Orthopedics-Online

Operation of knee osteoarthritis

introduction

In the presence of a Knee osteoarthritis surgery may be necessary.

This is the case when all conservative measures to treat joint wear and tear no longer show any effect and the suffering of those affected can no longer be improved by this.
These include, above all, taking painkillers such as NSAIDs as well as heat and cold treatments.

There are a number of surgical procedures that are used for knee osteoarthritis:
The procedure can be minimally invasive or open, corrections can be made to the existing joint or a Knee prosthesis can be used.

Surgical therapy of knee osteoarthritis

The general indication criteria include:

etiology (root cause) of the arthrosis, Stage of the disease, previous course,
Pain, Suffering
Other Joint disease
Age, General condition and Concomitant diseases
Compliance (Cooperation and motivation of the patient), work situation, social status, degree of activity of the patient

Common knee surgical procedures

In principle, the following procedures are possible:

Arthroscopy (possibly open)
artificial knee joint
Corrective osteotomy (Correction of the joint axis, e.g. Knock knees, Bow legs) etc.

Appointment with a knee specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The knee joint is one of the joints with the greatest stress.

Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

The knee arthroscopy

A Knee arthroscopy (Jointoscopy) is not only used for diagnostics but also for therapy.
It is a surgical procedure where the doctor inserts a probe into the knee joint. Among other things, a camera is attached to this probe, with which the condition of the knee joint or knee osteoarthritis can be assessed.

The knee arthroscopy as a diagnostic method is, however, from MRI of the knee joint, with which the knee can be visualized very well non-invasively, has been replaced.
From a therapeutic point of view, however, it makes sense, as it is a minimally invasive procedure and arthroscopy therefore involves relatively low surgical risks. Through two small cuts (about 3mm tall) a probe is inserted into the knee joint. This probe can be used to bring various instruments into the knee joint, with which, for example, the joint can be rinsed and splintered pieces of cartilage can be removed in the case of existing knee osteoarthritis.

It is still possible to remove excess bone that occurs in advanced knee osteoarthritis. The knee arthroscopy is performed either on an outpatient or inpatient basis. The patient appears sober for this procedure and should not have smoked if possible.
Since it is a minimally invasive surgery the risks of arthroscopy are much lower than those of open knee surgery.
Even so, arthroscopy is an operation and there are risks that the attending physician must inform his patient about. For example, general or regional anesthesia is also used during arthroscopy (e.g. Numb the knee) and thus has all the side effects that anesthesia can have.

Side effects such as drop in blood pressure, muscle cramps and Cardiac arrhythmias can occur during surgery. Nausea and vomiting are possible after the operation. There can also be general surgical risks, including infections in the knee, damage to the nerves, secondary bleeding or stiff joints.
A thrombosis is another risk that needs to be mentioned. After the knee arthroscopy, the doctor should develop a plan for adequate follow-up treatment to prevent possible infections. The plan should also include physical therapy and another knee osteoarthritis treatment plan. The patient should be informed about rules of conduct, such as how much weight or when the knee may be loaded again.

When is knee arthroscopy used?

With a knee arthroscopy, the following damage / symptoms / complaints can be remedied and carried out:

Lavage (irrigation of the knee joint)
Elimination of mechanical irritations
Synovectomy (removal of the joint lining)
Soft tissue intervention to improve patella / kneecap guidance

The knee prosthesis

If the knee osteoarthritis is very advanced, the cartilage is badly worn and the patient suffers from severe pain that can no longer be contained by therapy, it is possible to completely or partially restore the knee joint Knee prosthesis restore or make resilient.

With knee prostheses, one differentiates between a partial prosthesis and a full knee prosthesis.

The partial denture or surface reinforcement, so-called "Inlays“Are used when the knee osteoarthritis has only partially damaged the joint surfaces. This means that only a small part of the joint that has been damaged by knee osteoarthritis is replaced and the healthy part of the knee is preserved. That is, the healthy ligamentous apparatus (Sidebands and Cruciate ligaments) and healthier cartilage and bone so are not replaced.
This makes the movement of the knee feel more natural to the patient even after the partial denture has been inserted.
In the Full knee prosthesis the entire joint must be replaced. The full denture is used when the knee osteoarthritis is very advanced.
Such a prosthesis generally consists of one Thigh part, one Lower leg part and one Kneecap part. During the operation, all cartilage and bone parts that are injured or destroyed by knee osteoarthritis are first removed and then replaced by the artificial joint parts. The operation can take general anesthetic or Partial anesthesia respectively. The type of anesthesia to be chosen can be decided upon in consultation between the patient and the anesthetist. The latter then explains the risks of the anesthesia in question.

The insertion of partial and full dentures are operations that, like any other procedure, can involve complications. (please refer: Complications of surgery) In addition to a well-performed operation and follow-up treatment, the patient's constitution is also important.
This determines namely with his Age, General condition, body weight, Pre-existing illness and Comorbidities partly the success or the possible complications of an operation.
Thrombosis and a subsequent pulmonary embolism can also be a risk after surgery. After the operation, however, thrombosis is counteracted with medication and physiotherapy exercises. Infections, intra-articular adhesions with restricted mobility of the joint and loosening of the prosthesis can also occur.

In order to prevent loosening of the prosthesis, a two-year x-ray check should be carried out after approx. 5-6 years. All in all, a knee prosthesis can significantly increase the patient's quality of life, since pain is reduced or eliminated and the mobility and resilience of the joint are improved.

Read more on the subject here Operation of a knee prosthesis and general information about the artificial knee joint.

Joint osteotomies

Correction of the axis error near the knee joint (knock knees or bow legs) in order to reduce the mechanical stress on the knee joint and thus delay the progression of osteoarthritis.

Learn more at:

OP on bow legs
Operate knock-knees

In the case of retropatellar arthrosis (arthrosis of the kneecap), after all previous measures have been exhausted, an additional operation on the attachment of the kneecap tendon may be indicated.

Appointment with a knee specialist?

I would be happy to advise you!

The knee joint is one of the joints with the greatest stress.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in: