What is knee surgery?
Knee surgery is a surgical procedure on the knee joint. There is a huge amount of operations that can be performed in this area of the body. The aim is always to minimize and repair cartilage damage through surgery. Surgery on the meniscus, cruciate ligament or other part of the knee also falls under the category of knee surgery. Knee surgery is therefore a general generic term for all surgical procedures that can be performed around the knee joint.
The aim of knee surgery is to restore mobility and resilience as quickly as possible and to achieve freedom from pain and symptoms.
How is the knee joint structured?
The knee joint is one of the largest joints in the human body. It connects the thigh to the lower leg and ensures that we can move from A to B with our legs. Therefore, damage to it is also fatal for movement and limits walking.
The knee joint is formed from just 3 bones:
- femoral (femur),
- Lower leg bone (shin or tibia)
- kneecap (patella)
The construction of the knee joint allows us to bend, stretch and turn something inward or outward. For this reason, the knee joint is also known as the synonym “swivel hinge joint”. If knee surgery is performed, this complex construct must therefore be treated. Knee surgery can therefore cause ever greater damage and associated knee pain.
What knee surgeries are there?
The knee consists of many different parts and joints. Intervening with this complex matter should therefore always be a last resort to preserve the knee. There are various surgical procedures for various injuries and degrees of activity on the knee joint.
The following surgical procedures are performed on the knee joint:
arthroscopy/ knee mirroring/ minimally invasive procedure
arthroscopy And the Knee brace Refer to the same surgical procedure on the knee joint. Because no large incisions are required for this operation, arthroscopy is also known as minimally invasive procedure called. During knee mirroring, an endoscope (camera) is inserted through a minimal incision in the knee or knee joint. In this way, diagnostic and therapeutic findings on the knee joint can be identified.
Cartilage cell transplantation
Cartilage cell transplantation requires a laboratory breeding of your own cartilage. As a result, fresh cartilage can be grown in the laboratory, which is surgically applied to the joint cartilage so that it regenerate Can. Cartilage cell transplantation is used when a transplant needs to be carried out to maintain the function of the shock absorbers. Here Find out more about the topic.
Cruciate ligament surgery
Cruciate ligament surgery is often performed after a torn cruciate ligament. There are various surgical procedures: on the one hand, the cruciate ligament suture, the cruciate ligament replacement or the cruciate ligament plasty. This involves replacing the cruciate ligament with a transplant. As a rule, an endogenous tendon is used for this purpose. The procedure is primarily minimally invasive.
meniscus surgery
For treatment against acute meniscus injury There are a few options that depend on the degree of networking. Is the meniscus tear large, this is often a operative treatment approach recommended. Minor damage can ideally be caused by conservatives treatments be eliminated.
Artificial knee joint
An artificial knee joint should always be the last option to minimize knee damage. In the midst of metal components Will a plastic part screwed. Therefore, this surgery will Ultima ratio called: They are only used to finally save the knee, i.e. only when the joint is already so severely damaged that the broken areas cannot be restored even surgically.
Knee TEP: risks, process and wound healing phase
A prosthesis is the last resort that knee surgery specialists resort to when it comes to knee surgery. In a full prosthesis, the entire knee joint is replaced and there are sled prostheses in which only half of the joint is replaced. Depending on the defect pattern, the sled prosthesis is used when the damage is localized internally or externally. If there is cartilage damage in two areas, a full prosthesis must be inserted.
Fact check: knee prosthesis implantation
Artificial knee joints are made of metal alloy and are implanted with a knee opening as part of a one-hour operation. During this operation, the anterior cruciate ligament is removed in the clinic and it is therefore important that the other guidance structures in the knee joint area are intact. In other words, the inner outer ligament, the posterior cruciate ligament and the so-called anterior extensor (where the kneecap runs).
If there is cartilage damage behind the kneecap, a so-called kneecap replacement is also performed to install a knee prosthesis.
When it comes to knee prosthesis and its natural function, it is important to know that biomechanics are negatively affected by the knee prosthesis. If only because the anterior cruciate ligament must be removed during this operation with the full prosthesis.
In the case of a sled prosthesis, the ligament structure can be preserved. The postoperative outcome of these prostheses is therefore better than with a full prosthesis.
The alpha and omega of knee surgery:
It is important to ensure that the two components are implanted exactly because the upper and lower parts of each body are implanted three times incorrectly in three-dimensional space and if there is a deviation of more than 2 degrees is present, then kneeling will not work as the patient imagined.
Knee tep: This is how the operation works
A knee TEP (TEP = total endoprosthesis) is the complete replacement of the knee joint with an artificial knee joint. As part of knee surgery, the knee is opened on the side of the knee and operated on. The upper and lower legs are shaped according to the shape of the prosthesis. It is recommended to choose a computer-navigated hospital for this process in order to be able to surgically control the incorrect placement and ligament guidance so that no problems arise for the patient postoperatively.
After the individual components have been aligned, cementation is carried out with bone cement: The two metal parts are glued into the bone and a polyethylene meniscus replacement is placed between the two leg parts (a high-quality plastic with little abrasion) implemented. Finally, the patient's knee joint is closed with the new joint replacement and recovery and rehabilitation can then take place.
conclusion
An operation is always a delicate matter that should never be decided lightly. Knee surgery is often the last resort to be able to restore people's quality of life through freedom from pain and mobility. Knee surgery is about relieving patients of knee pain or at least reducing it sustainably.
The use of an artificial knee joint should be used by all Prof. Dr. Med. Be colleagues the last resort out of patients' suffering.
In our arthroprax clinic, surgical intervention is only ever the very last chance to improve your situation. We would be happy to provide you with non-binding advice on all therapies and treatment approaches.
FAQ
How is a meniscus tear treated?
First of all, it depends on the degree of cross-linking of the meniscus tear. The damaged areas of the torn meniscus can be removed or sutured after diagnosis. During removal, the parts of the meniscus frayed by the crack are sheared off. This allows the rough surface of the torn meniscus to be smoothed out. In a few rare cases, the meniscus tear is restored by a transplant, which is sutured and replaced with donor meniscus or biological tissue replacement.
Can a meniscus tear heal by itself?
Whether the meniscus tear can heal by itself is also decided here on the basis of the degree of injury. You should also know that the meniscus contains various zones. Some areas have good blood flow and other regions that are more centered in the knee joint do not.
If the tear is in the well-circulated region of the meniscus and it does not go too deep into the poorly circulated areas, it can heal conservatively.
How long does it take for a meniscus tear to heal?
How long it takes for the meniscus to heal depends on the type and method of treatment and depends on the individual case of one of the patients. The exact type of injury and the location of the crack are decisive. It takes 6 to 14 weeks for the meniscus to heal in most cases.
How quickly does a meniscus tear have to be operated on?
The pain and inability to move can be painful after a meniscus tear. As a rule, the knee can no longer be fully extended or bent. You should therefore see a doctor as soon as possible to discuss the next steps.
What happens if a torn meniscus is not treated?
If you opt out of the recommended meniscus tear treatment, this will necessarily result in cartilage damage and osteoarthritis. The crack is further damaged with every movement until walking is only possible with great difficulty.
FAQ
1. Risks?
Post-operative effect. If this occurs, the inner lining of the prosthesis and joint must be removed. Knee is then rinsed several times and then a “spacer” is inserted (bone cement prosthesis containing an antibiotic). This spacer stays in the body for an average of 6 months; the patient is not allowed to buy for 6 months. After 6 months, it is replaced by a full prosthesis.
2. Complications?
- Improper placement of the prosthesis:
- implants that are too big or too small
Movement restrictions, in the worst case worse after surgery than before.
3. Rehabilitation?
6-7 days KH. There are also rehab facilities or outpatient rehab (4 hours a day in a hospital and treatment there) → but is out of the question for people living alone.
4. Lifespan and durability?
Depends on various factors:
- quality
- medicines
- Gender and burden
- Positioning the load, loose prostheses must be replaced. It is advisable to check every 2 years so that any easing can be seen and prevented.
5th sport?
Biking, swimming, no problem. Stop-and-go sports, both shear forces acting on the knee joint, should be prevented as far as possible.
6. Is the right time for the prosthesis?
This is achieved when the patient says it can't get any worse. After the knee prosthesis has been inserted, the symptoms may be worse than before. If a patient can walk 5 km before surgery, he may only be able to run 500 m after surgery. Therefore, the right time is only when there is no other way out.
7. Duration of sick leave?
They work sedentary work earlier than stressful work. On average, it is 8-12 weeks.
8. How long do you walk with crutches?
After arthroscopy using degenerative procedures, supports must be run for an average of 4 weeks, then, depending on the findings, a splint takes over this function. However, if the meniscus is still implanted or if the upper and lower legs have cartilage damage opposite each other and has been repaired, this period is extended by 6-6 weeks, but depending on the patient's body weight.
9. What should you discuss with a doctor before knee surgery?
As a patient, you should leave the consultation with the feeling that you know that and why surgery may be necessary. This is the only way you can start the operation with a good feeling. Therefore, you should definitely ask what the alternatives to surgery are (and why they might not be an option for you). You should also ask what the possible risks of surgery are — more about this below — and when is the best time for surgery. If you are still unsure after the surgery consultation, get a second opinion.
10. Should I get a second opinion before knee surgery?
Knee surgery should be avoided if it can be avoided. On the one hand, every patient probably prefers to avoid going to the clinic; on the other hand, every operation represents a limited but existing risk that should only be taken when other forms of therapy have been exhausted. This is especially true when it comes to the question of whether an artificial knee joint needs to be inserted.
The knee joint is the joint in the body that is exposed to the greatest load. As a result, problems with the knee joint occur frequently. There are many things you can do to relieve the joint. Avoid knee-straining sports, but knee-saving physical activities and targeted exercises for the knee (physiotherapy); medications, bandages, orthotics — all of this can help reduce pain and relieve and stabilize the knees.
Even when surgery is unavoidable, the use of an artificial knee joint is often not necessary. There are already procedures that can even eliminate extensive cartilage damage with a transplant (cartilage cell transplant).
If an operation is recommended by your attending physician, then it makes sense to obtain a second opinion. Obtaining a second opinion is often also covered by health insurance companies. Of course, there are clear criteria as to when which procedure is to be used. But there are also borderline cases in which different specialists may well have different opinions. So if you want to be sure whether surgery is really necessary in your case, you should definitely get a second opinion from an expert in the field.
But always remember: The risk also represents an opportunity; avoiding one risk can lead to the next. If you refrain from knee joint surgery, this can not only lead to permanent pain and a restriction of mobility in the knee joint and thus quality of life. It can also have repercussions on the leg and hip should the pain cause incorrect strain in the knee.
11. How is the recovery process going?
This question is very individual and cannot be answered in general terms. It depends on the individual case and in particular on the type of surgical procedure. In any case, it will take several weeks before you can walk again without crutches after knee surgery, until you can fully exercise your knee again, usually up to six months, in some cases even 12 months.
In the case of a cartilage cell transplant, for example, the knee is usually able to regain normal strength only one year after the operation. The recovery process for cruciate ligament ruptures also takes a very long time; a full load may take place after six months at the earliest. This is more difficult to assess during meniscus surgery. The healing process can take from one week to six weeks. Whatever knee surgery you have, it is very important that physiotherapy starts immediately after the operation and that the recovery process is well supervised by professionals. Therefore, do not miss the follow-up tests. They contribute to the fact that
Whatever knee surgery you have, it is very important that physiotherapy starts immediately after the operation and that the recovery process is well supervised by professionals. Therefore, do not miss the follow-up tests. They help make the operation worthwhile for you and hopefully you can move (almost) pain-free again.
