Endoprosthetics of the knee: what is it?

Operation of knee arthroplasty: reviews. Endoprosthetics of the knee joint: rehabilitation

In orthopedics, a procedure for replacing part of a damaged joint is often used.

However, unlike hip arthroplasty, which occurs without complications and well tolerated, the replacement of the knee joint is more difficult, and there may be complications such as as:

• infectious processes at the site of the endoprosthesis;
• displacement of the prosthesis;
• in the patella, tearing or tearing of the ligament is possible;
• thrombus formation in the tibia;
• violation of the integrity of the femur (fracture).

Because of the presence of such complications, people leave such dissimilar responses. Endoprosthetics of the knee joint can take place without any complications.

It is worth noting that 10 years ago there was a larger number of patients with various complications after this method of joint replacement.

Over time, everything was improved - it's improving the quality of the prosthesis itself, as well as the process itself.

An important function in the rehabilitation is the rehabilitation period and a set of necessary exercises for a speedy recovery. These factors significantly reduced the likelihood of problems in the postoperative period.

In what cases is arthroplasty necessary?

The knee joint is a joint of the condylar type, the bone parts of which are covered with protective cartilage, consisting of fibers of collagen and chondrocytes, a germ layer and a basic substance.

Due to the articular cartilage and the substance allocated to it, the necessary movements occur.

The synovial membrane covers all articular surfaces, thanks to its assistance, the necessary liquid is developed, which prevents friction in the joint.

In the presence of such diseases at the initial stage, it is necessary to conduct medical treatment, which will improve the state of cartilage and remove the inflammatory process.

In the later stages, when there is already destruction of the cartilage and friction, in this case, surgery on the knee joint for prosthetics by installing a metal or plastic implant in place of the destroyed the joint.

Indications for implantation

1. Deformation of the joint with age.
2. Deformity of the joint, accompanied by inflammation.
3. Injury.
4. Osteoarthritis is dysplastic.
5. The presence of dead skin in the joint.

Potential patients are people who have:

• Restriction of movement with not passing strong pain.
• Significant change in the shape of the joint.

Common causes

- Sporadic cases of loss of the possibility of normal functioning of the knee joint are characteristic diseases. This is arthritis after trauma, fracture, rupture or sprain, and others.

- In rheumatoid rheumatoid arthritis, the synovial membrane becomes inflamed and compacted, due to which the active development of the joint fluid begins, which leads to the destruction of the joint.

- The appearance of osteoarthritis in elderly people, which is characterized by deterioration of mobility and wear and tear of the joint.

What is the benefit of implanting an artificial joint?

The operation of knee arthroplasty is carried out to facilitate or complete removal of pain for up to fifteen years. An artificial implant, similar and suitable anatomically, is inserted instead of the destroyed joint.

After the operation on the knee joint was successful, patients noted an increase in the volume of movements. The quality of life is drastically changing.

Therefore, many people leave positive comments.

Endoprosthetics of the knee joint in most cases is without complications, which leads to an early recovery of a person and a return to normal life.

Complications associated with endoprosthetics

Operation on the knee joint is also associated with the emergence of a number of risks, as in any other surgical intervention.

Such risks include blood loss, in elderly people, possible exacerbation of chronic diseases, thrombus formation in the lower extremities, infectious processes at the implant site and in the pathways urinary excretion. Recently, this has become rare.

One of the worst options is the formation of an infectious process, the treatment of which is rather difficult and very expensive.

Often, complications of this kind can only help remove from the body of an alien body, in this case an endoprosthesis.

There is a percentage of people who are more prone to infection than others, including those with rheumatoid arthritis, overweight, patients who need to take hormone preparations.

Terms of operation

The fixed prosthesis can last up to fifteen years, in some cases and longer, but with wear and tear When the implant loosens, a reoperation at the knee joint is possible, that is, a replacement or reendoprosthetics. In the case of the appearance of painful sensations before the expiry of the ten-year period or loosening, an operation is also necessary.

The process of endoprosthetics

The duration of the implantation operation can be 2-3 hours. Before surgical intervention, mandatory prevention of infection occurs. Before the operation, the patient undergoes spinal anesthesia.

To install the endoprosthesis, it is necessary to remove the fractured part of the joint and knee cap, the doctor also aligns the curved leg axis, if necessary, restores the ligaments.

Modern prostheses, made of high-quality and non-corrosive materials, allow the leg to bend to 150 degrees. Some after the operation left positive reviews.

However, one should never forget about the rehabilitation period, without which the treatment will not be complete.

Important will be a reminder that the operation in most cases is under local anesthesia, that is, in a wakeful state.

However, you can express your wish to an anesthesiologist or surgeon about making general anesthesia, if possible.

One must be very brave and patient in order to calmly listen to the sounds that accompany the procedures of enoprosthesis.

Postoperative period

After the operation, the lack of sensitivity and functioning of the lower extremities is considered the norm. During the intervention, the patient loses a large amount of blood, transfusion of blood substitutes, the introduction of necessary medications for anesthesia and antibiotics.

Further within a few days, the patient's vital signs are monitored (heart rate, pressure, ECG, change in blood counts).

In the absence of deterioration and normalization of the condition, the patient is transferred 24 hours from the intensive care unit to a simple ward.

Rehabilitation after knee arthroplasty

After the endoprosthesis is installed, the rehabilitation period lasts on average about 3 months, but it also lasts longer, depending on the patient's condition.

A mandatory recommendation is the daily workload and exercises after knee replacement to restore its functioning.

Most often, the rehabilitation period of the patient is spent in a specialized clinic (about one month).

Stages of the rehabilitation period

After the operation, the patient should stay for about two months in the clinic and perform the specified set of exercises by the doctor.

With an increase in the rate there will be an improvement in the motor activity of the joint, which will lead to an early return to the habitual course of life.

An extract from the clinic is also possible.

After staying in the rehabilitation center (in 2-3 months), the patient is recommended to continue physical activities in the form of swimming, walks and yoga sessions. It is worth remembering that excessive physical activity is contraindicated.

Exercises for restoration

Rehabilitation after knee arthroplasty includes a set of exercises that help overcome stiffness of movements, increase the strength of muscle mass in the joint, reduce painful Feel.

Begin with low rates and loads, gradually moving to more complex, on the adjustment of the physiotherapist. It is recommended to avoid too active sports so that it is not traumatic for a new joint.

Complex of necessary exercises for daily execution (4-5 times a day):

1. Ankle joint - flexion-extension with a gradual increase in tempo, starting from 5 and reaching 12.
2. Contraction of anterior femoral muscles for 5 seconds.
3. Reduction of the hind femoral muscles for 5 seconds.
4. Raising the leg in a straightened state.
5. Cut the muscles of the buttocks for 5 seconds.
6. Extension-flexion of the lower limb in the knee joint.
7. Hip to take away to the side.
8. Straighten the raised leg to a level of 45 degrees and hold it in a submerged position for up to 5 seconds.
9. Vzmahi foot in the straightened state to a level of 45 degrees and delay in this state to 5 seconds.
10. Application of the apparatus of "Dikul".

Contraindications to the procedure of prosthetics

Absolute contraindications:

• Independent movement is not possible.
• Diseases of the heart and CCC.
• Thrombosis with inflammatory process.
• Pathological impairment of respiratory function, respiratory failure of a chronic type.
• Infectious processes.
• Sepsis.
• Allergy.
• Neuromuscular pathology.
• Mental disorders.

Types of endoprostheses

Modern prostheses have a protective function and are subdivided as follows:

1. total;
2. prosthesis directly to the surface of the joint;
3. bipolar;
4. single-pole.

The prosthesis is fixed in several ways:

• cement;
• hybrid;
• cementless.

In order for the implanted prosthesis to last a long time, high-quality anti-corrosion and wear-resistant, and, most importantly, biocompatible materials are used in production:

1. ceramics;
2. polyethylene;
3. alloys of metals;
4. bone cement.

Many people, in order to decide on an operation, it is necessary to analyze various reviews. Endoprosthetics of the knee joint is performed by a physician taking into account the individual characteristics of the physiology of the patient.

Price policy

Endoprosthetics of the knee joint in Moscow, Israel, Turkey, Lithuania, Germany are carried out by qualified specialists who know their business.

There are quite a few clinics that specialize directly in carrying out surgery to replace the joint or its parts, including those performing endoprosthetics of the knee joint.

The cost of endoprostheses corresponds to the quality of the materials of which it consists, and the firm that produces it. Reviews of foreign clinics are often much better (especially with regard to the rehabilitation period).

However, in Russia this intervention is carried out at a high level.

Thanks to many years of experience and high qualification, the doctor will choose the most suitable biocompatible prosthesis and will perform knee replacement without complications. The price of this procedure depends on the complexity of the operation and the cost of the prosthesis.

A source: http://.ru/article/165440/operatsiya-po-endoprotezirovaniyu-kolennogo-sustava-otzyivyi-endoprotezirovanie-kolennogo-sustava-reabilitatsiya

Important advantages and disadvantages of total knee arthroplasty

Until a certain moment, the destruction of the knee joint with gonarthrosis and the pain relief is helped by conservative treatment. But in 3 stages destruction of cartilage leads to deformation of bones, the amplitude of movements is sharply reduced, and the pains become intolerable.

If the degenerative-degenerative processes in the joint take an irreversible character, it is only the operation of endoprosthetics that will help restore the mobility of the leg and eliminate pain.

Depending on the extent of joint damage, partial or total knee replacement is performed.

Today such operations are carried out practically in all large cities of Russia, among them Moscow, St. Petersburg, Barnaul, Nizhny Novgorod, Orenburg, Cheboksary. But before deciding to surgery, you need to weigh all the risks, pros and cons.

Technology

For a start, we'll figure out what endoprosthetics are and how this operation is carried out. Endoprosthetics are operations for the replacement of large and small joints or their components with prostheses.

A distinctive feature of endoprostheses is that they are located inside the body, under soft tissues. Most often, knee and hip joints are in need of prosthetics, which are subjected to intensive loads.

The endoprosthetics of the knee joint video is shown below.

Basic requirements for the material of the knee endoprosthesis:

• mechanical strength, resistance to abrasion;
• bioinertnost, hypoallergenic composition, causing good survival.

These requirements correspond to high-pressure polyethylene, ceramics, metal alloys based on stainless steel, titanium. How much does the prosthesis cost, depends on the model, the material, the manufacturer.

Before the operation, the patient undergoes a comprehensive examination, the indications and contraindications, the risk of complications are weighed, the optimal method of anesthesia is selected.

When choosing a model, the endoprosthesis is based on the results of an X-ray study to determine the design.

Also, financial possibilities of the patient are taken into account if the operation is not done on a quota.

Having provided free access to the joint, the doctor cuts the deformed, damaged parts of bones, It polishes and polishes sections, tests a trial prosthesis, installs and fixes all components endoprosthesis.

The wound is sutured with the installation of drainage, a dressing and a tire are applied for temporary immobilization.Already on the first day after the endoprosthesis of the knee, the joint development should be started.

If the artificial joint normally coexists, and the rehabilitation period proceeds without complications, after 4-6 weeks the operated leg can be subjected to normal loads.

When an endoprosthesis is shown

Radical treatment is used if complex therapy does not provide an improvement.

The main indications for endoprosthetics of the knee joint: complete or almost complete loss of leg mobility in the joint, progressive muscle weakness, severe pain syndrome.

The question of surgical intervention is considered in the presence of such diseases and conditions:

1. irreversible degenerative-dystrophic changes, usually characteristic of grade 3 gonarthrosis;
2. intra-articular fractures of the femoral, tibia;
3. defeat of joints on the background of rheumatoid arthritis, Bechterew's disease, gout;
4. necrosis (aseptic necrosis) of the bone, associated with circulatory disorders;
5. Bone Tumors.

If deforming osteoarthritis has passed into bone ankylosis, the operation is not always expedient. If the leg is fixed in a straightened (functionally advantageous) position, surgical intervention is unnecessary.

If in a bent (perverse), corrective osteotomy is performed - the bones are broken, if necessary cut off and again fixed in a functionally advantageous position.

To endoprosthetics resorted only with multiple joint ankylosis in a vicious position.

Risks and possible complications

Any operation involves a number of risks, for example:

• surgical intervention will be an unbearable burden for the body;
• there will be complications - infection, thrombosis or bleeding, allergic reaction, rejection of the prosthesis;
• insufficiently qualified physician during the operation will damage nerve fibers;
• The operation will not bring the expected result due to insufficient rehabilitation;
• After a while, the prosthesis will have to be changed due to wear or loosening.

Many people are particularly scared by the need for a repeat operation, and these fears are justified. Endoprosthesis is not eternal, because of the lack of natural lubrication (joint fluid), it wears out and collapses faster than the present joint.

Up to 95% of patients use the prosthetic knee joint for at least 10 years, 85-90% of the operated patients have a life of 15 years, 80% - 20 years, 70% - more than 20 years.

To prolong the life of the endoprosthesis it is necessary to comply with all the recommendations of the doctor, do not subject the joint to the stresses, including to control its own weight.

If the operation is done in old age, it is likely that the prosthesis will serve the owner for the rest of his life. Young people will not be able to do without a second operation.

Agreeing to the operation, the patient should seriously approach the choice of clinic and doctor.

If knee replacement in Moscow is carried out in dozens of clinics, then in Barnaul there are only 2 medical institutions where the quota operations are performed.

The second point is to understand that without rehabilitation the operation is useless, and rehabilitation is hard work. Preparation for it should begin before the operation (learn exercises, learn to use crutches).

Finally, before the operation, a comprehensive examination is required from different specialists, the delivery of tests. In the course of the survey, contraindications are revealed, possible ways of eliminating temporary contraindications and minimizing the factors that can cause complications are outlined.

Contraindications

Contraindications to surgery are relative and absolute. The absolute are:

• immaturity of bone and cartilaginous tissue;
• osteosclerosis (closure of the medullary canal) of articulating bones;
• active infectious process in the knee joint (the operation can be performed no earlier than 3 months after the complete elimination of the infection);
• dysfunction of the cardiovascular, respiratory system in the stage of decompensation, renal failure;
• presence in the body of the focus of infection, purulent processes, febrile state, exacerbation of any chronic diseases;
• disorders of blood clotting (thrombocytopenia, thrombocytosis) and vascular pathologies (acute thrombophlebitis, thromboembolism);
• 3-4 stage of oncological diseases;
• severe mental disorders.

Consider also the relative contraindications and factors that can provoke postoperative complications, prevent successful rehabilitation:

1. With obesity of grade 3, the knee endoprosthesis will be subjected to excessive loading;
2. with diabetes mellitus, an increased level of glucose in the blood increases the risk of bleeding;
3. at immunological disorders, systemic autoimmune diseases, the risk of joint rejection is high, and the weakness of the immune system threatens with infectious complications;
4. a patient with mental, neurological disorders may not be able to undergo a rehabilitation program, sometimes psychological personality characteristics, weak-willedness prevent the rehabilitation.

If the contraindications are temporary, after the course of treatment of the concomitant disease, a second examination is conducted and a decision is made about the possibility of the operation. Preoperative preparation helps to minimize risks.

For the prevention of postoperative infection, a course of antibiotic therapy is prescribed, for prevention of thrombosis - anticoagulants, with an increased risk of rejection of the prosthesis - immunosuppressors.

If contraindications are associated with incurable diseases in the stage of decompensation, the operation will have to be abandoned.

Types of endoprosthetics

There are 2 main types of knee arthroplasty:

• total;
• partial (single-muscle).

Total knee arthroplasty is a complete replacement with a bipolar prosthesis. The operation is rather complicated, long, traumatic, associated with significant blood loss.

After it requires a long period of rehabilitation, long-lasting pain.

But such a prosthesis allows you to lead an active lifestyle, excluding only the occupation of certain sports, and with the right treatment, it serves no less than a decade.

One-muscle arthroplasty of the knee joint is a simpler and more gentle operation. It is resorted to if only one of the spherical extremities of the femur (the condyles) is damaged. It is replaced by a single-pole prosthesis.

For this operation, a small incision is sufficient, it is not necessary to dislodge the patella, minor blood loss, pain after knee replacement takes place in a week. But a single-pole prosthesis is not designed for serious loads, and its service life is limited.

In general, this type of endoprosthetics is indicated for elderly people with moderate physical activity.

Types of prostheses

There are different types of endoprostheses of knee joints:

1. single-ulcer (single-pole);
2. bipolar with a movable platform (consists of femoral, tibial components, metal plate and polyethylene insert);
3. bound (complex loop) - is used for large-scale damage to bone tissue and weakness of ligaments;
4. combined, manufactured on an individual basis according to computed tomography, is an intermediate variant between a single-pole and two-pole.

With the preservation of bone tissue, prosthetic articular cartilage is used:

• hemicap - is made in the form of a screw with a wide cap, which is screwed into the bone, designed to eliminate local defects;
• Interpositional - is a gasket imitating cartilage.

There are also different ways of fixing the endoprosthesis:

1. cement - with the use of polymethyl methacrylate (bone cement);
2. cementless - by means of mechanical fastening.

Cementless dentures last longer, but they also last longer, for their installation, bone tissue should be sufficiently stable, not fragile, since such a prosthetic construction creates a load on the bone.

The financial side of the issue

The cost of the operation depends on its type (total or partial, primary or revision), the method of anesthesia, the clinic, the qualifications of the performer.

Some clinics include a total of diagnostic and rehabilitation activities.

In Moscow clinics prices for primary total knee arthroplasty vary from 200 to 400 thousand. rub.

In the Federal Center of Traumatology, Orthopedics and Endoprosthetics of Barnaul, an operation on a paid basis will cost 10, 00. rubles. A prosthesis is paid separately, the price range for it is 20-100 thousand. rub. and higher.

An alternative to a paid operation is the receipt of high-tech medical care (VMP) at the expense of budgetary allocations within the federal and regional programs, the so-called quota.

Programs cover large cities, and only some clinics.

How to get a quota?

1. Contact a local clinic at your place of residence with your doctor who will send you to the regional health department (you need the conclusion of the commission about the need for endoprosthetics, the visa of the head physician).
2. Apply to the health department and pass a second commission, which issues a coupon for a free VMP.
3. Go through another commission in a medical facility that falls under the subsidy program.
4. If all commissions are passed, the quota is received, absolute, unavoidable contraindications to the operation are not revealed, it remains to wait until the turn comes. Waiting is usually delayed for a year, the passage of all commissions and processing of documents is also a fairly long process.

In the late stages of gonarthrosis, endoprosthetics is the only way to restore limb functionality. This is a technically complex, expensive operation with a number of contraindications and risks.

In total, 5% of operations on endoprosthetics of the knee joint is completed by the patient's death, but there is a risk of disability due to complications or incomplete rehabilitation. Another disadvantage is the wear of the prosthesis and the need for a repeat operation, especially if the primary was performed at a young age.

All these points must be taken into account, choosing between conservative and operative treatment.

A source: https://artroz-help.ru/gonartroz/totalnoe-endoprotezirovanie-kolennogo-sustava

Endoprosthetics of the knee joint: who is prescribed the operation

Endoprosthetics of the knee joint - a heavy operation to replace the femur and tibia. The operation returns mobility to the leg and helps patients to return to their previous full life.

Indications and contraindications for surgery

The doctor prescribes surgical intervention in cases when the other treatment methods do not give the desired results.

Indications for knee arthroplasty:

• A pronounced pain syndrome
• Loss of motor ability of the leg (it is impossible to bend and unbend the leg)
• Muscle weakness

There are also contraindications,in the presence of which the operation can not be carried out:

1. Diseases of the hematopoiesis
2. Infections purulent
3. Heart diseases
4. Disorders of the psyche
5. Cancer (3-4 stages)
6. Thrombophlebitis
7. Renal insufficiency
8. Underdevelopment of the skeleton

Surgeons perform two types of prosthetics: partial and total.

How is surgery performed?

Before the surgery, many patients want to know how to do endoprosthetics. Most often the operation is performed in the morning.

The patient during the surgeon's work is under general anesthesia or under spinal anesthesia.

The operation to replace the knee joint takes about 2-3 hours.

The essence of the operation is to remove worn articular surfaces of bones and to install special components made of polyethylene and metal.

With total endoprosthetics, the knee joint is completely replaced with a prosthesis, which is fixed with bone cement (polymethylmethacrylate) or fixed mechanically.

The endoprosthesis is constructed from an artificial hip and tibial component of the joint, a metal plate and a liner made of polyethylene. Before the final installation, the surgeon "tries on" a trial prosthesis.

After fixing the endoprosthesis, the doctor puts the seams in several layers on the wound and establishes drainage. On the foot a bandage and a tire are applied.

A small swelling around the operated area is allowed; he will fall down in a few days. The swelling under the foot will help to eliminate puffiness.

Rehabilitation after endoprosthetics

Modern endoprosthesis can last for 15-20 years. After wear, it is possible to change it to a new one. Thanks to the prosthesis, a person gets rid of pain and returns to a mobile way of life.

However, after the operation, the correct rehabilitation period is very important, in order to get used to the prosthesis and learn how to live with it without pain.

What to do after the endoprosthesis of the knee statute?

On average, recovery after the installation of the prosthesis takes 3 months. This period can vary, based on the patient's age and individual characteristics.

To avoid thrombus formation, the patient should wear compression stockings or use elastic bandages.

After surgery, getting up for the first time from bed, you should remember the important rules:

• Getting up, you should start with a healthy leg, and the prosthetic leg should be pulled forward, but not bent.
• To lean on also a healthy leg and crutches. Nearby there must be someone who can help, if necessary.
• It is important to stand on a flat and dry surface, to avoid falling and injuries.
• An operated leg can only easily touch the floor in the first days of walking. Try to rely on the foot should be gradually and under the supervision of doctors.

As a rule, patients begin to take the first steps after endoprosthetics with crutches, then replace them with walkers, and closer to the end of rehabilitation they use it for walk walking sticks.

A few days after the operation, the patient is released home, but the rehabilitation course continues. It is important to follow all the prescriptions of the doctor, do exercises for the development of the foot, as well as undergo a course of exercise therapy.

Exercises after knee replacement

How to develop a knee joint?

Easy charging for the knee should be an integral part of rehabilitation. In the first month, each exercise should be repeated ten times.

The development of the knee joint should take place daily.

1. Flexion and extension of ankle joints.
2. Lying need to bend a healthy leg in the knee, and raise the operated leg, hold it for 10 seconds and slowly lower it onto the bed. Under the painful leg is put a roller
3. While lying, you need to pull up your aching leg as close to the buttocks as possible, "sliding" your heels along the bed. Healthy leg remains lying bent.
4. Lying to bend both legs in the knees and alternately raise only socks, not taking off his heels.

For the third month of rehabilitation, complete freedom of movement is allowed.

Such activities as:

• Swimming
• Yoga classes
• Cycling
• Exercise bike
• Dancing

Running, jumping, skiing is better to exclude before full recovery.

To prolong the "life" of a new prosthesis, it can not be overloaded - you can not lift and carry weights, you should avoid excess weight. The artificial joint is easily administered to infections, so you should monitor your health and start treatment on time.

If pain occurs, the discharge from the wound should be treated immediately.

Possible complications

Non-compliance with the doctor's recommendations may lead to complications such as:

1. inflammatory process
2. thrombus formation
3. dislocation of parts of the denture
4. endoprosthesis displacement
5. limited mobility of the prosthesis
6. bone fracture in the area where the prosthesis is installed

The responses of many patients indicate that the operation is generally well tolerated, the pains go away quickly, and the addiction to the new "joint" comes two weeks later.

Elderly people sometimes feel numbness of the limbs, a decrease in sensitivity on the leg, cold in the area of ​​the foot and shin. Such symptoms are associated with local circulatory disorders. Therapeutic massage will quickly eliminate unpleasant sensations.

In the endoprosthesis of the knee joint, it is important not only the professional work of the surgeon and the qualitative prosthesis. The rehabilitation period is a significant stage on the way to recovery.

A source: https://inet-health.ru/endoprotezirovanie-kolennogo-sustava/

Endoprosthetics of the knee: how is the operation

The staging of the knee joint endoprosthesis is rather complicated, but for many patients it is the last chance to return to a full life.

Endoprosthetics of the knee joint - the procedure is rather complicated, and therefore they designate it as an extreme measure of salvation. Depending on the condition of the bone and the joint itself, a specific type of prosthesis can be used.

But, despite this complexity, it is this operation that allows 90% to return to full-fledged life.

What is endoprosthetics and when is it performed?

What is endoprosthetics? This surgical intervention is designed to recreate the damaged parts of the knee joint. This approach is realized precisely because of the setting up of artificial implants.

And this is more than justified, since there are a number of diseases that "eat" a bone, for example, gonarthrosis or coxarthrosis (see Fig.

Coxarthrosis of the knee joint: features of the disease, causes of development and methods of treatment).

Because of this, the patient loses not only the functionality of the limb, but also experiences severe pain.

The installation of an endoprosthesis helps to restore the functioning of the diseased limb and to remove debilitating pains.

Endoprosthetics can replace damaged cartilage tissue and bone tissue, while restoring deformed knee, due to which the patient normalizes the gait and it becomes easier to keep the body in vertical position.

Of course, in most cases, after the operation, it is not possible to jump and run (as before) but walking and doing the usual daily movements in the joint - will be quite real.

Unfortunately, conservative treatment does not always give a positive effect, as many patients are drawn to the doctor to the last.

"Are joints aching? Does the spine "crunch"? "

Pain - a harbinger of terrible pathologies, which for a year or two can seat in a stroller and make you disabled.

And after all, there are such diseases that require immediate reaction, if there is a desire to do only with pills:

Disease	The process that takes place in the joint
Gonarthrosis	From the cartilage leaves "all the lime because of what happens the destruction of such tissue. As a consequence, the joint is gradually deformed.
Rheumatoid arthritis	Inflammation of a joint of a chronic form.
Avascular necrosis	Because of the violation of blood circulation in the joint region, the tissues do not receive all the necessary substances, which leads to their necrosis.
Tumor	Neoplasm, as it grows, leads to disruption of the functions of the joint and its destruction. Then the oncological endoprosthesis of the knee joint is established.
Fracture of the femur or tibia	Often injuries are of a combined nature and are reflected in the work of articulations of the limb, sometimes leading to a significant deformation.
Gout	Accumulation of uric acid in the joint tissues - leads to their destruction.

Indications for endoprosthetics of the knee joint can only be determined by a specialist - a trauma doctor. The patient will have to undergo a series of studies that will accurately determine the state of the articulation and understand exactly how it is worthwhile to perform prosthetics.

The doctor must tell his patient about all the risks associated with such an operation. And the person himself has the right to decide whether to intervene or not.

Types of prostheses

Before you look for where you can do endoprosthetics, it is worthwhile to get acquainted with what exactly will be "installed" in a sick leg. There are different types of prostheses that are selected depending on the situation.

To date, endoprosthetics are performed taking into account the extent and extent of damage.

Therefore, such an operation has its own classification:

• complete replacement of the joint, when a total knee joint endoprosthesis is established;
• one-implant endoprosthetics - a prosthesis with a sliding platform is used;
• total joint replacement with parallel axis correction - the joint is completely replaced, and its axis is corrected.

There are several types of prostheses (as in the photo).

Types of endoprostheses of the knee joint are divided into the following groups:

1. Prosthesis with posterior stabilization. It consists of a metal and plastic component, which are adjacent to each other. The movement is carried out smoothly, which means that the service life will be long. In this model, the design is such that the tibial component has an elevated surface, with a pin on it. It fits tightly into the hole on the femoral element. The whole design implies imitation of the operation of the remote posterior cruciate ligament.
2. Prosthesis with retention of posterior cruciate ligament. There is already no central pin. Therefore, this type of implant is set for those patients in whom the posterior cruciate ligament is in a satisfactory condition. This allows you to create sufficient stabilization of the knee joint.
3. Partial dentures. If there is a total endoprosthesis of the knee joint, then a very massive prosthesis is used. But with relatively little damage, the replacement is only subjected to a certain part. It is in the latter case that single-pole endoprostheses are used.
4. Prosthesis with a movable platform. The design has three main elements, which provide replacement of the present joint. But if you compare this model with other options, then it is very important to support soft tissue. If their underdevelopment is observed, the specialist will look for alternative models that will solve the problem of the diseased knee. In the opposite case, there is a high risk that the endoprosthesis of the knee joint will loosen.
5. Prosthesis with a fixed platform. The most common installation. The polyethylene element of the tibial component is firmly fixed on the metal platform. But this impulse is not suitable for patients who are overweight and those who, due to their activities, have to show high activity of the movement. Here the prosthesis will wear out too quickly. In more detail, such implants can be seen in the photo.

The price for each prosthesis is different, because a lot depends on the center where the operation and the manufacturer are conducted. For example, the German endoprosthesis of the knee joint is somewhat cheaper than the endoprosthesis of the knee joint of the United States. But the client has the right to decide what is available and acceptable for him.

Preparation for surgical intervention

Regardless of what operation is planned (total or partial), the patient is prepared for it in advance. And this process begins a month before the appointed date. The first step is diagnosing, which includes examining a specialist, taking tests, X-rays.

Before the operation, you need to find out whether there are any contraindications to endoprosthetics of the knee joint. This is usually done by a therapist or family doctor. For example, arterial hypertension or diabetes mellitus may become an obstacle to manipulation.

It is very important that specialists work together, but this depends on the patient himself.

But, here if the procedure will be done in a private clinic, then you can "order" all specialists to avoid running between different institutions.

Many people know that after endoprosthetics, a number of exercises are needed to develop the joint. But there is a complex that is done before the operation. This is necessary in order to maximize physical fitness.

Since during the rehabilitation period it will be necessary to use auxiliary walkers, the hands and the torso must be ready for this initially (cf.

How does the postoperative period after the endoprosthesis of the knee joint: the stages of recovery and certain difficulties). This article will tell you about specific exercises that you can perform at home.

It is not superfluous to buy crutches in advance and train on them.

It is very important to keep track of your weight. With excess body weight, a specialist develops a diet for the patient, in order to reduce the load on the prosthesis in the postoperative period.

Then during the rehabilitation period, there will be no special restrictions on eating in such patients (he will have to adhere to the principles of proper nutrition), but that's the amount in a portion of food will not matter small.

Because the motor activity in this period will be reduced, which means there is a risk to gain extra pounds. And so you can get used to a limited menu in advance.

And this will not become too much "stress" for the body.

Before surgery to replace the joint, patients with excess weight are prescribed a special diet.

In advance, you need to be prepared for various postoperative complications. Therefore, some experts recommend to think about the probability of blood transfusion.

You can turn in your own or leave a request in the blood bank.

And this can cause complications or rejection of the prosthesis.

Therefore, it is not just easy to go through all the diagnostics carefully, but also to visit a dentist (an otolaryngologist, if necessary, a urologist, gynecologist, etc.).

After all, teeth can become a hotbed of infection, which can easily spread through a weakened operation to the body.

Perhaps, the patient's home deserves special attention. It is also worth a few refit before the operation:

• all the items to be used (in the kitchen, in the bathroom, etc.) are best moved to the level of the hands, so that they are less stretched;
• the first time climbing the stairs will be harmful for the "new" knee, so for owners of private houses, It is worth thinking about moving rooms to the lower floors, and for high-rise buildings - to figure out how to facilitate climb;
• furniture should be maximally expanded in the corners, as walking on crutches requires space;
• subjects for sitting should be high, so that the knees are always at the level of the hip joints, not lower;
• It is better to remove carpets temporarily from the floor, so as not to stumble over their edges;
• it will be useful to build a small bench-step for the operated leg;
• all medicines must be in an accessible place;
• the bed should be located appropriately, since it is necessary to rest, initially relying on a healthy limb;
• it is best to arrange all the essentials in one place - a telephone, a TV, a computer, etc .;
• For the rehabilitation period, animals, such as cats and dogs, should be given to acquaintances or relatives so that they do not accidentally push the patient;
• it will be good to install the handrails in the bathroom so that it would be convenient to keep and rise.

The native should be prepared for the fact that after the operated patients (especially age-related), there will be a need for appropriate care for some time.

Sometimes it happens that it becomes necessary to carry out an endoprosthesis replacement of the second knee joint. Here the instruction of actions will be similar, as with the first knee. But here the stage of recovery in this case can become more lengthy.

Here you need maximum attention and patience from both the patient and his family. The main thing is to find a qualified specialist who will explain everything and tell from A to Z.

A source: https://vash-ortoped.ru/lechenie/protezirovanie/endoprotezirovanie-kolennogo-sustava-124