Knee osteoarthritis

Knee osteoarthritis is a disease related to degenerate changes of cartilaginous tissue when joint’s bones rub against one another.

Widespread reasons of the disease:

• Extra weight
• Pathologies of the musculoskeletal apparatus which increase load on the joint (scoliosis, osteochondrosis, flatfoot, constant joints diseases etc)
• Excessive physical load (professional sport)

Main symptoms in different stages of the disease are:

1. At stage I arthritis is characterized by pain which appears from time to time. Sometimes it is rather intensive. The is no deformity of joints, there can be slight swelling. Sometimes the first symptom is crunch. It is important to remember that musculoskeletal apparatus rehabilitation requires definite efforts and time. That’s why addressing to the doctor at earlier stages reduces the terms and makes treatment better.
2. At stage II knee arthritis grows progressively worse, pain becomes stronger and appears in case of a minimal load, but disappears after rest. Also, when moving, joints crunch, it is hard to bend a knee because of the more intensive pain. Because of bones deformity, the form of a knee changes, swelling increases as a result of inflammation of synovial membrane (synovitis).
3. At stage III all symptoms become worse: pain becomes stronger to such an extent that it hurts even at rest. A patient tries to find a comfortable position for pain decreasing. A patient always feels “twisting” of the joint. Mobility decreases which leads to the specific walking of a patient on bended knees.

Treatment

At stage I, II we offer conservative treatment which includes magnetotherapy (BTL 6000, superinductive magnet), laser therapy (Hil BTL600), intraarticular injections of platelet-rich plasma and Arthrex SVF (stromal vascular fraction).

At stage III only surgery is required.

In case of arthritis of one compartment we offer a unicompartmental knee replacement (partial replacement) with an implant “Oxford” of the company “Zimmer”.

In case of arthritis of both compartments of a knee a total knee replacement using minimally invasive technique. Surgeries of this type allow patients to have a painless, supple joint and return to a normal life style.

Surgeries are performed with the help of navigation system Aesculap which allows an ideal implanting.

Every patient is individual and requires and individual approach in choosing an implant.

In our clinic we use Aesculap (Germany), Euromed (Germany) and Evolutis (France) implants. Every patient gets a complete after-treatment care (rehabilitation) during his/her stay in the clinic with rehabilitation doctor assistance. In three days a patient is discharged.

Knee Arthroscopy

Indications to arthroscopy:

• Meniscus damage or disruption
• Damage of cartilage and ligaments
• Disruption or damage of a front/back crucial ligament
• Inflammation or damage of synovial membrane; knee trauma; cartilage damage etc.

Treatment

Our clinic offers minimally invasive method of a knee arthroscopy.

Arthroscope and instruments are inserted through the puncture of several millimeters diameter. The joint is filled with liquid, the image is seen on the screen. The damages structures of the joint are detected and their restoration is performed.

In case of a meniscus damage (either lateral or medial), depending on the zone and type of the rupture, partial resection of a damaged part or stitch of a meniscus is performed.

Arthroscopic plastics of an anterior /back crucial ligament

The inner damage of knee ligaments can’t knit on their own due to anatomy and peculiarities of a blood supply. Today the most effective treatment method of intraarticular damages of a knee is plastics of an anterior/back crucial ligaments.

Experienced orthopedic surgeons of the clinic Ligamenta perform arthroscopic plastics of an anterior/back crucial ligaments. This is minimally invasive endoscopic method of a surgery on joints. Arthroscope and instruments are inserted through the puncture of several millimeters diameter. The joint is filled with liquid; the image is seen on the screen.

An anterior crucial ligament restoration

It is performed with help of an autograft from the tendon m. Quadriceps Femoris which is the strongest graft and the most similar on morphology to a natural anterior crucial ligament. Ligament graft is fixed in canals of a femoral and tibia joints with the help of screws. After surgery a knee is fixed in a special hinged bandage which allows to move a knee from the first day after surgery.

A back crucial ligament restoration

It is performed with the help of an autograft from the tendon m. Semitendonosus m. Semimembranosus. Under electro-optical image converter (image intensifier) tunnels in femoral and tibia joints are made. Through tunnels the graft is inserted. Ligament graft is fixed in canals of a femoral and tibia joints with the help of screws. After surgery a knee is fixed in a special bandage.

Corrective osteotomies around knee

Indications to the corrective osteotomy:

• Inborn deformity of lower extremities
• Deformity after diseases (Pedget’s disease, rickets etc)
• Deformity after abnormality of extremities growth (Blount disease, damage of the growth zones at traumas etc)
• Deformities after abnormal jointing after traumas
• Arthrosis damages of one component (lateral or medial) of knee
• Compensation of instability of ligamentous apparatus of knee.

Corrective osteotomies are performed to correct deformities of lower extremities, allow to unload that part of a knee which is the most damaged, and in this way to postpone arthritis progress. These are surgeries during which osteotomies of tibia joint (genu varum) and femoral bone(valgus) are perfomed.

Corrective osteotomies are performed in combination with arthroscopy of a knee. After surgery a patient is allowed a partial load on the post-operative extremity. Corrective osteotomy is performed in such a way: through a small cut a tibia bone in the upper one-third or a femoral bone in the lower one-third intersect; deformity is corrected, and osteotomy zone is fixed in a correct position with a modern fixator. Jointing of osteotomy zone usually takes place in 8-10 weeks. Sport loads are allowed only 6 months after surgery.