The Orthopedic department of the Friedrichshafen clinic, headed by an experienced orthopedic surgeon Prof. DM Eugene Winter performs more than 5 000 knee replacement surgeries annually, aiming at best possible therapeutic effect with minimal traumatizing. Unicompartmental knee arthroplasty is recommended in case of progressive osteoarthritis, if conservative treatment wasn’t effective. The knee surgery is performed if knee joint disease considerably lowers patient’s life quality making all everyday activities impossible. In some cases the arthroscopic knee surgery can help to avoid the massive intervention. Unicompartmental knee arthroplasty is conducted in case arthritis affects only one area of knee joint. In each individual case orthopedic surgeon at the Clinic if Friedrichshafen decides if unicompartmental knee arthroplasty is a possible option according to results of patient’s examination. Modern technique of unicompartmental knee arthroplasty shows great short-term and long-term results in both young and elderly patients.
Knee joint consists of three parts: medial (inner), lateral (outer) and patellofemoral. If the damage is limited by one knee joint section (medial or lateral), it is possible to conduct unicompartmental knee arthroplasty and replace the damaged part.
Such kind of surgical procedure allows placing an implant through a relatively small incision (7,5-10 cm) without affecting main muscles controlling knee joint function. As a result, hospitalization time is reduced, patient recovers and gets back to everyday life much faster, compared with total arthroplasty. Unicompartmental knee arthroplasty is a serious surgery with the same risks as total arthroplasty. This is why it is so important to discuss any possible risks and advantages of such kind of surgical procedure with orthopedic surgeon and decide what kind of surgery would be possible for you.
Unicompartmental knee arthroplasty allows partially keeping bone and cartilaginous tissue and ligaments in healthy joint segments, which is why patients report that the implant functions more “naturally”. Unicompartmental arthroplasty provides better flexibility in knee function.
Before deciding whether unicompartmental knee arthroplasty is possible, patient has to be carefully examined by orthopedic surgeon. During the examination orthopedist asks the patient what kind of pain they experience in their knee joint. Special attention is paid to locating painful sensations in the knee. If pain is located in one of knee joint segments (outer or inner part), it is possible to conduct unicompartmental knee arthroplasty. If painful sensations are located in the whole knee or its front segments, it may be recommended to perform total arthroplasty.
When examining the knee, orthopedist thoroughly assesses its exterior and tries to locate painful sensations. Using special tests, surgeon determines the amount of movement in knee joint and quality of ligamentous apparatus. In case of expressed joint stiffness (constraint) and weakness in ligaments, total replacement of knee joint is an option. Intensity of knee joint arthritis can be assessed by X-ray examination. Some orthopedists use MRI scanning for better assessment of cartilaginous tissue condition.
Patient is admitted to a hospital several days before the surgery. During these days patient is examined by anaesthesiologist who analyzes their medical history and chooses the most appropriate kind of anesthesia. Possible options of anesthesia should be discussed with orthopedic surgeon beforehand. Two kinds of anesthesia can be used during unicompartmental knee arthroplasty: general anesthesia (drug-induced artificial sleep) and spinal anesthesia which allows for the patient to stay conscious but not feel any pain in their lower limbs.
Right before the surgery orthopedic surgeon examines the patient again and marks the site of surgical intervention with a coloured marker.
Unicompartmental knee arthroplasty takes 1-2 hours to perform. First, surgeon makes an incision in the front part of the knee. Then doctor assesses the condition of all three segments of knee joint so as to be sure that articular cartilage is damaged only in one segment and that knee joint ligaments are intact. If during the surgery orthopedic surgeon realizes that unicompartmental knee arthroplasty is not an option, total knee arthroplasty is performed. Such situation should be discussed beforehand so that surgeon has patient’s agreement for change during the surgery. In case it is possible to conduct unicompartmental knee arthroplasty, surgeon removes articular cartilage in the damaged segment of knee joint using special surgical saws and covers the edges of thigh and shin bones with metallic elements of the implant. Metallic elements are fixed on the bone by means of bone cement. Plastic pad is inserted between metallic elements of the implant to make their movements smoother.
After the surgery is completed, patient is moved to resuscitation and intensive care unit where for some time doctors control patient’s condition and anesthesia recovery. When patient’s condition is stable, they are moved to postoperative ward.
During postoperative period (knee replacement recovery) patients feel less expressed pain and edema, and rehabilitation is also much easier compared with total knee arthroplasty. Patient is discharged in several days after the surgery.
It is recommended to put certain stress on knee joint right after the surgery. Patient should use crutches, rolling walker or walking stick during several weeks after surgery until full recovery of motor skills.
Physical therapist shows patient special exercises for restoring motor activity and muscle strength. It is important to regularly visit orthopedist after surgery: doctor will assess patient’s general condition and rehabilitation period.
All usual motor skills are fully restored in 6 weeks after unicompartmental knee arthroplasty. If you have any questions, concerning the knee arthroplasty methods or costs, our English speaking team at the international office will give you all the necessary information.