Botulinumtoxin am Bewegungsapparat

Zusammenfassung

Im orthopädisch-unfallchirurgischen Gebiet liegt mit Botulinumtoxin seit nunmehr über 20 Jahren ein effektiver Wirkstoff vor, der es erlaubt, Muskeln selektiv zu schwächen bzw. deren Tonus herabzusetzen. Hieraus ergeben sich für das muskuloskeletale System zahlreiche Behandlungsmöglichkeiten, von denen die gängigen Indikationen in dieser Übersicht unter Einbeziehung der jeweils vorliegenden Studienlage dargestellt werden. Auch für die kommenden Jahre ist mit einer dynamischen Weiterentwicklung zu rechnen. Da es sich wie ausgeführt i. d. R. aber um Behandlungen außerhalb der Zulassung, also um einen „Off-Label-Use“ handelt, ist eine detaillierte Kenntnis der Pharmakokinetik ebenso unabdingbar wie die individuelle Indikationsstellung unter Einbeziehung des aktuellen Wissensstands. Zum Erwerb dieser Kenntnisse sei interessierten Kollegen hierzu eine spezielle Weiterbildung sehr empfohlen.

Abstract

Over the last 20 years, botulinum toxin has proven to be an effective agent in the orthopaedic treatment of musculoskeletal diseases. The author presents a detailed summary of the data on the use of botulinum toxin in different indications. New indications and dosages will be developed in the coming years. As some of the newer indications for botulinum toxin are off-label, its pharmacokinetics must be carefully considered and the indication must be strictly based on current study data. Physicians using this drug should attend special professional courses.

Schlüsselwörter

Botulinumtoxin - myofaziales Schmerzsyndrom - Epikondylitis - Plantarfasziitis - Zerebralparese

Key words

botulinum toxin - myofascial pain syndrome - cerebral palsy - tennis elbow - plantar fasciitis

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