Orthopädie am Rhy

Basel, Rheinfelden, Liestal

ORTHOPÄDIE AM RHY
Your specialists for knee problems

Don't let yourself be brought to your knees!

Knee problems are annoying, painful and have a huge impact on our lives. Many sporting activities are no longer possible. Let’s take a look at why.

The knee joint is a "swivel hinge joint", and as such the only one in our body.
It consists of three joints: Firstly, the so-called femorotibial joint between the thighbone and shinbone, in principle the actual knee joint, and secondly, the patellofemoral joint between the kneecap and the thighbone. Thus, four bones are involved in the joint: The thighbone (femur), the shinbone (tibia), the calf bone (fibula) and the kneecap (patella). Then there are the muscles, tendons and ligaments which connect them.

Between the thigh and the lower leg there is an inner and outer meniscus, which serves to distribute pressure in the joint. The inner or outer meniscus consists of a kind of fibre cartilage, serves as a shock absorber and helps stabilise the knee. Injuries to the menisci are often caused by a twisting movement.

There are a large number of ligaments in and around the knee. However, the femur and shinbones are mainly held in place by four ligaments that are important for the knee joint:
• The anterior cruciate ligament (ACL)
• The posterior cruciate ligament (PCL)
• The medial collateral ligament (MCL)
• The lateral collateral ligament (LCL)
The fairly frequent injury of one of these four ligaments can lead to instability of the knee joint in various directions.

The quadriceps muscles form a group of muscles which are attached to the kneecap by a common tendon. They are used to straighten the knee. The flexor muscles are a group of muscles attached to the tibia or fibula. They are used to flex the knee. The calf muscles are also involved in knee movement. 

Knee – an overview of our treatments

In recent years, a variety of new, highly effective and increasingly gentle treatments of the knee joint have been developed, including joint-preserving, conservative (non-surgical) and surgical measures. For example, nowadays treatment of osteoarthritis of the knee by means of a total knee prosthesis can be delayed further and further.
In addition to traditional applications such as physiotherapy and physical measures, conservative measures also include the infiltration (injection) of cartilage-protecting "lubricants" and selective treatment with stabilising and axis-correcting knee splints. If conservative treatment is no longer sufficient, almost all ligament, meniscus and cartilage regenerative operations can be performed in the course of minimally invasive "keyhole surgery" (arthroscopy). The best individual treatment is carried out for you using the latest techniques and biocompatible materials:

Read more about the treatment options by our experts on the following pages!
The following treatments can be applied individually according to the symptoms and age:
- Cartilage healing with ACP
- Microfracture knee surgery
- Chondrocyte transplantation
- Corrective osteotomies
- Partial replacement of the knee joint
- Total prosthesis of the knee joint 

In recent years, a variety of new, highly effective and increasingly gentle treatments of the knee joint have been developed, including joint-preserving, conservative (non-surgical) and surgical measures. For example, nowadays treatment of osteoarthritis of the knee by means of a total knee prosthesis can be delayed further and further.

In addition to traditional applications such as physiotherapy and physical measures, conservative measures also include the infiltration (injection) of cartilage-protecting "lubricants" and selective treatment with stabilising and axis-correcting knee splints. If conservative treatment is no longer sufficient, almost all ligament, meniscus and cartilage regenerative operations can be performed in the course of minimally invasive "keyhole surgery" (arthroscopy). The best individual treatment is carried out for you using the latest techniques and biocompatible materials:

Read more about the treatment options by our experts on the following pages!

The following treatments can be applied individually according to the symptoms and age:

- Cartilage healing with ACP
- Microfracture knee surgery
- Chondrocyte transplantation
- Corrective osteotomies
- Partial replacement of the knee joint
- Total prosthesis of the knee joint 

The anterior and posterior cruciate ligaments stabilise the knee joint and prevent the lower leg from sliding away from the thigh bone. Injuries to the anterior cruciate ligament are much more common than injuries to the posterior cruciate ligament. Typically, the anterior cruciate ligament can tear when the lower leg rotates outwards with the knee joint bent and tilted inward.

In principle, the following procedures are available for treating a rupture of the anterior cruciate ligament: conservative therapy, replacement of the anterior cruciate ligament or the healing response. The choice of the procedure depends on the age of the injury, the extent of the instability and the level of physical activity of the patient. The patient’s own cruciate ligament can be preserved in the healing response. During a small arthroscopic procedure, the displaced fibres of the cruciate ligament are restored to their correct position. Small holes are drilled in the bone in the area where the cruciate ligament attaches so that stem cells can escape from the bone marrow. These lead to the healing of the cruciate ligament. Advantages of this technology: The patient’s own cruciate ligament is preserved. There is no need to remove a tendon from anywhere else on the body. It is a minor procedure with a significantly lower risk of complications compared to replacing the cruciate ligament. Sporting activities can be resumed earlier. A healing response can only be carried out in the first few weeks after the anterior cruciate ligament injury.

Our practice specialises in this technique. 

The inner and outer meniscus have a shock absorbing function in the knee joint. They act as a buffer between the heads of the two bones, the femoral condyle and the tibial plateau. Meniscus damage can result from general wear and tear in the knee or from an accident (twisting of the knee joint). The inner meniscus is affected far more frequently. Not all meniscus damage requires immediate surgery. Conservative treatment is often possible, especially in the case of wear-related damage. Depending on the extent of the meniscus tear, an operation may be necessary; this is carried out arthroscopically. As a rule, the damaged parts of the meniscus that have lost their buffering function are removed. A rupture of the meniscus caused by an accident should be reaffixed (sutured) under certain circumstances. In rare cases, meniscus replacement is required. A synthetic meniscus implant is sewn into the defective area of the damaged meniscus. 

Kneecap (patella) dislocation and instability

Misalignments

If there is significant, wear-related damage to the cartilage covering on the knee joint and there is pain and restricted mobility, and if the conservative treatment options have been exhausted, the fitting of a knee prostheses may have to be considered. The worn cartilage coating (wear and tear) is replaced by a state-of-the-art metal surface. In the event of unilateral wear, a partial knee prosthesis can be implanted, in which only the affected section of the knee is replaced. However, if the cartilage damage has affected a large part of or the entire knee, we recommend a full prosthesis with renewal of the entire surface. The meniscus, which among other things serves as a shock absorber between the respective bone surfaces, is replaced by a durable special plastic. In certain cases, computer navigation, or personalised knee prosthesis created for the patient on the basis of a 3D reconstruction, has also proven its worth.

All of the above methods are only performed by our highly specialised knee experts. 

Your knee specialists in our practice

Dr Carsten Helfrich

Specialist for Orthopaedic Surgery and
Traumatology of the Musculoskeletal System

Main focus: hips, knees


Dr Robert Kilger, Prof. (D)

Specialist in orthopaedic surgery and traumatology of the musculoskeletal system FMH
Professor at the Fresenius University of Applied Sciences (D)
Sports medicine, SGSM

Main focus: Knee, foot

Dr Christian Mauch

Specialist in orthopaedic surgery and traumatology of the musculoskeletal system FMH

Main focus: Shoulder, knee


Dr Urs Kohlhaas

Specialist for Orthopaedic Surgery and
Traumatology of the Musculoskeletal System

Main focus: hips, knees



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