[Clinical results after refixation of proximal hamstring tendon ruptures comparing different anchor systems]. / Klinische Ergebnisse nach Refixation proximaler Hamstring-Sehnen-Rupturen unter Berücksichtigung verschiedener Ankersysteme.

BACKGROUND: Injuries to the hamstring muscles and tendon complex are among the most frequent muscular injuries with proximal hamstring tendon avulsion being a particularly severe form. The surgical treatment of these injuries is superior to conservative management with respect to patient satisfaction, recovery of muscle strength and function as well as return to sport rates. It is therefore the method of choice. OBJECTIVE: Presentation and comparison of the surgical results after treatment with titanium, polyether ether ketone (PEEK) and all suture anchors. MATERIAL AND METHODS: A systematic search was carried out in the PubMed medical database and the results are summarized. RESULTS: All systems exhibit comparable biomechanical properties regarding elongation and ultimate failure load. Tendon repair with these anchors results in good to excellent clinical outcomes and shows high return to sport and low complication rates. Patient satisfaction after hamstring tendon repair is reported to be over 90% and return to sport rate is 80-100%. The muscle strength recovers to 80-90% in comparison to the contralateral side. CONCLUSION: All available anchors systems provide good to excellent clinical outcomes and an explicit advantage for one anchor system could so far not be shown.

[Diagnosis and therapy of chronic patellofemoral instability]. / Diagnostik und Therapie der chronischen patellofemoralen Instabilität.

The chronic patellofemoral instability is a multifactorial disease, which is mostly congenital. Luxation of the patella is mainly atraumatic. Sole conservative treatment is often unsuccessful. Surgical treatment is needed in most cases and requires consideration of all pathologic changes of the patella-stabilizing anatomic structures. Rupture of the medial patellofemoral ligament is almost pathognomonic. In addition, the frontal mechanical axis, rotation of femur and tibia, the trochlear shape, the distance from the tibial tuberosity to the trochlear sulcus and the patellar height play an important role. Often, in addition to soft tissue reconstruction, the bony alignment needs to be corrected. Consideration of risk factors in both adult and adolescent patients is needed to avoid recurrent instability.