Symptoms :

• of the pains occurring with walk ;
• a reduction in articular mobilities, difficulty “of folding the knee” ; impossibility of climbing or of descending.

Diagnosis :
X-rays show a pinching of the articular line space by disappearance of the cartilage: the bone of the femur is in contact with the bone of the tibia. They show the number of touched compartments.

Treatment :
The treatment must always be medical initially acting on the pain; when the drugs are not enough, physiotherapy (using devices such the infra-red type or ultrasounds or laser acting on the pain and the inflammation) can be carried out.
If all these therapeutic did not generate improvement, the surgery can be discussed.

Principle :
To remove injured cartilage surfaces and to replace them by a prosthesis which is made up of 4 parts (for the total prostheses of the knee):

• a femoral implant :
  
  Of face, of profile
  
  
• a tibial implant on which is posed a polyethylene plate :
  
  
• an implant being fixed on the articular slope of the kneecap :
  
  

The assembly of the implants is represented on this sight :

Advantages :
The implants profited from significant technical improvements these last years :

• the implants are of more reduced size allowing more limited dissections and more reduced osseous removing(prostheses known as “of patching” replacing only injured articular surface) allowing immediate rehabilitation and the resumption of walk with a complete support after the intervention; the duration of the hospitalization is shorter of approximately a week and rehabilitation can be carried out close to the residence ;
• their implantation thus is facilitated of it making it possible to reduce the duration of the intervention; their implantation is also more precise and is adapted better to the anatomy of the patient thanks to a more powerful instrumentation ;

Limits : total ankylosis of the knee; associated neurological disease; antecedent of chronic infectious processes…

Demonstration with a clinical file :


Osteoarthritis of the knee
(concerning especially the intern
femoro-tibial compartment)


Irregularities of the articulation
enters the kneecap and the femur


X-rays of profile and face
after implantation of the prosthesis




X-ray kneecap after implantation
of the patellar implant compared
to the femoral implant


The knee right operated
(on the left of the image)
a few days after the operation ;
the patient supports completely without cane


Seen profile, the lower limb is well centered


A few days after the operation,
the complete inflection of the knee is obtained


Operational sight: wear of the cartilage
exposing the bone


Operational sight after implantation of the prosthesis