[Anterior cruciate ligament injury in adults : Diagnostics and treatment]. / Verletzung des vorderen Kreuzbandes beim Erwachsenen : Diagnostik und Therapie.

The anterior cruciate ligament (ACL) together with the posterior cruciate ligament is the central stabilizer of the knee. It stabilizes the tibia against increased anterior translation and internal rotation. With an incidence of 46/100,000 ACL tears are among the most common sports injuries in Germany. New prevention programs can reduce the risk of ACL injuries. Surgical treatment is recommended for young and athletic patients as it can also reduce the risk of further relevant injuries of the meniscus and cartilage. The standard of surgical treatment in Germany is the ACL reconstruction with an autologous tendon graft. In selected cases, the preservation of the ACL by arthroscopic refixation shows good results. Instead of the previously used purely time-based rehabilitation, function-based criteria are increasingly being included in the aftercare.

[Operative treatment of cartilage lesions]. / Operative Therapie von Knorpelschäden.

Cartilage damage is often associated with pain, reduced quality of life and decreased physical performance. In addition, even small cartilage lesions can lead to osteoarthritis. Since young active people are particularly affected, the correct treatment of cartilage damage plays an important role. Operative treatment includes bone marrow-stimulating procedures with or without a matrix, cell-based procedures and osteochondral graft transplantation. The choice of the best procedure depends on the localization, the size and the extent of the cartilage damage. In addition, especially in the treatment of cartilage damage to the lower limbs, the leg axis and loading relationships should be taken into account and possibly treated as well as additional joint instabilities. The following article gives an overview of the available surgical treatment possibilities as well as the correct indications and implementation. It also gives a brief projection of possible further treatment options associated with stem cells.