Arthroskopische Doppelreihenrekonstruktion bei Rotatorenmanschettenruptur
Tóm tắt
In den letzten Jahren haben sich die arthroskopischen Möglichkeiten der Rotatorenmanschettenrekonstruktion unter der Vorstellung weiterentwickelt, dass primär hochstabile Rekonstruktionen zu einer Verbesserung der klinischen und radiologischen Ergebnisse führen. Insbesondere für Einzelreihentechniken wurden selbstverblockende Nahtkonfigurationen beschrieben, die biomechanisch eine Verstärkung des Faden-Sehnen-Interface ermöglichen. Mit dem Aufkommen der Doppelreihentechniken wurde das Ziel verfolgt, Footprint-bedeckende Rekonstruktionen durchzuführen. Dennoch konnten die bisherigen klinischen und radiologischen Ergebnisse die Vorteile dieser neuen Techniken nicht einheitlich widerspiegeln. Biologische Determinanten scheinen für das Outcome nach arthroskopischer Rotatorenmanschettenrekonstruktion, eine deutlich höhere Wertigkeit zu haben. Das Ziel künftiger Untersuchungen wird es sein, die pathomorphologischen Veränderungen der muskulotendinösen Einheiten der Rotatorenmanschette genauer zu klassifizieren und ein daran angepasstes mechanisches bzw. biologisch optimiertes Rekonstruktionskonzept zu erstellen.
Tài liệu tham khảo
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