[Knee joint ligament reconstruction--indications, results].
Cruciate ligament injuries have increased in number in the last 10 to 20 years. Nonoperative treatment of ligament injuries about the knee joint has lost some of its popularity; however, there are only very few randomized prospective studies demonstrating that operative reconstructions of knee ligament injuries do have a positive effect on preventing late osteoarthritic changes. In contrast, one of the best studies recently published shows that there may even be some increased rate of osteoarthritis in reconstructed patients. Why this? The concept of the 'Envelope of Load Acceptance' may explain, why some of the patients who opt for a nonoperative treatment of cruciate ligament injuries do very well. They lower the load and frequency to the knee joint and diminish their activity level. Patients with successfully treated ligament lesions about the knee joint may wish to go back to their preinjury level and may want to reach their preinjury 'shell' of load acceptance [Scott Dye, 1995]; however, this may already be too much for their knees [physiological overload] and may eventually lead to the osteoarthritic changes about the knee joint. Careful consultation of each individual patient's case of knee ligament injuries is essential for the successful treatment, a treatment which may reduce the rate of osteoarthritis and reduce costs for the injured and the community.
Friederich
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NF
Klinik für Orthopädische Chirurgie/Traumatologie, Kantonsspital, Bruderholz.
Biedert
R M
RM
D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D010003:Osteoarthritis / Q000517:prevention & control; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods; D013709:Tendon Transfer
Bandplastik am Kniegelenk--Indikationen, Ergebnisse.