Patients often apply to the orthopedic outpatient clinic with complaints of pain intensifying around both knee joints, swelling in the knees that occur at the same time or at different times, and bending in the legs. In the early stages of the disease, the pain occurs when walking long distances and going up and down many stairs, but as the disease progresses, it starts as soon as the patient starts walking and can reach a level that wakes him up at night.
The knee joint is the most load-bearing joint of the body and is a joint vulnerable to trauma. There are 3 bone structures (femur, tibia and patella) that make up the joint, and there is a 4-5 mm thick cartilage structure at the ends of these bones forming the joint. In addition, the joint fluid (synovial fluid) that provides nutrition for the knee is effective in the nutrition of the cartilages. Knee sliding movement takes place over these cartilage structures and painlessly. After pathologies that cause deterioration of the cartilage structure, knee joint calcification (gonarthrosis), also known as “fluid loss” among the people, is observed in the knee.
The most common cause of knee joint calcification is “Primary Osteoarthritis”, the cause of which is unknown, but caused by various reasons or a combination of these. In this disease, articular cartilage deterioration occurs after the formation of substances that damage the cartilage in the synovial fluid in advanced ages. Apart from this, cartilage deterioration due to various reasons, called “secondary (secondary) osteoarthritis”, is also observed. These causes include trauma, previous fractures of joint structures, removal of meniscus at an early age, untreated anterior cruciate ligament tears, previous knee joint infection sequelae, rheumatic diseases.
Patients often apply to the orthopedic outpatient clinic with complaints of pain intensifying around both knee joints, swelling in the knees that occur at the same time or at different times, and bending in the legs. In the early stages of the disease, the pain occurs when walking long distances and going up and down many stairs, but as the disease progresses, it starts as soon as the patient starts walking and can reach a level that wakes him up at night. In patients with concomitant meniscal tear, cysts in the posterior knee space after the increased joint fluid escapes behind the knee ( Baker’s cyst ) may occur. Until the final stage, many patients undergo rehabilitation, knee injections, PRP treatment and/or closed knee joint surgeries.
After taking a detailed disease history by an orthopedist, the patients are evaluated with special examination techniques for the knee joint. After the preliminary diagnosis is made after the examination, two-way and comparative knee radiographs taken by “pressing” and “orthorontgenography” showing the lower part of the waist in a single X-ray are requested. In osteoarthritis patients, the closure of the joint space, the observation of bone protrusions called “osteophytes” and the observation of tiny cysts under the cartilage make the diagnosis.
Treatment is shaped according to the stages of the disease in the patients. Weight loss, rehabilitation, insoles, device support, intra-knee injections in the very early stages (Viscosupplementation, PRP) applicable non-surgical treatment methods. In patients where the entire knee is not affected and only the cartilage on the inside of the knee is affected “High tibial osteotomy” Bone correction surgery, which is called the bone correction surgery, which both reduces pain and delays the prosthesis, can be applied. In more advanced patients “Unicondylar knee prosthesis” Partial prosthesis, which we call and which is made only on the inner side of the knee, can be applied. In patients with calcification that has involved the entire knee and has advanced “Total knee replacement”It provides permanent comfort to patients.
Knee prosthesis is the creation of a new joint line with implants made of metal alloy (Cr-Co-Mo) and thick polyethylene with the help of special sets by entering through an open incision from the front of the knee, cutting the damaged ends of the bones forming the joint. Complications include post-surgical infection, clot formation (embolism) and vascular injury, which can be seen very rarely. Patients are carried out with support one day later. Physical therapy, which is started in the early period after surgery, has a positive effect on the surgical outcome.
What complaints are seen?
Pain often concentrated around both knee joints,
Swelling in the knees that occurs at the same time or at different times
Pain when walking long distances and going up and down stairs in the early period,
In the following period, the pain starts as soon as the patient starts walking and can reach the level that wakes him up at night.