A total knee endoprosthesis describes a form of prosthesis that represents a complete joint replacement, in this case the knee joint. If the knee joint can no longer be treated conservatively due to illness, wear and tear or injury and if there is irreparable damage, the knee TEP is the best treatment option for returning to a largely symptom-free life. Depending on the cause for the use of a knee TEP, there are different types of prostheses, which are selected individually for each patient and then in the course of an operation.
OP – What is done?
During the operation for a knee TEP, many different processes take place so that the insertion of the prosthesis is as smooth as possible. Depending on the selected prosthesis form, the procedures can differ slightly from each other, which is why the course of the operation is presented in the following in a generalized manner. After the patient has been anaesthetised, a thigh cuff is first used to ensure that the knee is relatively bloodless so that there is no heavy bleeding during the operation.
The knee joint is then opened via a skin incision at the front. To obtain a better overview of the surgical field, various levers are used to hold the knee or soft tissues in position. The kneecap is also folded outwards to the side.
Now the surgeon begins to remove damaged or inflamed tissue. The menisci as well as the anterior cruciate ligament (in some prostheses also the posterior cruciate ligament) are also removed. Once the knee has been prepared, the surgeon begins to work on the bones of the lower and upper leg with special templates (so-called cutting gauges) in such a way that they are adapted to the use of the prosthesis by means of various bone cuts.
A trial prosthesis is used to evaluate the work and to test the function of the inner and outer ligament. Once the prosthesis has been fitted as desired, it is fixed to the bone. Depending on the type of prosthesis, this is either cemented or uncemented. Finally, the femoral cuff is opened to allow blood to circulate freely again. Bleeding is stopped and special drains are inserted to drain the wound fluid (these are pulled 2-3 days after the operation), before the surgical wound is sutured and bandaged with a compression bandage and the patient is transferred to the recovery room.
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