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Knee



The knee is a hinged joint: it enables the bending and stretching of the leg and connects the thigh bone to the shin bone. The surface of the joint at the thigh is composed of an inner and an outer medial condyle. Its counter surface forms the trough-shaped tibial plateau on the lower leg bone. The joint surfaces are covered by shock-absorbing cartilage. Cavities at the edges are filled in by crescent-shaped cartilage pads, known as the outer and inner meniscus. They protect the joint cartilage by distributing pressure that comes every time we use the joint. The knee is stabilized on the side by the inner and outer collateral ligaments. At the center are the joint’s medial and lateral collateral ligaments which keep the thigh and the calf aligned and from moving away from each other. Encased around each knee is an articular capsule which secretes synovial fluid that nourishes the cartilage.

Symptoms


Knee ailments in childhood and adolescence frequently stem from injuries that affect the collateral ligament, meniscus and cartilage. Aging and severe strain (e.g. performance sports, heavy labour and excess weight) as well as joint inflammation (arthritis, gout) or joint misalignment (knock knee or bow leg) can lead to cartilage wear. Bits and pieces break off from the cartilage’s originally smooth surface layer and irritate the joint’s inner membrane. Inflammation leads to softening of the cartilage which in turn wears down the joint. Pain behind the knee cap, generally caused by damage of the cartilage surface to the bone, leads to restricted mobility. It is not rare to see cartilage deterioration caused by sports activities in younger people. The medical name for this ailment is arthritis of the knee or gonarthrosis.

Joint misalignment of knock-knees and bow-legs


Joint misalignment and the consequent biomechanical stress on the knee can as well lead to cartilage wear. With knock knee and bow leg, the deterioration tends to occur on one side. This can often be alleviated simply by prescribing orthopedic insoles. Corrective surgery frequently provides relief: by realigning the mechanical axis of the leg strain on the damaged cartilage area can be significantly reduced. We frequently use a navigational device during the operation to achieve greater precision in the correction of the leg axis, especially in the case of knock knee.

Therapy planning


Obtaining the most precise image possible of the magnitude of the cartilage damage and determining the patient’s genetic predisposition is vital to the planning of the therapy. To this end, we use cutting-edge diagnostic tools like low radiation, digital X-ray machine and open magnetic resonance tomography to obtain an exact measurement of the bone structure.

Conservative methods of treatment (nonsurgical)


Functional disorders of the joint often lead to muscle tension which can go on to cause various discomforts and ailments. Physiotherapy is often helpful. If pain continues, relief may be found in injections administered into the joint. In many cases a course of 5 injections administered under ultrasonic or X-ray guidance provide relief from pain and discomfort for many months or years to come.

Musculoskeletal shockwaves and its advantages


Musculoskeletal shockwaves are short energy-loaded waves administered from outside the body. We use shockwave therapy in orthopedics and trauma surgery. A good example of this non-surgical alternative is in the treatment of osteochondritis dissecans, an ailment which frequently leads to the shedding of joint fragments and arthritis of the knee: after smoothing down the cartilage using arthroscopy, shockwave therapy is applied to stimulate the formation of new cartilage cells. The affected area is smoothed down while further damage to the joint is halted.

Cartilage cell transplant


We have also achieved excellent results with cartilage cell transplant. In this fascinating procedure, a few healthy cartilage cells are extracted from the patient and cultured in a laboratory. The rejuvenated cartilage structure is then surgically reimplanted into the body. This cutting-edge procedure even permits a three-dimensional reconstruction of the cartilage to achieve better and suppler cartilage.


 

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