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Noch immer streiten Experten darüber, ob intensives Fußballspiel in der Jugend zu O-Beinen führt oder ob die Auswahl der jungen Spieler, die vermehrte Zahl an O-Beinen im Kollektiv mit sich bringt, weil diese fraglich besser dribbeln können. Dr. Florian Wolf, Facharzt für Unfallchirurgie und Orthopädie von der Arbeitsgruppe 3D-Chirurgie der Klinik für Allgemeine, Unfall- und Wiederherstellungschirugie der LMU München stellt auf dem internationalen Kongress der Gesellschaft für Orthopädisch-Traumatologische Sportmedizin dazu eine wissenschaftliche Studie vor. Das Ergebnis: ein intensives Fußballtraining in der Jugend erhöht das Risiko für die Entwicklung von O-Beinen signifikant.
„Der Hauptgrund dafür scheint in den noch aktiven, offenen Wachstumsfugen begründet. Diese schließen sich regelhaft bei Mädchen zum 14./15. Lebensjahr, bei Jungen sogar erst zum 16. Lebensjahr. Möglicherweise entstehen durch das intensive Training bei wiederholten Mikrotraumata schädigende Effekte am Schienbeinkopf. Daraus können später Deformitäten am Schienbein resultieren“, so Wolf. Durch die O-Deformierung werden die Strukturen auf der Innenseite des Kniegelenkes stärker belastet. Dies kann mit zunehmendem Alter zu einer Kniegelenks-Arthrose und später bis zur Notwendigkeit eines künstlichen Kniegelenkes führen.
Patienten mit O-Beinen oder Schmerzen am inneren Kniegelenksspalt sollten sich einer sorgfältigen klinischen und radiologischen Untersuchung mit Analyse der Beingeometrie unterziehen. Ab einem bestimmten Grad der Abweichung, beziehungsweise der Beschwerden, ist eine Achskorrektur der Beine zu erwägen, so die Mediziner.
Wolf: „Dabei greifen wir operativ je nach Ort der Deformität am Schienbeinkopf oder Oberschenkelknochen in Kniegelenksnähe, selten auch an beiden Knochen ein. Bei der klassischen Methode wird nach Durchtrennung des Knochens mit Platten die korrekte Beinachse fixiert. Falls bei einer begleitenden Verdrehung der Knochen die Füße sehr weit nach innen oder außen stehen, die Hüften ungünstig eingestellt sind oder gar zusätzlich eine Beinlängendifferenz vorliegt, wird eine Korrektur mit Marknägeln bevorzugt“
Besonders die Umstellungs- und oder die Verlängerungs-Operationen mit Marknägeln lassen sich mit kleinsten Zugängen, sozusagen minimal-invasiv durchführen. Die Patienten gehen im Anschluss durchschnittlich vier bis sechs Wochen unter Teilbelastung an Gehstützen und können dann wieder sportlich aktiv sein.
Eine nur leichte O-Bein-Stellung, ohne anhaltende Beschwerden sollte erstmal konservativ behandelt werden. Dabei empfiehlt sich z.B. das Meiden besonderer Spitzenbelastungen, Kräftigung der Muskulatur, eine Schuhaußenranderhöhung und die Gabe entzündungshemmender Medikamente.
„Unsere Ergebnisse zum Leistungssport würden wir gerne mit Vereinen und Sport- und Trainingswissenschaftlern weiter erörtern, um gegebenenfalls die betroffenen jugendlichen SportlerInnen frühzeitig zu identifizieren und entsprechende Anpassungen des Trainings umzusetzen, so der Mediziner.
Für ihre Studie analysierte die Arbeitsgruppe 3D-Chirurgie der LMU München systematisch die vorhandene Literatur und fasste die Ergebnisse anschließend wissenschaftlich zusammen. Dabei schloss die wissenschaftliche Analyse internationale Studien mit zusammen über 1300 jungen männlichen Leistungssportlern im Fußball und vergleichbar große Kontrollgruppen ein.
Das Phänomen der O-Beine bei heranwachsenden Leistungssportlern wird im Übrigen in geringerem Ausmaß auch bei anderen high-impact Sportarten wie Tennis, Handball und Volleyball beschreiben. Auch hier werden als Ursache die häufigen, schnellen Richtungswechsel vermutet. Die Forscher betonen ausdrücklich, dass die Ergebnisse nicht auf den Breitensport zu übertragen sind – im Gegenteil: Der Breitensport ist wichtig und förderlich für die Entwicklung der Heranwachsenden!
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