Legs and Knees: Surgery for Pain and Arthritis in the Knee |  NDR.de - Guide

Status: 08/16/2022 2:53 PM

Many people experience knocks on the knees or bowed legs. In some cases, this misalignment can lead to cartilage wear and even osteoarthritis. Sometimes an operation, a so-called shunt osteotomy, can help.

Even if most sufferers do not have problems, a defect in the knee joint can have serious long-term consequences in individual cases: cartilage wear, persistent pain, an artificial knee joint, and occupational limitations.

Symptoms: knee pain up to osteoarthritis

Bowed legs are common, especially in men. However, they lead to one-sided strain on the knees, and the joints cannot always withstand this for the rest of their lives. Problems threaten above all when sufferers put too much pressure on their knees at work or in sports – and when they smoke. Without treatment, knee pain increases very slowly. In the case of bow legs, the weight of the body is mainly on the inside of the joint, in the case of the knees on the outside. Over time, the cartilage continues to wear away, and osteoarthritis develops about 20 times more in bowed legs than it does without deformity.

Conservative treatment: insoles, orthotics and exercises

Sports and conservative therapy with increased edges of shoes, insoles, orthotics, and targeted muscle strengthening for knee problems are often recommended. But their chances are limited if the imbalance is very obvious. Before you decide to have surgery, these options must be exhausted. This requires patience, as it may take a few weeks for the pain to be relieved with orthotics or insoles.

Surgery: arthroplasty, partial prosthesis, or artificial knee joint

If conservative measures do not lead to lasting success, there are several surgical procedures that can be used. It is important for deciding how much the cartilage has already been damaged: if the damage is still minor, the leg can be straightened. In the case of moderate damage, the so-called partial prosthesis is used, with completely destroyed cartilage, only a knee prosthesis, a full prosthesis, can help.

Transformational osteotomy: straightening preserves the knee joint

By straightening the legs in time, the knee joints can be perfectly preserved. But the process required for this procedure is complicated: In what’s called a transformation osteotomy, surgeons saw the bone in a minimally invasive procedure and then flexed it until the leg was straight. The leg is fixed at this angle with a titanium plate so that bone tissue can grow into the gap. Ultimately, the new bone tissue should be as hard and flexible as the rest of the bone. The cartilage also recovers during this time. Although the hyaline meniscus itself does not reproduce, some kind of scar tissue grows in the areas of the defect, at least relieving symptoms significantly.

Straightening the legs is actually a well-known procedure that was basically developed over a hundred years ago. However, experts criticize that this method has been largely forgotten due to the widespread and profitable use of artificial joints today. Artificial joints are not always a good solution, especially for younger patients, because their durability is limited and replacement is not possible indefinitely.

OP: Faster healing by bending the bones

However, today’s leg straightening procedure no longer has much in common with the previous procedure, because the bones are no longer broken as they were before, but are bent. This makes the process easier and allows for a faster recovery. After four to six weeks, most patients are fit for daily life again. However, one problem is that leg straightening is not compensated by health insurance companies as well as other procedures and at the same time requires more time-consuming preparation with accurate leg measurement.

Experts on this topic

Medical Director and Chief Physician of the Orthopedic Clinic
Leipziger Strasse 24
38124 Braunschweig
(0531) 699 20 01

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visit | 08/16/2022 | 8:15 pm

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