Installation of the knee prosthesis
A knee prosthesis can be made of different materials or can be attached using different surgical methods. Which surgical method is used in an individual case depends on the condition of the joint, the patient’s ability to bear weight and the surgeon. The operation is usually performed by orthopedic specialists, the specialists in this field.
The operation is always performed under anesthesia. Based on the X-rays obtained, the surgeon can design a surgical plan. The size and type of prosthesis as well as the surgical method can thus be determined before the operation begins.
The total duration of the operation is usually less than 2 hours. At the beginning of the operation, the surgeon makes an incision in the middle of the knee joint to gain access to the joint. With the help of special surgical tools, the joint surface can now be adapted to the required prosthesis.
The prosthesis components are now fixed to the previously treated joint surfaces on the bone. After all parts of the prosthesis are fixed in the desired position, the joint is moved again and checked if all movements are feasible. Afterwards, the previously severed tissue is sutured again.
In order to drain off blood and fluid, thin plastic tubes are often placed in the wound, which look out of the wound (a so-called drainage). A bandage is then applied, which can reduce the swelling somewhat.In general, a distinction can be made between a unilateral (i.e. limited to the femur or tibia only) and a bilateral (femur and tibia) prosthesis, as well as the axis-guided prosthesis. In most cases a two-sided prosthesis, also called knee total endoprosthesis (knee TEP), is inserted.
The prosthesis components can be fixed to the bone with cement, cementless or with a combination of both methods. You can find more information on this topic here: Surgery of a knee prosthesisThere are indications which prove that a replacement of the knee joint by an artificial knee joint may become necessary. Below are some indications that may occur in combination and may even reinforce the need for a knee prosthesis.
However, there is no mandatory indication for the installation of a knee prosthesis. Ultimately, the decision must be made individually with the patient. You can find more information on this topic here: Surgery for knee arthrosis
- Considerable pain under stress and/or at rest, whereby all conservative, but also possible operative therapy options were exhausted.
- Possibly associated with increasing movement restrictions (especially: inhibition to stretch the leg)
- Advanced arthrosis, such as retropatellar arthrosis, whose treatment, both conservative and operative-arthroscopic (through arthroscopy), did not result in any improvement.
- Axis malpositions of the leg (bow legs or knock-knees), if a repositioning osteotomy is not considered. (Particular stability is required for extreme knock-knees or bow legs. For this reason a coupled knee prosthesis is usually necessary).
