Neues Verfahren kann ursprüngliches Kreuzband wieder reparieren – erste Ergebnisse auf dem GOTS-Kongress im Juni 2017 in Berlin
Wenn im Juni in Berlin die geballte Elite zum internationalen Sport-Medizin-Kongress aufeinander trifft, ist auch Prof. Dr. Mirco Herbort, Traumatologe und Unfallchirurg der Uni-Klinik Münster dabei. Der Kniespezialist stellt ein neues Verfahren und seine Ergebnisse vor, dass viele Sportler aufhorchen lässt: das Ligamys-Verfahren.
Jeder Sportler kennt das Desaster von sich oder seinen Freunden, ein kleiner Sportunfall und schon ist das vordere Kreuzband gerissen.
Herbort erklärt: „Es wird hochgradig spannend, auch für den Laien. Während bislang immer noch eine Sehne samt Muskel aus der Innenseite des Oberschenkels oder ein Teil der Sehne aus dem Streckapparat entnommen und dann als Kreuzband für´s Knie ´umfunktioniert´ wird, ist es jetzt auch möglich, das eigene Kreuzband zu erhalten. Dazu wird unter einer Minikamera der abgerissene Stumpf an seine alte Position gebracht und wieder angenäht. Zusätzlich kommt ein Stabilitätsfaden als Schiene innen durch das Knie. Den kann man sich wie eine gedrehte Kordel vorstellen, er hält bis 2000 Newton Belastung aus – eben wie das eigene Kreuzband. Damit die Beweglichkeit des Kniegelenkes nicht eingeschränkt wird, wird die Kordel am Unterschenkel mit einem Federmechanismus verbunden, der das Ganze beweglich hält.“
Der gute Nebeneffekt: es fehlt jetzt nicht mehr die Muskelfunktion des Oberschenkels, wo Sehne und Muskel meist „entwendet“ wurden. Denn, so Herbort: „Genau dieser Muskel -Muskulus Semitendinosus- ist eigentlich der Unterstützer des Kreuzbandes.“
Wer hat´s erfunden? Die Schweizer! Wie gut, dass in der Gesellschaft für Orthopädisch-Traumatologische Sportmedizin (GOTS) länderübergreifend agiert wird. So war dann die Uni-Klinik in Münster die Erste in Deutschland, die das neue Verfahren angewendet hat. Auf dem GOTS-Kongress in Berlin werden nun die ersten Ergebnisse vorgestellt. 300 Patienten wurden bislang in Münster auf diese Weise operiert und es gibt eine sehr hohe Heilungs-Quote. Besonders Breiten-Sportler ab 30 Jahre aufwärts werden in Zukunft wohl besonders davon profitieren, bei ihnen gab es bisher nahezu kein Versagen des genähten Kreuzbandes. Bei jüngeren, 16-18 jährigen Leistungssportlern aus dem Hand- oder Fußball war ein Wieder-Reißen des Kreuzbandes zum Teil zu beobachten.
Mehr Spannendes aus der Welt der Sportmedizin gibt es unter www.gots-kongress.org
Vier Fakten rund um unser Kreuzband
- Das vordere Kreuzband ist von Sportverletzungen 10 Mal häufiger betroffen, als das hintere Kreuzband. Aber am hinteren Kreuzband sind Verletzungen meist schwerer und – sie werden häufig übersehen.
- Verletzungen am Kreuzband passieren am häufigsten bei Sportarten mit schnellen Richtungswechseln. An erster Stelle stehen Hand- und Fußball, gefolgt von den Wintersportarten, ausgenommen den Snowboardern. Danach folgen Volleyball, American Football und Kite-Surfen. Während beim Kite-Surfen ein Großteil der Elite im Leistungssport mit einer Orthese unterwegs ist, passieren Knieverletzungen im Tennis recht selten.
- Für die Prognose der Heilung ist gar nicht so sehr der Kreuzbandriss selbst entscheidend, sondern eher seine Begleitverletzungen, wie Meniskus-Schädigungen, unfallbedingte Knorpelschädigungen oder zusätzliche Verletzungen der Seitenbänder.
- Das wichtigste Symptom bei einem Kreuzbandriss ist nicht der Schmerz, sondern die sogenannte „subjektive Instabilität“. Die Betroffenen trauen sich nicht mehr schnelle Richtungswechsel durchzuführen oder sich schnell umzudrehen. Manche haben das Gefühl, auf wackeligen Stelzen zu gehen. Ein Kreuzbandriss kann auch einfach übersehen werden, wenn der Patient keine Schmerzen verspürt und die Schwellung sich moderat darstellt.
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