Introduction
If knee arthrosis is present, it may be necessary to perform surgery. This is the case when all conservative measures to treat joint degeneration are no longer effective and the suffering of the affected person can no longer be further improved by them. These include above all the use of painkillers such as NSAIDs as well as heat and cold treatments. There are a number of surgical procedures that are used for knee arthrosis: The operation can be minimally invasive or open, corrections can be made to the existing joint or a knee prosthesis can be inserted.
Operative therapy of knee arthrosis
General indication criteria include
- Etiology (cause) of the arthrosis, stage of the disease, previous course,
- Pain, suffering
- Other joint diseases
- Age, general condition and accompanying diseases
- Compliance (cooperation and motivation of the patient), work situation, social status, activity level of the patient
Frequent surgical procedures on the knee
In principle, the following procedures are possible:
- Arthroscopy (open if necessary)
- Artificial knee joint
- Adjustment osteotomy (correction of the joint axis, e.g. knock-knees, bow legs) etc.
The knee arthroscopy
Knee arthroscopy (joint endoscopy) is not only used for diagnosis but also for therapy. It is a surgical procedure in which 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 arthrosis can be assessed.
Knee arthroscopy as a diagnostic procedure has, however, been replaced by MRI of the knee joint, which is a non-invasive method of visualizing the knee very well. It is, however, useful from a therapeutic point of view, since it is a minimally invasive procedure and thus involves relatively low surgical risks. A probe is inserted into the knee joint through two small incisions (approx.
3mm in size). Through this probe, various instruments can be introduced into the knee joint, which can be used, for example, to rinse the joint and remove chipped pieces of cartilage in cases of existing knee arthrosis. It is also possible to remove bone excrescences that occur in advanced knee arthrosis.
Knee arthroscopy is performed either on an outpatient or inpatient basis. The patient should be fasting for this procedure and should not smoke. Since it is a minimally invasive procedure, the risks associated with arthroscopy are much lower than those associated with open knee surgery.
Nevertheless, arthroscopy is an operation and there are risks about which the treating physician must inform his patient. For example, arthroscopy is also performed under general or regional anesthesia (e.g., anesthesia of the knee), and thus involves all the side effects that anesthesia can entail. Side effects such as a drop in blood pressure, muscle cramps and cardiac arrhythmia can occur during the operation.
Nausea and vomiting are possible after the operation. There may also be general risks associated with the operation, including infections in the knee, nerve injury, post-operative bleeding or joint stiffness. Thrombosis is another risk that must be mentioned.
After knee arthroscopy, the doctor should draw up a plan for appropriate follow-up treatment to prevent possible infections. The plan should also include physiotherapy and a further treatment plan for knee arthrosis. The patient should be informed about rules of conduct, such as how much or from when on the knee may be loaded again. The following damage-symptoms-complaints can be remedied and performed during a knee arthroscopy:
- Lavage (rinsing of the knee joint)
- Removal of mechanical irritations
- Synovectomy (removal of the joint mucosa)
- Soft tissue surgery to improve patella guidancePatellar guidance
