Partial Knee Replacements and Early Osteoarthritis Treatment
Introduction to joint-preserving knee surgery
Knee joint pain and joint wear and tear are common problems that affect people of all ages. Many patients immediately think of a knee replacement if their symptoms persist. However, modern orthopaedic procedures offer numerous joint-preserving techniques that can significantly delay or even avoid the need for a total knee replacement. These include osteotomies (axis corrections), cartilage and bone transplants and meniscus transplants.
These surgical procedures aim to restore knee joint function while preserving as much of the natural joint structure as possible. Patients suffering from chronic knee pain due to malalignment, cartilage damage or meniscus defects can benefit from these procedures to improve their mobility and quality of life – without a total knee replacement.
Ursachen und Risikofaktoren
Mehrere Faktoren tragen zur Patellainstabilität bei, darunter:
- Anatomische Anomalien (flache Trochleagrube, hochstehende Patella)
- Bandlaxität
- Vorherige Knieverletzungen oder Luxationen
- Muskeldysbalancen, die die Patellaführung beeinflussen
- Genetische Veranlagung
What is joint-preserving knee surgery?
Patienten mit Patellainstabilität können folgende Beschwerden haben:
- Wiederholte Kniegelenksluxationen
- Schmerzen an der Vorderseite des Knies
- Gefühl der Instabilität oder „Wegknicken“
- Schwellungen und Steifheit
Joint-preserving knee surgery involves various advanced orthopaedic procedures that correct structural problems and repair damaged tissue in the knee joint. In contrast to total knee replacement, in which the damaged joint is removed and replaced with a prosthesis, these operations focus on preserving and restoring the natural joint structures.
The most important procedures include
Osteotomies: Axial correction for long-term joint health
What is an osteotomy?
An osteotomy is a surgical procedure in which bones are cut and reshaped to correct misalignments. This technique is particularly beneficial for younger, active patients with early stages of osteoarthritis or joint deformities that lead to uneven cartilage wear.
- High tibial osteotomy (HTO): Used to correct bow legs (varus deformity) in order to shift the load away from the damaged side of the joint.
- Orthesen zur Stabilisierung der Patella
- Anpassung der Aktivitäten
- Entzündungshemmende Medikamente
Advantages of osteotomies
Bei wiederkehrender oder schwerer Instabilität ist eine Operation erforderlich, um die Patella auszurichten und die normale Gelenkfunktion wiederherzustellen.
Cartilage and bone transplants
Cartilage transplantation
Cartilage transplantation is used to treat localized cartilage damage before it leads to more serious joint damage. The main techniques include:
Bone grafting
Bone grafting is used in cases of significant bone loss, e.g. due to trauma, osteonecrosis or previous surgery. This procedure helps to restore the structural integrity of the knee and create a stable basis for cartilage repair.
Trochleoplastik
Die Trochleoplastik vertieft die Trochlearinne, damit die Patella eine stabilere Gleitbahn hat. Dies reduziert das Risiko weiterer Luxationen.
Femurosteotomie
Diese Operation korrigiert eine abnorme Rotation des Oberschenkelknochens (Femur), die eine Patellaluxation begünstigen kann.
Meniscus transplantation: My 25 years of experience
- Patients under the age of 50 who have already had a complete or partial meniscectomy.
- Geringeres Risiko für langfristige Komplikationen im Vergleich zu Knieprothesen
- Schnellere Erholungszeiten
- Reduziertes Risiko für postoperative Arthrose
Success rates and case studies
Gelenkerhaltende Verfahren sind besonders geeignet für:
- Osteotomies significantly reduce knee pain and improve joint function with a success rate of over 80% after 10 years.
- Cartilage and bone transplants provide long-term pain relief and improved joint mechanics in over 80% of cases.
- Meniscus transplants have been shown to delay the progression of osteoarthritis and improve knee joint function in more than 85% of cases.
- Patienten mit frühem Knorpelschaden
Erfolgsraten und Fallstudien
Long-term clinical studies and patient histories confirm the high success rates of joint-preserving knee operations:
Frequently asked questions
The recovery time varies depending on the procedure. Osteotomies and meniscus transplants usually take 3-6 months, while cartilage and bone transplants can take around 4-6 months.
Suitable candidates are patients with early to moderate joint degeneration, knee instability, cartilage damage or meniscus deficits who wish to avoid a knee prosthesis.
General surgical risks include infections, blood clots and healing complications. However, with professional aftercare and rehabilitation, the risks are low.
The return to sporting activities depends on the procedure and the healing process. Light exercise is often possible after 4-6 months, while high-performance sport requires around 9 months.
Please do not hesitate to contact me for further information or a consultation in my practice in Vienna.
Die Trochleoplastik hat eine hohe Erfolgsrate. Die meisten Patienten berichten über eine deutliche Linderung der Symptome und ein geringeres Risiko für erneute Luxationen.
Kontakt für eine Beratung
Wenn Sie unter Symptomen einer Patellainstabilität leiden, zögern Sie nicht, mich für weitere Informationen oder eine persönliche Beratung in meiner Praxis in Wien zu kontaktieren.
