7.11.2018

Osteoarthritis: When do I need an artificial knee joint?

Artificial joints enable many millions of osteoarthritis patients in Germany to move painlessly. The decision to the artificial knee joint but wants to be well considered. Therefore, the doctor and the patient must discuss together before surgery what results are realistic. A patient guideline co-designed by those concerned describes the criteria that should be considered before joint replacement. Experts will speak at a press conference in the run-up to the German Congress of Orthopedics and Traumatology (DKOU) 2018 on October 17 in Berlin. The Arthrosetag, which takes place as part of the DKOU in Berlin, provides information about current treatment options.

If joint wear in the knees progresses, it can mean unbearable pain for the person affected. Familiar activities such as walking, shopping, working or driving are torture - many sufferers are dependent on the help of relatives in everyday life. Patients then face the difficult question: Articular joint - yes or no? A knee endoprosthesis can bring the desired pain relief. Although joint replacement is one of the most successful procedures in orthopedics and trauma surgery, 10 to 20 percent of patients are dissatisfied with the result. "This is mainly because they place very high expectations on the life after the operation, which unfortunately we can not always meet," says Professor Dr. med. Dr. med. Werner E. Siebert, who heads the DKOU 2018 as Congress President for the German Society for Orthopedics and Traumatology. "Depending on the severity of osteoarthritis and possible concomitant diseases, the patient will have to live with restrictions even after joint replacement," said the specialist.

"It is all the more important that patients have a say in the decision for or against joint replacement," emphasizes Professor Dr. med. med. Erika Gromnica-Ihle of the German Rheumatism League. Together with the DKOU 2018, the Hilfsgemeinschaft is organizing the Arthrosetag for the tenth time. "It is well known that the expectations of surgery differ from doctors and patients," says the expert. Therefore, patient representatives were also involved in the preparation of the new guideline "Indication for knee endoprosthesis". The guideline provides scientifically proven recommendations to educate patients about the criteria for joint surgery and help them decide.

The guideline identifies four main criteria that should be met for a knee endoprosthesis:

  • The pain has been present for at least 3 to 6 months and occurs either permanently or several times a week during exercise.
  • The damage to the joint must be clearly visible on the radiograph.
  • Medication and non-medical measures such as exercise and physiotherapy can no longer sufficiently relieve the pain over a period of 3 to 6 months.
  • The pain so severely restricts the patient in daily life that he is no longer prepared to accept it.

In addition to these main criteria, some secondary criteria can be considered, such as how far the patient can go without a break, stand or climb stairs, whether he can still carry out his job or household activities and to what extent he depends on the help of others. "The important thing is that the doctor informs the patient about the likelihood that surgery will improve on these points," says the expert. It is also important to consider risks that may worsen the course and outcome of the operation, for example, if the patient is frail or has comorbidities. "Only when all these points are considered, the patient can come to a self-determined decision," said the expert. The patient guideline "Indication knee endoprosthesis" is available free of charge on the internet.

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