What is osteoarthritis?
Osteoarthritis is the wear and tear of joint structures. It usually refers to the destruction of joint cartilage. In principle, this wear and tear can occur on all joints of the human body. However, osteoarthritis is increasingly developing in hip and knee joints.
How does osteoarthritis develop?
Stage 1
A change in pressure in the joint causes the cartilage to soft first (chondromalacia).
Stage 2
The wear develops, the cartilage ruptures and is unable to distribute pressure more poorly. This is where the first pain occurs.
Stage 3
If the defective cartilage is further stressed, the cartilage is increasingly broken down. As a result, the distance between the bones is reduced and the load on the bones increases.
Stage 4
In the final stage, the Cartilage is almost completely broken down and the bones rub directly against each other, causing severe pain for those affected.
symptoms of osteoarthritis
- Severe pain
- Restricted mobility
- puffiness
- Stiffness of the Joint
Causes of Arthrosis
Physicians generally differentiate between primary and secondary osteoarthritis.
Primary osteoarthritis is the wear and tear of a healthy joint for no apparent reason. The cause of primary osteoarthritis is unknown. Favourative factors include:
- overload (physical work, too much physical activity)
- Obesity
- Age
- sustenance
Secondary osteoarthritis is caused by joint injuries. Especially in the case of fractures in the knee and ankle joints, even the smallest axial deviations result in a shift in the pressure load. This burden then results in osteoarthritis.
How is osteoarthritis treated?
conservative
For all forms of osteoarthritis, the rule is “who rests, rusts.” But how should you move when pain limits this?
A detailed therapy concept is required here. This includes correcting the axle position and, if necessary, reducing excess weight. Under guidance, the muscles around the affected joint are strengthened. The focus is on building muscles and thus strengthening the joint-carrying muscles. By strengthening the muscle in this way, the patient's pain can be reduced.
Further strengthening takes place by itself, as reducing pain can increase the patient's activity again. However, patient motivation is important. Because without the patient's cooperation, there is no effective therapy.
If satisfactory results are not achieved as a result of the above mentioned initial measures, the further procedure depends on the age of the patient.
Especially in the initial stages of osteoarthritis, there are good opportunities to regenerate cartilage using the body's own substances without surgery.
Operationally
1. Cartilage induction/cartilage regeneration
In the case of cartilage damage from the third degree onwards, cartilage regeneration can only be carried out through surgery. Our many years of experience show that cartilage induction followed by stem cell therapy from lower abdominal fat achieves the best results in cartilage regeneration. This therapy can be performed on knee and ankle joints.
From the age of 65, cartilage regeneration takes place with high-molecular hyaluronic acid. This therapy can be performed on the shoulder, hip, knee and ankle joints.
2nd joint replacement
If osteoarthritis is in its final stages and all conservative measures have been exhausted, all that remains is joint replacement. Here, the patient should actively approach the doctor. Because anyone who can no longer go about everyday life without pain should address the issue of an artificial joint.
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.
