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Sehnenmanagement in Praxis und Klinik am Beispiel der Achillessehnentendopathie

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Patientenzentrierte Medizin in Orthopädie und Unfallchirurgie

Zusammenfassung

Die Tendopathie der Achillessehne ist ein multifaktorielles Krankheitsbild, bei dem völlig unterschiedliche Patientengruppen betroffen sind. Die Problematik wird immer noch von vielen Patienten als Entzündung begriffen. Die Behandlungsdauer wird dabei unterschätzt, viele Behandlungsmaßnahmen bleiben ineffektiv. Sehnenprobleme sind degenerative Erkrankungen, die realistische Behandlungszeit beträgt Wochen bzw. Monate. Für die konservative Therapie wird ein multimodales, auf den Patienten zugeschnittenes Behandlungskonzept angeregt, das idealerweise mit einem multiprofessionellen Team umgesetzt werden sollte. Eine operative Therapie ist bei der Mid-portion-Tendopathie der Achillessehne selten notwendig, bei den insertionsnahen Tendopathien jedoch, vor allem bei hohem Leistungsanspruch der Betroffenen, fast unumgänglich. Teilrupturen der Achillessehne werden abhängig vom Umfang des betroffenen Sehnenquerschnitts, der mit dem Funktionsverlust korreliert, konservativ oder operativ behandelt. Komplette Sehnenrupturen werden unter Berücksichtigung des Leistungsanspruchs des betroffenen Patienten unter Beachtung individueller Risikofaktoren behandelt. Um die Funktion der Achillessehne bestmöglich herzustellen, ist die operative Therapie mittels Triple-Bündel-Technik Mittel der Wahl.

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Authors and Affiliations

  1. Sportpraxis Rottal-Inn, Frontenhausener Str. 20, 84140, Gangkofen, Deutschland

    Dr. Frank Weinert

  2. Sehnenzentrum Schweiz, Altius Swiss Sportmed Center, Habich-Dietschy-Str. 5A, 4310, Rheinfelden, Schweiz

    Dr. med. Lukas Weisskopf

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  1. Dr. Frank Weinert
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Correspondence to Frank Weinert .

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  1. Klinik für Orthopädie, Unfallchirurgie und Sportmedizin, Johanna-Etienne-Hospital, Neuss, Germany

    Jörg Jerosch

  2. Leiterin Health Care Initiatives, Zimmer Biomet Deutschland GmbH, Berlin, Germany

    Claudia Linke

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Weinert, F., Weisskopf, L. (2016). Sehnenmanagement in Praxis und Klinik am Beispiel der Achillessehnentendopathie. In: Jerosch, J., Linke, C. (eds) Patientenzentrierte Medizin in Orthopädie und Unfallchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48081-6_36

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