Orthoplastische Kniechirurgie – Interdisziplinäre Behandlungsansätze von Weichteildefekten im Rahmen der Knieendoprothetik

Zusammenfassung

Komplikationen nach Knie-Totalendoprothese (TEP) führen oftmals zu Revisionsoperationen und langer Hospitalisierung. Sowohl bei bestehenden aber insbesondere auch bei zu erwartenden Haut-Weichteildefekten ist eine interdisziplinäre Behandlung mit frühzeitiger Einbindung der Plastischen Chirurgie essenziell, um ein gutes postoperatives Ergebnis zu erzielen. Aktuell fehlen einheitliche und standardisierte Empfehlungen zum Vorgehen bei komplizierten Knie-Endoprothesen. In dieser Übersichtsarbeit wird daher anhand von drei Fallbeispielen ein standardisierter Therapiealgorithmus für die orthoplastische Interdisziplinarität bei Knie-TEP und Weichteildefekten vorgestellt. Eine enge interdisziplinäre Zusammenarbeit ist aus funktioneller, infektiologischer und sozioökonomischer Sicht unerlässlich. Entsprechende Patienten sollten frühzeitig in interdisziplinären Extremitätenboards vorgestellt und in überregionalen Zentren mit der erforderlichen Expertise und Infrastruktur behandelt werden.

Abstract

Complications following total knee arthroplasty (TKA) frequently require multiple revision surgeries and prolonged hospital stays. In this context, an interdisciplinary treatment strategy–particularly involving plastic surgery–is crucial for managing both existing and anticipated soft tissue defects to ensure optimal postoperative outcomes. Despite the clinical relevance, a notable lack of standardised, evidence-based guidelines remains for the management of such defects after knee arthroplasty. This review proposes a structured treatment algorithm to guide interdisciplinary orthoplastic management of complicated knee arthroplasties. Timely and close collaboration across disciplines is essential–not only from a functional and infectious disease perspective but also in terms of socioeconomic implications. Furthermore, patients should be referred early to interdisciplinary extremity boards and treated in specialised tertiary care centres equipped with the required expertise and infrastructure.

Schlüsselwörter

Orthoplastische Chirurgie - Knieprothese - Rekonstruktion - Interdisziplinäre, plastische Chirurgie

Keywords

interdisciplinary plastic surgery - free flaps - orthoplastic surgery - total knee replacement - reconstruction

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