Official website of the Academic Hospital Solingen

Knee replacement

Gonarthrosis is a degenerative disease of the knee joint. In this case, there is a complete loss of articular cartilage, which is accompanied by painful limited mobility of the knee joint.

For more information about knee diseases, please visit our website “Knee Joint Diseases”.

Treatment of gonarthrosis is first carried out by conservative methods, such as, physiotherapy and analgesic therapy. If the disease is in a phase that has gone so far that there can be no further treatment for joint preservation, then a total knee replacement is performed. Endoprostheses of the knee joint have already been successfully implanted for 30 years. During this time, this operation has become a standard procedure. The prostheses used were smaller, and more biocompatible and improved from the point of view of mechanics. To date, during the operation, the ligamentous apparatus is preserved, that is, the knee does not lose its leading function. When implanting from the femur and the shinbone, only the surface layers are removed and replaced with caps. Therefore, today this process is called surface replacement.

Depending on the phenomena of aging of the knee joint, there are two basic types of prosthesis:

“Unicompartmental prosthesis”: in this case, we are talking about a prosthesis, by means of which the external or internal side of the joint is replaced.

Directly the substitute of the surface (implant) itself, by means of which all joint surfaces are replaced, including the posterior side of the knee cap.

All types of prostheses are presented in various sizes, which makes it possible to select an individual prosthesis for each individual patient during the operation. Fixation of the implant, as a rule, is performed with the help of cement. For young patients, it is possible to use implants with uncemented use, in which the bones grow to the prosthesis and, thus, connect with it. Implants consist of titanium or alloy of chromium and cobalt. As a sliding part, a polyethylene pad is inserted between the femur and the shinbone. The most important goal of the operation is to remove pain and achieve good mobility by restoring the axis of the lower extremity. Therefore, before the operation, it is necessary to perform the CT scan to determine the extremity axis in order to be able to perform appropriate treatment planning before the operation. During the operation, the damaged parts of the joint are removed with the help of precise instruments, and the new prosthesis of the knee joint is adjusted to a new bone to within a millimeter. It is an opportunity of support using the navigation system when installing the components. After the operation, patients can give full load to the operated leg starting from the first day. Intensive sessions of physiotherapy exercises are conducted in the department or in the treatment pool. After two weeks of treatment in the inpatient department, as a rule, rehabilitation measures should be performed in the outpatient department.



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