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in this area:
Prof. <br /> Dr. med. habil.<br /> Georg Matziolis
Dr. med. habil.
Georg Matziolis

Senior Consultant of the Clinic for Orthopaedics and Accident Surgery

Acting holder of the Chair for Orthopaedics of the FSU Jena at the Waldkrankenhaus Eisenberg

036691 8-1002

Operating procedure

The artificial knee joint

The operating procedure for inserting an artificial knee joint can be roughly divided into four steps:

Step 1

After introduction of the anaesthetic, a so-called "blood arrest" is applied to the thigh: This inflatable pressure sleeve briefly interrupts the blood flow. The doctor thus has a good view of the operation area, unnecessary blood loss is avoided and when cementing the prosthetic in place, a "blood-dry" situation prevails.

The surgeon opens the joint and the destroyed cartilage and bone surfaces of the knee joint are removed. If implantation of a surface prosthetic is planned, the collateral ligaments are always retained. The remaining bone is prepared with special operating instruments and saw gauges in such a way that the shape of the  femur and tibia bones matches the fit of the prosthetic. At the same time, malpositions of the knee and leg axis are corrected.

Step 2

In the next step, a trial prosthetic is first inserted:  thus the surgeon determines the best position and size of the final endoprosthetic. The stability of the ligaments, the correction of the leg axis and the mobility of the prosthetic is tested.

Step 3

First the surgeon inserts the optimally measured original prosthetic. After cleaning and rinsing of the bone surface, the prosthetic is generally fixed with bone cement. This ensures high stability between the bone and prosthetic surface and already hardens after a short time.

Cemented prosthetics enable a tighter connection with the bone and a long service life. In principle, the prosthetic can be subjected to loads immediately. In the case of more serious bone defects or poor bone quality, fixing is increased with shaft extensions on the prosthetic parts or special coupling pins between the femur and tibia part of the prosthetic. The patella is retained when inserting the knee prosthetic. Only the surface of the cartilage is replaced id necessary.

Step 4

The finally cemented knee prosthetic is checked for functioning in terms of mobility, ligament stability and axial orientation. In the last step, the surgeon removes the blood arrest and stops any bleeding. Drains should prevent formation of a haematoma.

Then the joint capsule and skin are sewn together again and a compression bandage is applied. The operating time is normally 90 minutes. The surgeon checks the correct fit of the prosthetic in the operating theatre with an x-ray.

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The surgeon adapts the prosthetic ideally to the anatomy of the patient. A navigation system can contribute to an even more precise implantation.

The surgeon adapts the prosthetic ideally to the anatomy of the patient. A navigation system can contribute to an even more precise implantation.

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Clinic for Anesthesia and Intensive Therapy
Brief profile

We want the patients in our hospital to receive the best possible care and to recover as quickly as possible. To this end, the Clinic for Anaesthesia and Intensive Therapy makes an important contribution: The highest possible degree of freedom from pain during and after the operation increases the well-being and thus accelerates the healing process.

More information.

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