Knee arthroplasty is a specialization in orthopaedics and involves fitting a patient with an artificial knee joint. Knee arthroplasty specialists have various knee prostheses to choose from, depending on the existing disease and treatment purposes. A knee prosthesis is a customized therapy that can restore mobility and quality of life!
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Doctors who have been awarded the seal are medical facilities that have been certified as an EndoProstheticsCenter (EPC) or as an EndoProstheticsCenter of Maximum Care (EPCmax) via endocert and have therefore demonstrated compliance with the requirements set out in an audit. Recertification is required every three years.
The criteria, requirements and differences between EPZ and EPZmax can be found here.
Knee arthroplasty is the insertion of an artificial knee joint(knee prosthesis). Depending on how much of the joint is replaced, it is either referred to as a total knee arthroplasty (also known as knee TEP ), i.e. the entire joint surface is replaced by an artificial implant, or as a partial arthroplasty, when only part of the joint is removed and replaced with foreign materials.
The human knee joint involves the femur and tibia as well as the kneecap. These bones are connected to each other via tendons and ligaments(cruciate ligaments, medial and lateralcollateral ligaments, quadriceps tendon, patellar ligament) and thus provide the knee joint with the necessary stability. The surfaces of the femur and tibia involved in the knee joint are located in the joint capsule, which is filled with synovial fluid. Thesynovial fluid (synovia) serves to nourish the cartilage layers on the bone, which on the one hand prevent direct bone contact and on the other, together with the two menisci, function as a kind of shock absorber in the event of vibrations.
Due to this complex structure of the human knee joint and the special mechanical demands placed on an artificial knee joint, the implantation of an artificial joint in the knee is very demanding.
As a result of rheumatic diseases (e.g. joint inflammation, known as rheumatoid arthritis), severe obesity, malalignment(knock knees, bow legs), deformities or after injuries (post-traumatic arthritis), the cartilage, menisci and then the bone surfaces involved in the joint can be destroyed. This process is called osteoarthritis, i.e. wear and tear of the joint that goes beyond the normal level. In contrast to localized cartilage damage, the entire joint is more or less affected.
If osteoarthritis occurs in the knee, it is referred to as gonarthrosis . Whenever the joint wear is so advanced that conservative therapies or joint-preserving operations no longer help, a joint replacement is considered.
However, if there is no radiologically confirmed knee osteoarthritis or if the existing osteoarthritis hardly causes any pain that limits everyday life, knee prosthesis implantation should initially be avoided.
Injuries to the ligamentous apparatus can impair the stability of the knee joint to such an extent that it leads to increased wear of the joint, i.e. osteoarthritis develops, which also makes a knee joint prosthesis necessary. Bone tumors or comminuted fractures (broken bones) can also make it necessary to insert a knee endoprosthesis.
If osteoarthritis or other changes or diseases of the knee joint are suspected based on the patient's symptoms and medical history (patient questioning), the bony conditions and leg axis can be assessed very well using an X-ray examination. In addition, magnetic resonance imaging(MRI) can be used to visualize the joint cartilage, the menisci and the ligamentous apparatus.
Ultrasound examination(sonography) allows the soft tissue and fluid-filled spaces (joint capsule) to be visualized. In rare cases, bone scintigraphy is used to examine the bone area below the cartilage more precisely. Depending on where and in what quantity an administered substance accumulates, conclusions can be drawn about the degree of destruction of the cartilage and any incipient bone damage.
In order to be able to use specially manufactured prostheses, the exact anatomical measurements of the affected leg are determined using computer tomography prior to a knee joint operation. The computer then creates a three-dimensional image of the knee joint, which is used as a model for the actual customized knee endoprosthesis manufactured for each individual patient.
In principle, surgeons only try to replace as much of the knee joint surface as the condition requires. They therefore insert a smaller or larger endoprosthesis depending on the extent of the cartilage and bone destruction(stage-appropriate knee arthroplasty).
In addition to selecting the right type of prosthesis, the range of services offered by a knee arthroplasty specialist includes the following methods:
Individual prosthesis solutions that are precisely tailored to the patient and manufactured using the 3D process are considered to be particularly innovative and promising. These individual prostheses are available as partial and total endoprostheses.
The modern prosthesis design, which is adapted to the patient's individual anatomy, has been proven to come much closer to the individual biomechanics of the knee joint to be replaced than conventional knee endoprostheses and has an uncompromisingly precise fit.
Knee arthroplasty experts are usually specialists in orthopaedics and trauma surgery with many years of surgical experience in knee surgery and arthroplasty. They can reliably diagnose osteoarthritis of the knee joint and other diseases and then select the most suitable treatment method (conservative or surgical) for the patient. Through certifications (country-specific), they guarantee a high quality of surgical care.
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