Structure of the joint – in simple terms: The knee joint is composed of the vat-like end of the femur, the plateau-shaped upper end of the tibia, the kneecap, the cruciate ligaments, the 2 meniscuses (cartilaginous washer-like wedges between the femur and the tibia), a surrounding joint capsule, lateral ligaments and muscle tendons. Thus, its structure is much more complex than that of a simple hinged joint and permits much more complex movement patterns.

Causes of injury:

Due to its design, mobility, and the forces acting on this joint, it is frequently affected by falls and abrasion. It may be damaged by an accident or due to inappropriate or excessive loading over a long period of time.

Treatment of the knee:

The goal is to achieve a painless and mobile joint with stable ligaments. The joint should be able to transfer forces easily and withstand loads. This is aided by exercises to strengthen muscles, coordination exercises, physical therapy, physiotherapy, cartilage build-up, medical aids such as knee-length stockings or splinting the joint, injections or surgery to achieve pain relief.

Surgery should be performed when all conservative options have been exhausted or are deemed ineffective. Surgical options may be divided into joint-preserving and joint substitution (artificial joint) operations.

Depending on the type and size of the defect/damage/injury, the appropriate treatment/surgery should be used.

The following table provides a short summary of frequent diseases of the knee joint and their treatment options. The second table is practically a mirror image of the first one and describes, in its first column, the operations. The corresponding diseases or conditions are mentioned in the second column. I hope this will make it easier to find the desired term.

Diseases:

Knee surgery:

joint preserving operations:

Joint replacement surgery:

Duration of the in-hospital stay after surgery:

Arthroscopy: Usually only 1 day. The patient may be discharged the day after surgery.

Cartilage transplantation: approximately 1 week

Correction of the axis: approximately 1 week

Slide prosthesis: about 7 to 11 days

Complete joint replacement: about 8 to 11 days

Suture removal: is always performed 10 to 12 days after surgery (either during the in-hospital stay or at the outpatient department, at the office of the general physician or the specialist).

Follow-up treatment:

Arthroscopy: Smoothing the meniscus: Protecting the operated leg for 2 weeks, then muscle build-up

Meniscus suture: Crutches and de-loading or partial loading of the operated leg for a few weeks, depending on the size and location of the tear. Thereafter strength and coordination exercises.

Cartilage transplantation: Crutches and de-loading, partial loading and special knee splint for 6 to 12 weeks. Thereafter strength and coordination exercises.

Correction of the axis: Crutches and partial loading of the operated leg usually for 6 weeks, knee splint if necessary, then strength and coordination exercises.

Slide prosthesis and complete knee replacement: Basically full loading can be started immediately after surgery. During the in-hospital stay the patient is treated with a motor splint in order to improve the mobility of the joint. Walking and climbing stairs is also practiced. Thereafter, crutches should be used for several weeks until the patient feels confident about walking. Sometimes it is advisable to continue the treatment with a motor splint even after the patient has been discharged from the hospital, in order to improve the mobility of the joint. The 3-week rehabilitation stay should start about 6 to 8 weeks after discharge from the hospital in order to optimise the outcome of surgery.