Summary
Once the opoortunity for primary repair of injured knee ligaments after traumatic dislocation has been lost, ligamentous reconstruction is difficult using only autogenic tissues because of the risk of loss of function at the donor site, so other substitutes are needed. The four major ligaments in the unstable knee of a 35-year-old man were reconstructed by solvent-preserved human fascia lata three months after traumatic open dislocation. The clinical results were satisfactory. Arthroscopic examination one year later showed that the reconstructed ligaments had good thickness and tension and were composed of autologous connective tissue without evidence of rejection. The literature on dislocation of the knee and on cruciate ligament reconstruction by allograft was reviewed, and a brief introduction to solvent-preserved human fascia lata was presented. The commercialization of this material has solved some common problems concerned with using allogenic tissues.
Zusammenfassung
Die bisherige Auffassung, eine Bandverletzung des Knies nach traumatischer Dislocation primär zu versorgen, ist verlassen worden. Ligamentäre Rekonstruktion ist schwierig, wenn man nur autogenes Material verwendet, mit dem Risiko der Funktionseinbüßung auf der Spenderseite. Somit müssen andere Materialien gefunden werden. Die 4 großen Bänder in einem instabilen Knie eines 35jährigen Mannes sind nach einer offenen Knieverletzung drei Monate nach dem Trauma durch ein homologenes Fascia lata Transplantat ersetzt worden. Das klinische Resultat war hervorragend. Arthroskopische Kontrolle nach einem Jahr zeigte eine gute Transplantatadaptation und Funktion. Die Literatur wurde dahingehend ergänzt und ein Vorschlag zur Verwendung von Fascia lata Transplantat repräsentiert. Die Verbreitung hat aber einige Probleme gebracht.
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Kobayashi, S., Takei, T., Yagi, R. et al. Reconstruction of the four major ligaments in an unstable knee joint after dislocation by solvent-preserved human fascia lata transplantation. Arch Orthop Trauma Surg 108, 246–249 (1989). https://doi.org/10.1007/BF00936210
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DOI: https://doi.org/10.1007/BF00936210