Knee joint surgery is a basic direction of modern orthopedics. German orthopedic surgeons and specialized prosthetics centers in Germany are on high demand today. According to Federal Service for National Statistics, the number of patients requiring treatment of orthopedic conditions multiplied by 2.5 during the last 25 years.
The most widespread traumas and conditions of knees are:
- Gonarthrosis – arthrosis of knee joint;
- Tear of crucial ligament;
- Meniscal tear;
- Damage of cartilaginous tissue;
- Knee dearticulation.
How knee joint is organized?
When we move during walking and straighten legs or bend, our knee joint is actively working. This is a very flexible connection tissue between the hip and the shin. A healthy knee has the connection of three bones:
- Thighbone (Femur)
- Shin bone (Tibia)
- Knee-cap (Patella)
These bones are covered with smooth cartilaginous tissue in the area of connection and are kept together with the help of ligaments, muscles and tendons. There’s space between bones filled with meniscus that absorb pressure and distribute load evenly.
How knee joint is disrupted?
Disrupt of knee joint can be caused by different reasons. Most often, it is connected with mechanical damage, arthrosis, inborn deficiency in limb development and other rheumatic diseases.
Gradually, cartilaginous tissue of knee joint wears down. Since it cannot regenerate by itself, it wears and disrupts permanently. When the cartilaginous tissue of the knee joint is worn down considerably and bones almost get in contact without being protected by cartilage, every motion causes severe pain.
During such condition, doctors initially prefer traditional knee joint treatment methods. These include physical therapy, wrapping, baths and pain-killers. If these methods don’t bring considerable results, doctors resolve to implantation of an artificial knee joint – patient’s knee joint is replaced by an implant.
What an artificial knee joint is?
An artificial knee joint replaces smooth natural surface of bones composing it. Such implant consists of a thighbone component, meniscus imitator and upper shin bone component. All above mentioned components are designed to bear a high load, which is why high-quality materials are used for production.
The parts for thighbone and shin bone covering are made of metal alloys, mostly – titan or chrome with cobalt. These materials are highly durable and are not typically rejected by human body, just like polyethylene meniscus.
The most demanded knee joint surgeries are:
- prosthetics of knee joint;
- knee cartilage transplantation;
Endoprosthetic surgery on knee joint is the radical surgery approach when joint components are replaced by artificial implants fully or partially.
According to statistics of German orthopaedics and orthopaedic surgery, German medical centers perform about 150.000 surgeries for knee joint replacement.
The surgery of knee joint prosthetics is typically performed in case of complicated arthrosis forms (dysplastic arthrosis, post-trauma arthrosis, osteonecrosis arthrosis) or arthritis (autoimmune arthritis, rheumatoid arthritis). Installed endoprosthesis imitates anatomic knee mechanism and is ideally fixed with the help of cementing polymer material or by usual coalescence of material with bone tissue. The implant consists of metal femoral and tibial components, and a plastic insert imitating cartilage is put between them. All of them are checked for biocompatibility with patient’s body. Endoprosthesis serves to restore normal and painless functionality of the joint.
Types of knee joint prosthetics (replacement)
If only some certain part of knee joint has been damaged, German specialists recommend partial prosthetics. Such operation can be performed with minimally invasive method. Minimally invasive surgery means that a small cut is made and special instruments are used to perform operations with minimal alterations in body tissue.
If knee joint has severely worn, and strong painful sensations persist, replacement of surfaces of knee joint components is required. That’s why the term “superficial prosthetics” is used. Optimal implant size in this case is defined when checking X-ray images and correcting it during implantation.
Specialists use three ways of implant fixation:
- Cemented endoprosthesis of knee joint. Special cement made of artificial components is used to fix implants.
- When hybrid endoprosthesis is fixed, its upper part (the component for the thighbone) is fixed without cement, and its lower part (shin component) is fixed with cement made of artificial components.
- During cement-free prosthetics, all components of artificial knee are fixed without cementing material. With the time being, bone tissue gets fused together with the implant.
Arthroscopy is a minimally invasive or spare operation on knee joint. According to German online statistics collection websites, arthroscopic meniscus and cartilage operations are on the second place after the most widespread surgical procedures in German clinics. Orthopedic surgeons in Germany perform about 305.000 similar operations which proves a high level of their knowledge and professional skills.
Arthroscopy is based on using a special video device – arthroscope. Technically, an arthroscopic operation on a knee joint does not require making big cuts: a few small incisions are made for the instruments to get inside patient’s body. Arthroscope is equipped with lenses and light emitted diodes. Light is shot via an optic fiber wire, knee space is lightened, and camera transmits video signal on computer screen. Precision of the picture reaches 95-100% which allows the surgeon to make the right joint analysis and plan the future actions.
This technology has the following advantages:
- the surgery does not cause trauma;
- it allows making a precise and high-quality diagnosis of knee;
- rehabilitation period shortens considerably (3-4 months maximum);
- it helps to save money.
Indication for the procedure:
- Pathologic defects of cartilage.
- Chronic instability of knee cap.
- Meniscus damage.
- Inflammation of synovial membrane caused by unknown reasons.
- Spontaneous aseptic necrosis, intra-articular bodies, etc.
Keyhole surgery on knee cap is used torn o solve various problems starting from knee cap cleaning and finishing by reconstruction of torn ligaments.
Knee cartilage replacement
Replacement or transplantation is a modern operation on a knee joint during which all damaged cartilage areas are repaired with transplants (artificially grown cartilage corpuscles). About 10 mln people in Germany suffer from chronic knee pains, and 2.5 mln people experience pain because of knee cartilage tissue damage.
Transplantation of knee joint requires removal of pathological cartilage parts. At the next stage, healthy cartilage cells are punctured to be cultivated in laboratory conditions. Within a few weeks, the multiplied cartilage area will transform into the defected area. For the transplant to be connected with the bone, it is placed on a special carrier that allows acquiring more voluminous form in the future. When cartilage corpuscles take roots, they start multiplying and grow actively. Therefore, new cartilage tissue forms. Such bioelements are fixed with thin fibers – tiny dissolvable pins. After the procedure, painful sensations disappear, a person can control motions better and return to everyday activities. Transplantation surgery on knee joint is effective in case of osteochondritis dissecans, age-related cartilage changes (loss of elasticity), and severe inflammations.
Arthrotomy is an invasive knee surgery. A cut is made by special instruments to get into the joint and fix displaced meniscus, remove foreign objects, and cure old and inborn disarticulations. Arthrotomy surgery on knee joint is efficient for treating infections and purulence in knee. All cuts are made according to minimally invasive techniques, and joints are treated very carefully.
If you need to go through a surgery on a knee joint (damage of crucial ligament, degenerative disorders or pathological disorders that have affected meniscus), our orthopedic clinic can help patients to solve problems with joints with the help of advanced techniques and methods.
If you have any questions or want to draw up an application for treatment in one of the above mentioned clinics, please use feedback form or call us 49 (7221) 39.65.785.