Kompartiments eine besondere Rolle spielt. Unerheblich sind das Ausmaß der Achsenfehlstellung, das Geschlecht oder psychopathologische Komorbiditäten.

Abstract

A frequently asked question in the context of any surgical procedure, including an osteotomy around the knee joint, is “which parameters are in favor of a therapeutic success in this special case?” If the analysis of the leg geometry is in favor of an osteotomy, then the patient must be assessed further, taking into account the joint status and patient’s condition. Positive outcome predictors for long-term success of an osteotomy around the knee, especially for a valgus osteotomy at the tibia are a tibial bone varus angle (TBVA) > 3–5°, knee joint range of motion > 100° flexion, male sex, and a BMI < 30. It is unclear whether the degree of degeneration of the affected (medial) compartment is of special relevance. The severity of malalignment, the patient’s sex, and psychopathological comorbidities are not important.

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  1. OrthoPlus München, Lenbachplatz 2a, Alte Börse, 80333, München, Deutschland

    S. Hinterwimmer

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Hinterwimmer, S. Positive und negative Prädiktoren für das Langzeitresultat nach kniegelenknaher Osteotomie. Orthopäde 46, 563–568 (2017). https://doi.org/10.1007/s00132-017-3419-1

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