Prospektive klinische Studien zum Vergleich zweier Rekonstruktionstechniken, bei Revisionsoperationen und bei ligamentären Kombinationspathologien des Kniegelenkes

摘要

Injuries of the anterior cruciate ligament are very common in sports injuries. Thus this injury and ist therapy are of a high socio-economic importance. Different surgical procedures have been developed in the last decades. Until today the perfect treatment is not found. One of the main discussed points is the choice of graft. Thus we performed a prospective clinical comparison of two different grafts (patellar-tendon and hamstring-tendons) using an identical surgical procedure. We could demonstrate that functional postoperative results were superior in the hamstring-tendon group. Additionally we found a better knee stability in the hamstring-tendon group.But, not every reconstruction of the anterior cruciate ligament is successful in the long term. Revision reconstruction might be necessary in case of graft failure. There is low evidence about clinical results after revision anterior cruciate ligament reconstruction. Thus, we performed a prospective clinical comparison of primary and revision anterior cruciate ligament reconstruction. This investigation mainly demonstrates superior functional outcome for the primary reconstruction group although no significant differences for postoperativ knee stability were found. Additionally we performed a clinical analysis of patients with chronic insufficiency of the posterior cruciate ligament and a reconstruction of the anterior cruciate ligament I their history. This mismanagement often leads to early and massive degenerative changes of the knee. The main results of this clinical investigation are the developed therapeutic strategies for these patients.