Total knee prosthesis
1
A
total knee prosthesis is placed in older patients that are invalidated by
violent pain complaints as a result of wear of their knee (1).
2
3
Before
the start of the operation the operation assistants must unpack the instruments
that are necessary for the operation and arrange them in the correct order on
sterile tables (2,3)
4
5
6
After
the leg is desinfected and a sterile drape is applied, a straight cut over
the knee is made with a length of approximately 20 cm (4). The knee joint is
opened (5) and the knee cap is tilted to the outside
7
8
Then
a special device is placed in the marrow cavity of the upper leg. The surgeon
estimates the measure and the position of the prosthesis for the upper leg (7,
8).
9
10
11
12
Using
special devices, the deformed cartilage areas are removed by a special saw so
the knee prosthesis fits exactly to the bone (9,10,11). The same goes for the
lower leg.
13
14
15
After complete removal of the cartilage (13) a provisional prosthesis
can be placed to assess if the knee can stretch entirely, can bend sufficiently
and if it is stable (14,15).
16
17
Then
the definite prosthesis is unpacked(16,17). Also it is estimated if the knee cap
has to be made artificial. Mostly this is not necessary (like in this example).
18
19
20
21
With bonecement in a vacuum system (18) the prosthesis is fixed in the leg. The knee plateau is placed firstly (19) and then the prosthesis for the upper leg. The redundant bone cement is carefully removed (20,21).
22
23
24
25
26
The
prosthesis is now at its place and the knew knee is closed with sutures for the
deep layers and staples for the skin (22-26).
After three months rehabilitation, in the hospital and at home, these patients will be relieved from their pain complaints and can walk well again.