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The knee joint connects the upper leg and the lower leg and is made up of the femur (thigh bone), the tibia (shin bone), the patella (kneecap) as well as of tendons and muscles. It allows you to bend and extend your leg and, at the front, it is limited by the kneecap which you can feel under the skin. When you extend your lower leg, the kneecap will slide up over the joint. The tendons that extend over the medial and lateral sides on the back of the knee joint from the upper to the lower leg form the popliteal space which accommodates important nerves. Diseases and injuries of the knee joint
Meniscus injuries)
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Most cases of meniscus injuries require surgery to prevent secondary damage to the cartilage surface. For this reason, meniscal tears should be operated as early as possible. The surgical technique applied will spare as much of the meniscal tissue as possible. If the tear is located in the inner or middle third of the meniscus proximal to the joint, destroyed tissue will normally be removed and as much healthy meniscal tissue as possible will be preserved. If the tear is located in the posterior third of the meniscus next to the joint capsule, the meniscus can be sutured. Cartilage injuries)
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Injuries of the cartilage surface may be caused by trauma or by false strain. Depending on the site and severity of the cartilage injury, several therapy options may be envisaged. Their primary goal is to stop the degenerative process and/or to regenerate new cartilage tissue. In our institute we offer the procedures of abrasion, microfracture as well as autologous chondrocyte implantation (ACI). This technique uses the patient's own cartilage cells which are harvested, grown and then reimplanted in the articular surface defect. Injuries of the cruciate ligament)
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Another injury of the knee joint is tearing of the cruciate ligaments, a problem that occurs more frequently due to increasing sports activities. There is general agreement nowadays that injuries of the cruciate ligaments also require surgery, because an instable knee joint may result in secondary damage to the meniscus, the articular cartilage and the stabilizing capsular structures. Personally, I perform reconstructions of the cruciate ligaments, using the central third of the patellar tendon with a bone block of the patella or of the tibia attached. In case of recurring ruptures or when the patellar tendon cannot be used, we choose the semitendinosis tendon. The patellar tendon is secured in the femur and/or tibia by means of bioabsorbable screws. After surgical reconstruction of a cruciate ligament, the patient should start physical therapy as early as possible. Patients may stop using crutches as of the 10th day after the procedure. Patella problems)
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The patella (kneecap) transmits the force of the thigh muscles to the lower leg. When you bend your leg 30° or more, the patella tracks in a groove in the femur, the so-called femoral groove, which acts as a sliding bearing. The following problems may be encountered: Patellar luxation, dislocation of the kneecap as well as damaged cartilage behind the kneecap with the associated clinical picture. Patellar luxation can be corrected by an arthroscopic procedure. The procedure consists of suturing the medial joint capsule and lateral release associated with lateral splitting of the joint capsule. Cartilage injuries behind the kneecap can be treated by smoothing the cartilage or, if the cartilage is severely damaged, by implanting cartilage cells. |