A knee prosthesis can be used to partially or completely replace a knee whose damaged cartilage no longer provides joint mobility and pain-free support.
When is surgery indicated? When there is incurable wear and tear of the knee joint, which leads to severe pain during exercise and at rest, and this pain significantly limits daily life, the knee joint can be surgically replaced with a prosthesis, which helps reduce pain and improve function.
Surgery technique Under partial or general anesthesia, the knee joint is exposed and the damaged surface of the joint is removed. Depending on the size of the damage, a naturally shaped metal cap replaces the entire surface of the joint or only the most affected part. Fixation can occur with or without bone cement. Sometimes, to eliminate pain, it is necessary to replace the lateral side of the kneecap. For more severe cases, various special prostheses are available.
How is the operation performed? The operation is performed under partial or general anesthesia. The knee joint is released through an incision on the front side, and the diseased parts of the joint surface are removed with special instruments. Then, using special templates, the femur and tibia are prepared one by one and trial prostheses are installed, with which the expected result is checked. Only then are the final components of the prosthesis installed and strengthened. A synthetic attachment (polyethylene) is used as a shock absorber and sliding plane between the main components of the prosthesis. The parts of the prosthesis themselves consist of special, very high-quality metal alloys. With cementless prostheses, the parts adjacent to the bone are made of titanium.
When should you choose a total or partial denture?
During knee arthroplasty, the surgeon may choose to install a total (3-compartment) or partial (1-compartment) prosthesis depending on the condition of the knee joint and ligaments.
- 3-compartment prostheses: Replace all of the damaged knee cartilage (eg, arthrosis) and sometimes require removal of some of the cruciate ligaments. This can be the entire femoral cartilage, and sometimes the patella. There are three-compartment dentures with sliding or hinged joints, the latter being less common.
- Single-compartment dentures: Also known as hemoprostheses or partial dentures, these replace only part of the cartilage of the damaged compartment without touching other knee compartments or ligaments. This may be the internal or external femortobial compartment. They are used for osteoarthritis limited to one compartment. Other compartments and ligaments must not be damaged.
Rice. Single compartment knee joint
Rating of knee pads for arthrosis
A knee brace is also called a bandage or orthosis for fixing and stabilizing the knee joint, supporting the balance of the lateral ligaments and meniscus. The list of manufacturers of such goods is constantly expanding. After consultation with leading orthopedists and surgeons, we selected the leaders.
When arranging top positions, the following characteristics were compared:
- Type of design;
- Materials;
- Hardness degree;
- Latch type;
- Size;
- Age indications;
- Purpose;
- Design;
- Rules of care;
- Price, manufacturer's reputation.
The result of a comprehensive study, analysis of medical practice, and patient experience was a top review of 8 positions. These are the best knee pads for joints - 5 nominees in the category of fixing models, 3 warming ones. From customer reviews, we have identified the strengths and weaknesses of each position.
How to choose between a fixed and movable earbud?
The tibial liner is one of the components of total or three-compartment knee prostheses. There are knee prostheses with a fixed liner and knee prostheses with a movable liner.
Movable earbuds have become very popular in recent years and theoretically have certain advantages over fixed earbuds, such as greater comfort during movement and a longer service life.
However, to date there is no concrete evidence of clinical benefits associated with the use of mobile inserts.
Rice. Knee prosthesis with movable insert
Purpose
An orthopedic knee brace helps to fix the damaged part of the body in the least dangerous position. It can be worn by a traumatologist or orthopedist to improve the condition after injury, provide treatment or preventive measures.
Athletes and other people who constantly experience severe physical activity receive the greatest benefit from the use of fixation devices. With this lifestyle, the risk of injury due to awkward movement, sprains or swelling increases. Elastic bandages help stabilize the area in need and speed up recovery. They also provide gentle warming and relief.
Often the doctor prescribes wearing a bandage in the following situations:
- Sprained knee ligaments.
- Joint diseases – arthritis, arthrosis, osteoarthrosis.
- Swelling, inflammation of the knees.
- Severe pain after injury or surgery.
Unlike more common elastic bandages, knee braces can provide enhanced fixation of the desired area of the limb. The greatest rigidity that can be obtained when putting on a product depends on the features of its design. Due to the correct increased tension, the clamps can remove some of the load from the damaged area, reduce pain and inflammation, and improve blood circulation. Thanks to the use of devices, it is possible to speed up recovery and ensure the knee is in the correct position when moving.
What type of fastening should I choose?
When implanting a prosthesis, there are three types of anchorage to choose from: neutral mechanical alignment, kinematic hinge, or hybrid anchorage. What are their differences:
- Neutral mechanical alignment : Bone cuts and components are aligned to the mechanical axis of the lower extremity (femur + tibia). Previously, this technique was considered the only correct one; it helped to avoid premature failure of the prosthesis and the need for its early replacement. But this was true in the early years of knee arthroplasty, when the quality of implants and fixation techniques were less advanced than they are today. Kinematic or hybrid fastening methods are also now accepted and widely practiced.
- Kinematic hinge : cuts match the kinematics of the knee in motion, maintaining the alignment of the limb in its original deformity. The alignment angle is determined individually for each patient.
- Hybrid fixation : One part of the incisions is aligned with the mechanical axis of the lower extremity, and the other part is aligned with the kinematics of the knee.
Indications
Knee replacement surgery is called arthroplasty. Like any other serious invasion, it is carried out only when indicated.
The latter include:
- severe limitations in knee mobility due to wear and tear or injury;
- severe pain in the knee area, felt even in a stationary position;
- irreversible changes in the joint caused by osteoarthritis;
- knee damage as a result of injury;
- deformations;
- diagnosed death of bone tissue as a complication of impaired blood supply;
- deformations or destruction resulting from a number of diseases (gout, rheumatoid arthritis, hemophilia);
- disorders that provoke abnormal bone growth of the lower limb.
Installation of a knee joint prosthesis is an operation of a fairly high level of complexity. This is a radical treatment method. Replacement is usually done if the disease progresses despite best efforts with therapy.
What are the possible complications?
Three types of complications can occur during knee replacement surgery: intraoperative complications, primary complications, and secondary complications. They are related to the nature of the procedure itself and exclude possible risks associated with anesthesia or risks associated with the age and medical history of the patient.
Three types of complications:
- Complications arising during surgery : these are exceptional and can be caused, for example, by injury to a large artery of the lower limb (popliteal artery) or a nerve (external popliteal sciatic nerve) during surgery.
- Primary complications : The main complication of this type is infection. This is a serious complication, but it is rare. Monitoring for several weeks after surgery allows infection to be identified and treated with appropriate antibiotics. Often a new operation is required to clean out the joint and prosthesis. Primary complications also include phlebitis, hematoma, knee stiffness, etc.
- Secondary complications : These include mechanical complications related to the functioning of the prosthesis, delayed infection, which may be caused by the prosthesis becoming infected with an infection outside the knee (tooth abscess, urine infection, etc.), or knee stiffness that occurs over time after operation.
How does postoperative treatment occur? Therapeutic gymnastics exercises begin already on the first day after surgery. In this case, mobile movements on mobile splints, as well as active exercises to strengthen strength, are combined individually. In addition, walking on crutches and later climbing stairs are trained. Inpatient treatment is usually followed by rehabilitation, which, based on need and agreement with the relevant health insurance fund, can be carried out either on an outpatient or inpatient basis.
Where is knee replacement performed in Kyrgyzstan?
Today, knee replacement is performed in the following hospitals in Kyrgyzstan in the arthrology department:
1. “ City Clinical Hospital No. 4” (Bishkek)
2. “Kyrgyz Research Institute of Balneology and Rehabilitation Treatment” (Tash-Dobo village (Vorontsovka))
Surgeons of hospitals in Kyrgyzstan, such as City Clinical Hospital No. 4 and the Kyrgyz Research Institute of Balneology and Rehabilitation Treatment (Tash-Dobo village (Vorontsovka)) recommend hip joint endoprostheses from Aesculap.
Aesculap is one of the leaders in the medical products market. It produces not only endoprostheses, but also surgical instruments, equipment for laparoscopic surgery, extracorporeal blood purification, and infusion systems.
How to wear it correctly?
It is important to use a knee brace correctly: some knee braces need to be worn only from time to time, others, on the contrary, throughout the day.
Soft bandages for preventive purposes are usually worn only during sports or long walks. Orthoses for therapeutic purposes are worn to alleviate the condition of arthritis or arthrosis for several hours. However, it is not recommended to use them constantly.
During rehabilitation after injuries, orthoses are usually worn throughout the day, as they keep the knee in a fixed position. They are removed either at night or only for a few minutes to massage the legs and prevent stagnation.
When wearing an orthosis for a long time, it is especially important that it is made of high-quality, hypoallergenic materials. This will protect the skin from eczema and irritation. At Prometer
which is a manufacturer of orthopedic equipment, carefully monitors such technological nuances.
Only a doctor can recommend the exact mode of wearing orthoses and other orthopedic devices when recovering from injuries. He will also select other procedures that will help avoid inflammatory processes, congestion or muscle atrophy.
Advantages of Aesculap prostheses
When using endoprostheses produced by Aesculap, it is possible to restore full mobility of the damaged joint. Implants do not affect muscle fibers, tendons or blood vessels.
Main characteristics of Aesculap products
- sustainability;
- strong fixation;
- Full compatibility with bone.
Increased resistance to wear makes it possible to re-replace the prosthesis much less frequently compared to lower quality products. The material does not cause allergic reactions in patients. After the operation, joint mobility is restored as soon as possible.
Types of Aesculap endoprostheses
The company's products are divided into categories depending on the functions they perform.
- Recovery systems. This includes artificial joints used to work on the hip joints.
- Partial replacement. Implants are used in operations on the knee joint and for reconstruction of its structure.
- Systems for the treatment of fractures of the humerus and femur. Damaged areas heal and restore functionality thanks to the use of rods.
The company's products can completely replace a damaged joint even with very poor bone tissue condition. Aesculap endoprostheses will restore the ability to move in cases where other prostheses cannot cope. Innovative developments of various coatings significantly reduce the wear of the prosthesis. When creating each implant, numerous tests are carried out to reduce friction between the parts.
You can purchase Aesculap® endoprostheses at BOSTI offices in Bishkek, Osh and Jalal-Abad. Also, all Aesculap® products are available for order throughout Kyrgyzstan.
If you have any questions about knee replacements, you can consult with Dr. BOSTI by calling 0551717713. We look forward to your call!
How can you properly fix the knee joint?
What is the purpose of wearing knee pads?
They are used to strengthen weakened or replace the function of damaged or missing “parts” of the knee joints, which include menisci, ligaments, tendons, and patellas. Thanks to this, the motor activity of the damaged limbs is maintained at a normal level, the cartilage tissue of the joint becomes more protected, since the articular surfaces of the cartilage act on each other with less pressure.
The knee brace is often used for the prevention of diseases of the musculoskeletal system of the lower extremities (during household and sports activities), as well as for the treatment of pathological conditions and rehabilitation after injuries and surgical interventions on the knees.
What types of retainers exist and what are they made of?
Knee pads can have a different structure, ranging from the most primitive to those that have a large number of structural components and auxiliary parts. Accordingly, they distinguish:
- bandages (also called elastic knee pads made of fabric material), made from cotton fabric, knitted fabric, as well as various types of synthetics. Their composition may include the wool of some animals, which has certain medicinal properties;
- Knee pads made of neoprene material have many advantages (they last a long time, are easy to use and care for, are well fixed and stay on the knee when performing loads, walking, running, and are also easy to apply). Due to all the above advantages, they are one of the most popular. Good quality and long service allowed them to be used as the main material in the production of knee braces. Even in the composition of complexly designed fixators, such as orthoses and splints, neoprene is included in large quantities;
- orthoses that have a more complex design and many other elements compared to circular clamps. Thanks to them, the fixation can be made much stronger and more targeted. Auxiliary elements are silicone inserts, hinges and special plates. Orthoses come in circular and semicircular types, and can also consist of separate strips that are connected by several rigid bridges. Such devices are fixed on the legs using special Velcro;
- splints are devices that are similar to orthoses, but they fix the limb more rigidly, almost to the same extent as a plaster cast. True, they cost an order of magnitude more, and the only difference is that with a splint you can carry out some minor movements, thanks to which you can somewhat shorten the period of rehabilitation of knee pathology.
How to choose the right knee brace?
The selection of a fixator must be approached individually; this choice depends on the degree of impairment and the need for fixation. If you combine the useful capabilities of the brace with the type of knee joint disease, you can choose exactly the option that will be the most optimal. It is advisable that this choice is made only by an orthopedic traumatologist or osteopath, who will take into account both the indications and possible effect of using a particular knee brace, as well as the financial capabilities and wishes of the patients.
Thus, to prevent knee injuries during sports and heavy household loads, as well as during the rehabilitation period after minor injuries, it is better to use rigid braces that have a complex design. In this case, circular knitted or neoprene knee pads and even the most ordinary elastic bandages are ideal.
During strength sports with a high load on the leg joints, which include weightlifting and powerlifting, the use of neoprene orthoses is indicated.
They are reinforced with rigid silicone inserts or special plates that stabilize the joint on the sides. In this case, movements in the knee are preserved almost completely, and fixation does not leave much to be desired. Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr
