Zusammenfassend sind eindeutig symptomatische und lokalisierbare Gelenkschäden an Knorpel, Menisken und Bändern erfolgreich operativ durch arthroskopische Techniken und Umstellungsosteotomien gelenkerhaltend therapierbar. Je früher das Stadium der Arthrose ist, umso effektiver ist deren Behandlung. Als Kombinationseingriff ist die Umstellungsosteotomie bei lateralen oder medialen Kompartiment-Arthrosen als knochenerhaltendes Verfahren heute etabliert. Zusammenfassend eignen sich alle beschriebenen Verfahren bei korrekter Indikation und im richtigen Stadium der Arthrose einzeln oder kombiniert angewendet gut, um die Gonarthrose gelenkerhaltend erfolgreich zu therapieren.

Korrespondenzadresse

Dr. med. Erhan Basad

ATOS-Klinik Heidelberg

Zentrum für Hüft- und Knie-Endoprothetik, Regenerative Gelenkchirurgie
Bismarckstraße 9–15

69115 Heidelberg

basad@atos.de

Literatur

1. Neogi T, Zhang Y: Epidemiology of osteoarthritis. Rheum Dis Clin North Am 2013; 39: 1–19

2. Andersen S, Thygesen LC, Davidsen M et al.: Cumulative years in occupation and the risk of hip or knee osteoarthritis in men and women: a register-based follow-up study. Occup Environ Med 2012; 69: 325–330

3. Schienkiewitz A, Mensink GB, Scheidt-Nave C: Comorbidity of overweight and obesity in a nationally representative sample of German adults aged 18–79 years. BMC Public Health 2012;
12: 658

4. Felson DT: Developments in the clinical understanding of osteoarthritis. Arthritis Res Ther 2009; 11: 203

5. Steinhagen J, Kurz B, Niggemeyer O et al.: The pathophysiology of cartilage diseases. Ortop Traumatol Rehabil 2001; 3: 163–168

6. Pollard TC, McNally EG, Wilson DC et al.: Localized cartilage assessment with three-dimensional dGEMRIC in asymptomatic hips with normal morphology and cam deformity. J Bone Joint Surg Am 2010; 92: 2557–2569

7. Evans CH, Mazzocchi RA, Nelson DD et al.: Experimental arthritis induced by intraarticular injection of allogenic cartilaginous particles into rabbit knees. Arthritis Rheum 1984; 27: 200–207

8. Hunt SA, Jazrawi LM, Sherman OH: Arthroscopic management of osteoarthritis of the knee. J Am Acad Orthop Surg 2002; 10: 356–363

9. Aichroth PM, Patel DV, Moyes ST: A prospective review of arthroscopic debridement for degenerative joint disease of the knee. Int Orthop 1991; 15: 351–355

10. Goldman RT, Scuderi GR, Kelly MA: Arthroscopic treatment of the degenera-tive knee in older athletes. Clin Sports Med 1997; 16: 51–68

11. Reichenbach S, Rutjes AW, Nuesch E et al.: Joint lavage for osteoarthritis of the knee. Cochrane Database Syst Rev 2010;CD007320

12. Hempfling H: Intra-articular hyalu-
ronic acid after knee arthroscopy: a two-year study. Knee Surg Sports Traumatol Arthrosc 2007; 15: 537–546

13. Buckwalter JA: Articular cartilage injuries. Clin Orthop Relat Res 2002; 21–37

14. Steadman JR, Rodkey WG, Briggs KK et al.: [The microfracture technic in the management of complete cartilage defects in the knee joint]. Orthopade 1999; 28: 26–32

15. Benthien JP, Behrens P: The treatment of chondral and osteochondral defects of the knee with autologous matrix-induced chondrogenesis (AMIC): method description and recent developments. Knee Surg Sports Traumatol Arthrosc 2011; 19: 1316–1319

16. Hangody L, Rathonyi GK, Duska Z et al.: Autologous osteochondral mosaic-plasty. Surgical technique. J Bone Joint Surg Am 2004; 86-A Suppl 1: 65–72

17. Peterson L, Minas T, Brittberg M et al.: Treatment of osteochondritis dissecans of the knee with autologous chondrocyte transplantation: results at two to ten years. J Bone Joint Surg Am 2003; 85-A Suppl 2: 17–24

18. Behrens P, Ehlers EM, Kochermann KU et al.: [New therapy procedure for localized cartilage defects. Encouraging results with autologous chondrocyte implantation]. MMW Fortschr Med 1999; 141: 49–51

19. Behrens P, Bosch U, Bruns J et al.: [Indications and implementation of recommendations of the working group “Tissue Regeneration and Tissue Substitutes” for autologous chondrocyte transplantation (ACT)]. Z Orthop Ihre Grenzgeb 2004; 142: 529–539

20. Minas T, Gomoll AH, Solhpour S et al.: Autologous chondrocyte implantation for joint preservation in patients with early osteoarthritis. Clin Orthop Relat Res 2010; 468: 147–157

21. van der Kraan PM, van den Berg WB: Osteophytes: relevance and biology. Osteoarthritis Cartilage 2007; 15: 237–244

22. Leon HO, Blanco CE, Guthrie TB et al.: Intercondylar notch stenosis in de-
generative arthritis of the knee. Arthroscopy 2005; 21: 294–302

23. Papalia R, Del Buono A, Osti L et al.: Meniscectomy as a risk factor for knee osteoarthritis: a systematic review. Br Med Bull 2011; 99: 89–106

24. Noble J, Hamblen DL: The pathology of the degenerate meniscus lesion. J Bone Joint Surg Br 1975; 57: 180–186

25. Herrlin SV, Wange PO, Lapidus G et al.: Is arthroscopic surgery beneficial in treating non-traumatic, degenerative medial meniscal tears? A five year follow-up. Knee Surg Sports Traumatol Arthrosc 2013; 21: 358–364

26. Petty CA, Lubowitz JH: Does arthroscopic partial meniscectomy result in knee osteoarthritis? A systematic review with a minimum of 8 years’ follow-up. Arthroscopy 2011; 27: 419–424

27. Fauno P, Nielsen AB: Arthroscopic partial meniscectomy: a long-term follow-up. Arthroscopy 1992; 8: 345–349

28. Howell SM: The role of arthroscopy in treating osteoarthritis of the knee in the older patient. Orthopedics 2010; 33: 652