The knee joints are exposed to constant load. Pain in the knees is the result of a long and unspectacular process, one of the reasons for which may be the wearing away of the cartilage of the knee joints, with high load-bearing capacity. The degeneration of joints can be triggered and accelerated by biological ageing, overweight, lifestyles lacking sufficient movement, various injuries or excessive sporting activities. The wearing away of the cartilage results in pain in the knees, often coupling with a limp, limited general movement and the restricted movement of the joints. If conservative therapies fail to produce the desired results, surgery on knee joints may take place. In many cases, the operation involves implanting a knee prosthesis, after which pain is alleviated and the patient may start living an everyday life once again.
The surgery involves replacing the damaged knee joints with an implant. The surgical procedure and technique and the type of the prosthesis implanted are selected depending on the patient’s age and physical condition. Unless there is a reason to the contrary, the knee prosthesis is implanted using a minimally invasive procedure, involving less intervention, pain and fewer complications as well as a shortened period of recovery.
Total knee prosthesis (TEP-total endoprosthesis) replaces the whole surface of the knee joints. The implant to be built in may be made of a special metal alloy or plastic and is fixed by cement. In some cases it may be necessary to replace earlier implanted knee prostheses, by knee prosthesis revision surgery. Surgery on the knee joints also includes the High Tibial Osteotomy (HTO) procedure, by which the axes of the shinbone and of the thighbone compared to one another are adjusted if, for any reason, abnormal and causing pain ( e.g. X-shaped and O-shaped legs).
Rehabilitation after knee prosthesis surgery has two phases.
What is referred to as early rehabilitation takes place in a hospital environment, under the supervision of a physiotherapist. This usually takes 7-10 days. In the two days following the operation, the knee that underwent surgery is moved by a special motion machine, which is later replaced by physiotherapy combined with active physical exercise for the knee joints.
This is followed by outpatient rehabilitation, which requires no hospital stay and takes some 3 months. In the beginning, medical aids (like crutches or a walk frame) are used, which are less and less relied upon, while physical load on the patient is gradually increased, strengthening the muscles within the framework of an active, personalised mobilisation programme. Important parts of outpatient rehabilitation are physiotherapy and physiotherapeutic exercise done at home persistently, the programme of which latter is also designed by the physiotherapist.