Lobenhoffer P
Unfallchirurgische Klinik, Medizinischen Hochschule Hannover.
Zentralbl Chir. 1997;122(11):974-85.
The treatment of knee joint injuries has seen a marked development. Arthroscopy is standard for diagnostic purposes, for meniscus resection and meniscus refixation. Anterior cruciate ligament reconstruction may be performed mini-invasive by arthroscopic or mini-open technique with comparable result. Drill guide systems and fixation techniques allow for precise and stable graft placement. Posterior cruciate ligament surgery is presently undergoing a similar process of optimisation as ACL surgery has some years ago. The surgical trauma of intraarticular fracture reconstruction was also reduced significantly. Retrograde nailing, percutaneous plating and specific exposures to distal femur and proximal tibia fractures have been established. Percutaneous osteosynthesis controlled by arthroscopy or fluoroscopy is widely used for B-fractures of the tibial plateau. Injectable bone mineral cement adds to reduced trauma of surgical treatment of these fractures. Mini-invasive knee surgery will develop rapidly in the coming years.
膝关节损伤的治疗取得了显著进展。关节镜检查是用于诊断目的、半月板切除术和半月板修复术的标准方法。前交叉韧带重建可通过关节镜或小切口开放技术微创进行,效果相当。钻孔导向系统和固定技术可实现移植物的精确稳定放置。后交叉韧带手术目前正经历与几年前前交叉韧带手术类似的优化过程。关节内骨折重建的手术创伤也显著减少。逆行髓内钉固定、经皮钢板固定以及对股骨远端和胫骨近端骨折的特定显露方法已经确立。通过关节镜或透视控制的经皮骨固定广泛应用于胫骨平台B型骨折。可注射骨水泥进一步减少了这些骨折手术治疗的创伤。微创膝关节手术在未来几年将迅速发展。