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Dennoch ist die Rolle der Quadrizepsmuskulatur bei Patienten mit patellofemoraler Instabilit\u00e4t vor und nach einer patellofemoralen Stabilisierung mittels MPFL-Plastik bislang nicht vollst\u00e4ndig gekl\u00e4rt. Die vorliegende Studie untersucht den Einfluss der Quadrizepsmuskulatur auf den patellofemoralen Kontaktmechanismus bei Patienten mit strecknaher patellofemoraler Instabilit\u00e4t (PFI) vor und nach einer operativen patellofemoralen Stabilisierung mittels MPFL-Plastik anhand von statisch-dynamischen 3\u2011Tesla MRT-Datens\u00e4tzen in fr\u00fchen Beugegraden (0\u201330\u00b0).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methoden<\/jats:title>\n                <jats:p>In dieser prospektiven Kohortenstudie wurden 15\u00a0Patienten mit strecknaher PFI vor und 11\u202f\u00b1\u20095\u00a0Wochen nach einer isolierten MPFL-Rekonstruktion und 15\u00a0Probanden mit gesunden Kniegelenken mittels dynamischen MRT-Scans untersucht. Die MRT-Scans wurden in einer individuell angefertigten pneumatischen Kniebelastungsvorrichtung zur Bestimmung der patellofemoralen Knorpelkontaktfl\u00e4che (CCA) mit und ohne Quadrizepsaktivierung (50\u202fN axiale Last) durchgef\u00fchrt. Vergleichende Messungen wurden anhand von 3D-Knorpel- und Knochen-Meshes in 0\u201330\u00b0\u00a0Kniebeugung an den Patienten mit patellofemoraler Instabilit\u00e4t pr\u00e4- und postoperativ und an den kniegesunden Probanden durchgef\u00fchrt.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ergebnisse<\/jats:title>\n                <jats:p>Die pr\u00e4operativ ermittelte patellofemorale CCA von Patienten mit strecknaher PFI betrug 67,3\u202f\u00b1\u200947,3\u202fmm<jats:sup>2<\/jats:sup> in 0\u00b0-Flexion, 118,9\u202f\u00b1\u200956,6\u202fmm<jats:sup>2<\/jats:sup> in 15\u00b0-Flexion und 267,6\u202f\u00b1\u200996,1\u202fmm<jats:sup>2<\/jats:sup> in 30\u00b0-Flexion. Unter aktivierter Quadrizepsmuskulatur (50\u202fN) zeigte sich eine Kontaktfl\u00e4che von 72,4\u202f\u00b1\u200945,9\u202fmm<jats:sup>2<\/jats:sup> in Streckung, 112,5\u202f\u00b1\u200954,9\u202fmm<jats:sup>2<\/jats:sup> in 15\u00b0\u00a0Beugung und 286,1\u202f\u00b1\u200992,7\u202fmm<jats:sup>2<\/jats:sup> in 30\u00b0\u00a0Beugung ohne statistische Signifikanz im Vergleich. Die postoperativ bestimmte CCA ergab in 0\u00b0, 15\u00b0 und 30\u00b0-Flexion 159,3\u202f\u00b1\u200951,4\u202fmm<jats:sup>2<\/jats:sup>, 189,6\u202f\u00b1\u200962,2\u202fmm<jats:sup>2<\/jats:sup>  und 347,3\u202f\u00b1\u200952,1\u202fmm<jats:sup>2<\/jats:sup>. Unter Quadrizepsaktivierung mit 50\u202fN zeigte sich eine CCA in Streckung von 141,0\u202f\u00b1\u200963,8\u202fmm<jats:sup>2<\/jats:sup>, 206,6\u202f\u00b1\u200967,7\u202fmm<jats:sup>2<\/jats:sup> in 15\u00b0\u00a0und 353,5\u202f\u00b1\u200964,6\u202fmm<jats:sup>2<\/jats:sup> in 30\u00b0\u00a0Beugung, ebenso ohne statistischen Unterschied im Vergleich zur unbelasteten CCA. Bei Probanden mit gesunden Kniegelenken zeigt sich bei 30\u00b0\u00a0Beugung ein Zuwachs der CCA von 10,3\u202f% (<jats:italic>p<\/jats:italic>\u202f=\u20090,003).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Schlussfolgerung<\/jats:title>\n                <jats:p>Obwohl sich die patellofemorale CCA nach MPFL-Plastik bei Patienten mit strecknaher patellofemoraler Instabilit\u00e4t signifikant vergr\u00f6\u00dfert, zeigt sich weder pr\u00e4- noch postoperativ ein signifikanter Einfluss der Quadrizepsmuskulatur.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00132-023-04413-2","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T16:02:17Z","timestamp":1691769737000},"page":"834-842","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Einfluss der Quadrizepsmuskulatur auf den patellofemoralen Kontaktmechanismus bei Patienten mit strecknaher patellofemoraler Instabilit\u00e4t nach MPFL-Rekonstruktion","Influence of the quadriceps muscles on the patellofemoral contact  in patients with low flexion patellofemoral instability after MPFL reconstruction"],"prefix":"10.1007","volume":"52","author":[{"given":"Markus","family":"Siegel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elham","family":"Taghizadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Fuchs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Maier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hagen","family":"Schmal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Lange","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tayfun","family":"Yilmaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans","family":"Meine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaywan","family":"Izadpanah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,8,11]]},"reference":[{"key":"4413_CR1","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/BF01552649","volume":"2","author":"H Dejour","year":"1994","unstructured":"Dejour\u00a0H, Walch\u00a0G, Nove-Josserand\u00a0L, Guier\u00a0Ch (1994) Factors of Patellar Instability: An Anatomic Radiographic Study. 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