Patients often apply to the orthopedic clinic with complaints of pain concentrated around both knee joints, swelling in the knees occurring simultaneously 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 begins as soon as the patient starts walking and can reach a level that wakes the patient up at night. The knee joint is the joint that carries the most weight in the body and is a joint that is prone to trauma. There are 3 bone structures (femur, tibia and patella) that form the joint, and there is a 4-5 mm thick cartilage structure at the ends of these bones that form the joint. In addition, joint fluid (synovial fluid), which provides nutrition for the knee, is effective in nourishing the cartilages. The sliding movement of the knee occurs through these cartilage structures and is painless. Following pathologies that cause deterioration of the cartilage structure, knee joint calcification (gonarthrosis), also known as "fluid loss" among the public, is observed in the knee.
Among the causes of knee joint calcification, the most common one is the cause of which is unknown, but it may be due to various reasons or factors. "Primary Osteoarthritis" is a disease that occurs as a result of a combination of In this disease, deterioration of the joint cartilage occurs in older ages as a result of the formation of cartilage-damaging substances in the synovial fluid. Apart from this, cartilage deterioration due to various reasons, called "Secondary (secondary) osteoarthritis", is also observed. These reasons include trauma, previous fractures of joint structures, removal of menisci at an early age, untreated anterior cruciate ligament tears, sequelae of previous knee joint infections, and rheumatic diseases.
Patients often come to the orthopedic clinic with pain concentrated around both knee joints. They apply with complaints of swelling in the knees occurring simultaneously 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 begins as soon as the patient starts walking and can reach a level that wakes the patient up at night. In patients with an accompanying meniscus tear, cysts (Baker cyst) may form in the posterior knee space after the increased joint fluid escapes from the back of the knee. Many steps until we reach the final stage. Patients undergo rehabilitation, knee injections, PRP treatment and/or closed knee joint surgeries.
Patients are evaluated with special examination techniques for the knee joint after a detailed disease history is taken by an orthopedist. After the examination, after the preliminary diagnosis is made, two-way and comparative knee radiographs taken by "pressing" and "orthoroentgenography" showing the area below the waist in a single radiograph are requested. In patients with arthritis, the diagnosis is made by observing closure of the joint space, bone protrusions called "osteophytes" and observing tiny cysts under the cartilage.
Treatment is shaped according to the stages of the disease in patients. In very early stages, weight loss, rehabilitation, insoles, device support, intra-knee injections (Viscosupplementation, PRP) are non-surgical treatment methods that can be applied. In patients where the entire knee is not affected and only the cartilages on the inside of the knee are affected, a bone correction surgery called "High tibial osteotomy" can be performed, which will both reduce pain and delay the prosthesis. In slightly more advanced patients, a partial prosthesis, which we call "Unicondylar knee prosthesis" and which is made only on the inner side of the knee, can be applied. "Total knee prosthesis" provides a solution for patients with advanced arthritis that has affected the entire knee.
Knee prosthesis is entered through an open incision in front of the knee, the damaged ends of the bones forming the joint are cut and metal is used with the help of special sets. It is the creation of a new joint line with implants made of alloy (Cr-Co-Mo) and thick polyethylene. Post-surgical complications include infection, clot formation (embolism) and very rarely vascular injury. Patients are walked with support the next day.
Which complaints are seen?
- Pain often concentrated around both knee joints,
- Swelling in the knees occurring at the same time or at different times
- In the early stage, pain occurs when walking long distances and going up and down many stairs.
- In the later period, the pain begins as soon as the patient starts walking and can reach a level that wakes up at night.
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