Zum Hauptinhalt springen

Kreuzbandverletzung, vorderes Kreuzband

Zuletzt bearbeitet: Zuletzt revidiert:
Zuletzt revidiert von:


Definition:
Die Ruptur des vorderen Kreuzbands kann isoliert auftreten, häufig aber mit anderen Begleitverletzungen des Kniegelenks.
Häufigkeit:
In Deutschland treten etwa 50.000 VKB-Rupturen pro Jahr auf.
Symptome:
Eine akute Verletzung verursacht Schmerzen, Schwellungen, Funktionsverlust und ein Instabilitätsgefühl im Kniegelenk.
Befunde:
Bewegungseinschränkung, Schwellung, Hämarthrosbildung, Instabilität.
Diagnostik:
Klinische Untersuchung aller Strukturen des Kniegelenks, Röntgen in 2 Ebenen und MRT.
Therapie:
Bei jungen, sportlich aktiven Patienten in der Regel operative Rekonstruktion, bei geringem Anspruch ans Kniegelenk konservatives Prozedere möglich.
  • Deutsche Gesellschaft für Unfallchirurgie. Vordere Kreuzbandruptur, AWMF-Leitlinie Nr.012-005. S1, Stand 2018. www.awmf.org 
  • Deutsche Gesellschaft für Unfallchirurgie. Hintere Kreuzbandruptur, AWMF-Leitlinie 012-029. S1, Stand 2018. www.awmf.org 
  • AWMF Arbeitsgem. der Wiss. Medizin. Fachgesellschaften. S3-Leitlinie Prophylaxe der venösen Thromboembolie. AWMF-Leitlinie 003-001, Stand 2015. www.amwf.org 
  1. Boden BP, Dean GS, Feagin JA, et al. Mechanisms of anterior cruciate ligament injury. Orthopedics. 2000;23:573-578. PubMed  
  2. Cimino F, Volk BS, Setter D. Anterior cruciate ligament injury: diagnosis, management, and prevention. Am Fam Physician 2010; 82: 917-22. American Family Physician  
  3. Deutsche Gesellschaft für Unfallchirurgie. Hintere Kreuzbandruptur. AWMF-Leitlinie 012-029. Stand 2018. www.awmf.org  
  4. Myklebust G, Engebretsen L, Brækken IH, et al. Prevention of Anterior Cruciate Ligament Injuries in Female Team Handball Players: A Prospective Intervention Study Over Three Seasons. Clin J Sport Med 2003; 13(2): 71-8. www.ncbi.nlm.nih.gov  
  5. Deutsche Gesellschaft für Unfallchirurgie. Vordere Kreuzbandruptur, AWMF-Leitlinie Nr.012-005, Stand 2018, www.awmf.org  
  6. Myklebust G, Maehlum S, Holm I, et al. A prospec- tive cohort study of anterior cruciate ligament injuries in elite Norwegian team handball. Scand J Med Sci Sports 1998; 8(): 149-53. www.ncbi.nlm.nih.gov  
  7. Shimokochi Y, Shultz SJ. Mechanisms of noncontact anterior cruciate ligament injury. J Athl Train 2008; 43: 396-408. PubMed  
  8. Myer GD, Ford KR, Paterno MV, Nick TG, Hewett TE. The effects of generalized joint laxity on risk of anterior cruciate ligament injury in young female athletes. Am J Sports Med 2008; 36: 1073-80. PubMed  
  9. Myer GD, Ford KR, Barber Foss KD, Liu C, Nick TG, Hewett TE. The relationship of hamstrings and quadriceps strength to anterior cruciate ligament injury in female athletes. Clin J Sport Med 2009; 19: 3-8. PubMed  
  10. Bjordal JM, Arnly F, Hannestad B, Strand T. Epidemiology of anterior cruciate ligament injuries in soccer. Am J Sports Med 1997; 25: 341-5. PubMed  
  11. Slauterbeck JR, Hickox JR, Beynnon B, et al. Anterior cruciate ligament biology and its relationship to injury forces. Orthop Clin North Am. 2006;37:585-591. PubMed  
  12. Spindler KP, Wright RW. Clinical practice. Anterior cruciate ligament tear. N Engl J Med 2008; 359: 2135-42. New England Journal of Medicine  
  13. Benjaminse A, Gokeler A, van der Schans CP. Clinical diagnosis of an anterior cruciate ligament rupture: a meta-analysis. J Orthop Sports Phys Ther. 2006;36:267-288. PubMed  
  14. Scholten RJPM, Opstelten W, van der Plas CG, Bijl D, Devillé WLJM, Bouter LM. Accuracy of physical diagnostic tests for assessing ruptures of the anterior cruciate ligament: A meta-analysis. J Fam Pract 2003; 52: 689-94. PubMed  
  15. Solomon DH, et al. The rational clinical examination. Does this patient have a torn meniscus or ligament of the knee? Value of the physical examination. JAMA 2001; 286: 1610-20. Journal of the American Medical Association  
  16. AWMF Arbeitsgem. der Wiss. Medizin. Fachgesellschaften. S3-Leitlinie Prophylaxe der venösen Thromboembolie. AWMF-Leitlinie 003-001, Stand 2015. www.awmf.org  
  17. Toanen C, Demey G, Ntagiopoulos PG, et al. Is There Any Benefit in Anterior Cruciate Ligament Reconstruction in Patients Older Than 60 Years. Am J Sports Med 2017; 45(4): 832-7. www.ncbi.nlm.nih.gov  
  18. Cohen PH, . Anterior cruciate ligament injury. BMJ Best Practice, last updated March 2018 bestpractice.bmj.com  
  19. Sanders TL, Kremers HM, Bryan AJ, et al. Is Anterior Cruciate Ligament Reconstruction Effective in Preventing Secondary Meniscal Tears and Osteoarthritis?. Am J Sports Med 2016; 44(7): 1699-707. www.ncbi.nlm.nih.gov  
  20. Herbort M, Glasbrenner J, Michel P, et al. Aktuelle Techniken zur operativen Versorgung der Ruptur des vorderen Kreuzbandes.. Sports Orthopaedics and Traumatology Sport-Orthopädie - Sport-Traumatologie 2017; 33: 367-78. doi.org  
  21. Freedman KB, D'Amato MJ, Nedeff DD et al. Arthroscopic anterior cruciate ligament reconstruction: a metaanalysis comparing patellar tendon and hamstring tendon autografts. Am J Sports Med 2003; 31: 2-11. PubMed  
  22. Eriksson K, Anderberg P, Hamberg P et al. A comparison of quadruple semitendinosus and patellar tendon grafts in reconstruction of the anterior cruciate ligament. J Bone Joint Surg 2001; 83B: 348-54. www.ncbi.nlm.nih.gov  
  23. Kohl S, Evangelopoulos DS, Schär MO, et al. Dynamic intraligamentary stabilisation: initial experience with treatment of acute ACL ruptures. Bone Joint J 2016; 6: 793-8. www.ncbi.nlm.nih.gov  
  24. Jia ZY, Zhang C, Cao SQ et al. Comparison of artificial graft versus autograft in anterior cruciate ligament reconstruction: a meta-analysis. BMC Musculoskelet Disord. 2017; 18(1): 309. pmid:28724372 PubMed  
  25. Janko M, Voth M, Frank J, Marzi I. Sporttraumatologische Besonderheiten am Knie im Kindesalter. OUP 2015; 6: 286–292 DOI 10.3238/oup.2015.0286–0292 www.online-oup.de  
  26. Ramski DE, Kanj WW, Franklin CC, et al. Anterior cruciate ligament tears in children and adolescents: a meta-analysis of nonoperative versus operative treatment. Am J Sports Med. 2014; 42: 2769-76. doi: 10.1177/0363546513510889 DOI  
  27. Hildebrandt C, Müller L, Zisch B, et al. Functional assessments for decision-making regarding return to sports following ACL reconstruction. Part I: develop- ment of a new test battery. Knee Surg Sports Traumatol Arthrosc 2015; 23: 1273–1281. www.ncbi.nlm.nih.gov  
  28. Kim YS, Chung SW, Kim JY, et al. Is early passive motion exercise necessary after arthroscopic rotator cuff repair? Am J Sports Med 2012; 40: 815-21. PubMed  
  29. Grant JA, Mohtadi NG, Maitland ME, Zernicke RF. Comparison of home versus physical therapy-supervised rehabilitation programs after anterior cruciate ligament reconstruction: a randomized clinical trial. Am J Sports Med 2005; 33: 1288-97. PubMed  
  30. Bahr R. Sports medicine. Recent advances, Clinical revirew . BMJ 2001; 323: 328-31. PubMed  
  31. Gilchrist J, Mandelbaum BR, Melancon H, et al. A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players. Am J Sports Med 2008; 36: 1476-83. PubMed  
  32. Hanzlíková I, Richards J, Tomsa M, et al. The effect of proprioceptive knee bracing on knee stability during three different sport related movement tasks in healthy subjects and the implications to the management of Anterior Cruciate Ligament (ACL) injuries. Gait Posture 2016; 48: 165-70. www.ncbi.nlm.nih.gov  
  33. Harilainen A, Sandelin J, Vanhanen I, et al. Knee brace after bone-tendon-bone anterior cruciate ligament re- construction. Randomized, prospective study with 2-year follow-up. Knee Surg Sports Traumatol Arthrosc 1997; 5: 10-13. www.ncbi.nlm.nih.gov  
  34. Gagnier JJ, Morgenstern H, Chess L. Interventions designed to prevent anterior cruciate ligament injuries in adolescents and adults: a systematic review and meta-analysis. Am J Sports Med 2012 Sep 12. PMID: 22972854. PubMed  
  35. Øiestad BE, Engebretsen L, Storheim K, Risberg MA. Knee osteoarthritis after anterior cruciate ligament injury. A systematic review. Am J Sports Med 2009; 08: 1434-43. doi:10.1177/0363546509338827 DOI  
  36. Ajuied A, Wong F, Smith C, et al. Anterior cruciate ligament injury and radiologic progression of knee osteoarthritis: a systematic review and meta-analysis. Am J Sports Med. 2014;42(9):2242-52. doi: 10.1177/0363546513508376. www.ncbi.nlm.nih.gov  
  37. Ardern CL, Webster KE, Taylor NF, et al. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med. 2011;45:596-606. PubMed  
  38. Gammons M. Anterior cruciate ligament injury. Medscape, last updated Oct 06, 2014. emedicine.medscape.com  
  39. Salmon L, Russell V, Musgrove T, Pinczewski L, Refshauge K. Incidence and risk factors for graft rupture and contralateral rupture after anterior cruciate ligament reconstruction. Arthroscopy 2005; 21: 948-57. PubMed  
  40. Sommerlath K, Odensten M, Lysholm J. The late course of acute partial anterior cruciate ligament tears. Clin Orthop 1992; 152-8. www.ncbi.nlm.nih.gov  
  • Lino Witte, Dr. med., Arzt in Weiterbildung, Innere Medizin, Frankfurt
  • Ingard Løge, spesialist allmennmedisin, universitetslektor, institutt for sammfunsmedisinske fag, NTNU, redaktør NEL
  • Arild Aamodt, overlege/professor, Ortopedisk avdeling, Lovisenberg Sykehus, Oslo