Aches in the joints - causes, diagnosis and treatment

Causes of inflammation in the knee joint Stages of inflammation of the knee joint How to treat inflammation of the knee joint Drugs for inflammation of the knee joints

Inflammation of the knee joint is a protective process of the body

. It can be triggered by the penetration of a pathogen (for example, an infection) or a traumatic fragment (for example, a bone fragment or a gouty crystal of uric acid), or simply the presence of damaged, destroyed cells in the tissues (due to injury, oxidative shock during stress).

Inflammation of the knee joint makes it difficult to lead a normal lifestyle and, without timely treatment, can lead to disability.

When the knee joint becomes inflamed, immune cells begin to group in the affected area and destroy the irritant (after all, the body also needs to eliminate the decay products of its own cells).

Everything seems to be fine: the body has its own mechanisms to combat the irritant, and no medications are needed for inflammation of the knee joints. If not for a few “buts”:

even with high activity of immune agents, dead cells still secrete enzymes that begin to damage nearby tissues (the edge of inflammation seems to be spreading);
due to the fact that cells in the area of inflammation cannot function normally, under-oxidized products of their metabolism lead to accumulation of acids in the tissues - this provokes their further destruction;
The further the inflammation goes, the longer it will take to rehabilitate the affected area - after all, hormones and blood cells are involved in the process, the pathological process affects the functioning of nerve endings, and free radicals accumulate in the tissues.

Therefore, you cannot leave your body alone with the enemy: he, of course, will win, but not with little blood and not without consequences. How to treat inflammation of the knee joint?

Causes of inflammation in the knee joint

Inflammation in the knee area is not always associated with damage to the cartilage or joint architecture. It can be caused by changes in the normal functioning of the musculo-ligamentous apparatus (for example, myositis) or nerves. Also, the inflammatory process can also begin not in the knee joint, but directly in the bone - for example, with osteomyelitis. Typically, such pathologies are associated with necrotic changes in bone and cartilage tissue.

But the most common cause of “inflammatory” pain in the knee area is structural and functional disorders in the knee joint.

They can be called:

injuries;
infectious diseases;
metabolic and endocrine disorders (gout, diabetes, hormonal imbalances);
autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus);
vascular diseases of the lower extremities (varicose veins, thrombosis);
exposure to vibration or other sources of microtrauma;
unhealthy diet (especially one poor in vitamins A, B, C, E);
overweight;
excessive stress (for example, when carrying heavy objects or playing sports);
poisoning;
chronic stress;
hypothermia or overheating;
wearing uncomfortable shoes.

Even if the source of pathology is located, for example, in soft tissues, inflammation can always “spread” to the joint, like a forest fire, even from a small hematoma. Therefore, it is so important to treat any periarticular inflammation and damage (joint capsule, menisci, ligaments, nerves, bones, patella) and systemic infections (cholecystitis, pneumonia, urethritis, endometritis) at the first symptoms.

Inflammation of the knee joint due to arthrosis

Arthrosis is a degenerative disease that affects articular cartilage and bone heads

. If left untreated, it leads to fusion and complete immobility of the joint, i.e., disability.

The knee joint is one of the most vulnerable to arthrosis, since it experiences high stress every day. Even if you do not run or jump, but simply work in an uncomfortable position for a long time or move little, the risk of disease increases.

Obvious signs of inflammation in knee arthrosis - swelling, hot skin, redness and stiffness - usually appear already at the 2nd stage of the disease.

Therefore, you should consult a doctor if you experience pain and discomfort in your knee after physical activity, which goes away with rest - then medications for inflammation of the knee joints will be most effective.

Inflammation of the knee joint due to arthritis

Arthritis of the knee joint is an inflammatory process that occurs in the joint capsule due to injury, infection or other reason that disrupts the metabolism in the knee

In addition to pain and stiffness, arthritis often causes general weakness, fever, and swelling. The skin above the knee becomes painful, hot and red. Unlike pain with arthrosis, pain with arthritis only intensifies at rest - it increases at night and at the time of awakening, during immobile work.

Diagnosing arthritis requires identifying its causes. To do this, the doctor may prescribe an X-ray, MRI or CT scan, general and biochemical blood test, and puncture of synovial fluid.

Inflammation of the knee joint due to bursitis and tendinitis

Bursitis is an inflammation of the joint capsule containing synovial fluid, which often occurs due to injury, infection or gout.

. The main symptom of bursitis is severe pain when moving the joint. The knee swells noticeably and may hurt when you touch the skin. To accurately diagnose bursitis, in addition to examination, an ultrasound or sampling of synovial fluid may be required.

The reasons already mentioned can also cause tendonitis, an inflammatory-dystrophic disease of the tendon. It is characterized by sharp or burning pain during and after movement, stiffness in the joint, tension in the muscles and ligaments. Swelling with the formation of a characteristic “nodule” is a characteristic but optional symptom of this pathology.

If left untreated, bursitis and tendinitis can progress to periarthritis - inflammation of the tendons, muscles and ligaments around the knee, which causes pain with any load on the joint.

Inflammation of the knee joint due to chondropathy and meniscus lesions

Chondropathy is a collective name for a number of diseases associated with metabolic disorders in cartilage tissue.

Chondropathy is often caused by diseases associated with impaired collagen synthesis and anatomical structural features (for example, congenital and acquired deformities of the patella). Due to the weakness of cartilage tissue and improper load distribution, articular cartilage begins to deteriorate. Muscle fibers and ligaments can get into the joint space, which leads to injury, hemorrhage and inflammation. Chondropathy is characterized by a feeling of friction when trying to bend the knee, pain when pressing, and swelling of the joint.

Excessive flexion or extension, or eversion movements in the knee joint can lead to inflammation of the meniscus and its further degeneration. Meniscus damage is characterized by acute pain, swelling, joint stiffness, clicking and a foreign body sensation in the knee when moving.

Palpable anatomical landmarks[edit | edit code]

Medial surface

Tibial collateral ligament
Medial joint line
Medial meniscus

Lateral surface

Peroneal collateral ligament
Lateral line of the joint
Lateral meniscus

Front surface

Quadriceps tendon
Patella
Patellar ligament

Rear surface

Popliteal fossa
Biceps femoris tendon
Semitendinosus tendon
Semimembranosus tendon

Stages of inflammation of the knee joint

Any inflammatory process has 3 stages:

alteration - actual damage;
exudation - the formation of edema in tissues;
proliferation - cell multiplication and restoration of affected tissues.

In the case of the knee, this process has its own peculiarity. Cartilage tissue grows very slowly, even if periarticular metabolism proceeds normally. In the case of inflammation, the destroyed area of cartilage in the knee joint may recover only partially or (in old age) not recover at all.

Therefore, it is also worth highlighting 3 stages of the inflammatory process in the knee joint:

Stage 1

: mild pain, stiffness of movement, in the morning you need to “disperse”, patients feel that their joints are stiff from an uncomfortable sleeping position.

Stage 2

: swelling appears, pain intensifies, especially after physical exertion, the temperature of the skin over the joint rises.

Stage 3

: joint mobility is severely limited, patients suffer from pain both during movement and at rest, performing everyday tasks without taking strong painkillers is impossible.

Inflammation in the knee joint can be either acute (from 3 days to 3 weeks) or chronic (over 3 weeks). Both of these conditions require immediate treatment and elimination of the causes.

Acute inflammation in the knee makes itself felt by pain (sometimes mild - pulling or bursting, and sometimes sharp, shooting), convulsive muscle twitching, swelling, redness of the skin over the joint, and a local increase in temperature. Often the diseased joint becomes difficult to bend or straighten completely. It is difficult for patients to stand for a long time, there is a feeling of stiffness or a desire to take care of the knee.

Survey

To determine why aches and pains are felt in the joints and bones, it is necessary to consult a therapist or family doctor, who will conduct an initial diagnosis and prescribe examinations by specialized specialists. Taking into account the nature of the unpleasant sensations, the speed of their occurrence, and accompanying symptoms, the following are recommended to determine the cause of the disorder:

Laboratory blood test
. An assessment of the leukocyte count and ESR level is required to exclude infections, inflammatory and oncohematological processes. In systemic diseases, it is important to measure the content of total protein, the ratio of protein fractions in the blood, specific acute-phase proteins, markers of rheumatoid arthritis and other inflammations. Tests for the concentration of vitamins, electrolytes (especially calcium), and uric acid help diagnose metabolic disorders.
Bacteriological examination
. Bacterial culture is necessary if the aches felt in the joints and the whole body are likely to be infectious. Urine, feces, sputum, and discharge from the urogenital tract are collected for research. To select an antimicrobial therapy regimen, sensitivity to antibiotics is determined. In doubtful cases, microscopy and culture are supplemented with serological reactions (RIF, ELISA, PCR).
Sonography of articular joints
. It is usually used for clear localization of painful sensations and the suspected presence of rheumatic diseases. Ultrasound of the joint allows us to examine its structure, identify destruction of cartilage and bone, preclinical inflammatory changes, and study the condition of the periarticular soft tissues. The advantages of the method are accessibility, non-invasiveness, and high information content.
X-ray techniques
. Changes in the width of the joint space, hardening of soft tissues, the presence of calcifications, osteophytes, and erosions of the articular surfaces are detected during radiography of the joints. To improve diagnostic efficiency, special techniques are used - contrast arthrography, pneumoarthrography. In the initial stages of the lesion, tomography (MRI, CT of joints) is considered more indicative. Bone density can be conveniently assessed using densitometry.
Invasive examination techniques
. In some cases, to determine the cause of joint pain, a puncture with a biopsy of cartilage, the inner lining of the synovial membrane, and tophi is performed. Morphological analysis of biopsy specimens and examination of synovial fluid reflect the nature of the pathological processes occurring in the joints. Simultaneous collection of materials with visual examination of the articular cavity is convenient to do during arthroscopy with tissue biopsy.

A less common way to diagnose the cause of joint pain is scintigraphy with the introduction of technetium, which accumulates in the affected tissues. In recent years, there has been increasing interest in joint thermography as a modern non-invasive method for recognizing inflammatory diseases, tumors, and circulatory disorders in joints and periarticular tissues. If the number of formed elements in a clinical blood test decreases, an extra-articular bone puncture is performed. Patients with joint pain without fever are advised to consult a rheumatologist and an orthopedic traumatologist.

To find out the causes of joint pain, radiography may be prescribed.

How to treat inflammation of the knee joint

Treatment of inflammation of the knee joint is aimed at relieving pain, eliminating swelling and preventing complications. It is also important to restore metabolism and microcirculation of blood in the periarticular tissues, protect cartilage tissue from destruction and stimulate its restoration.

Comprehensive treatment of inflammation of the knee joints will give the most lasting result in getting rid of pain.

In the early stages, purely conservative treatment of inflammation in the knee joint is carried out:

pharmacotherapy;
physiotherapy;
diet therapy.

If there are large foci of erosion, cracks and chips in the cartilage, massive accumulations of exudate, as well as overgrowing of the joint space with osteophytes, surgical treatment of inflammation in the knee joint is carried out using:

punctures;
cartilage polishing;
arthroscopy;
periarticular osteotomy;
partial or complete endoprosthetics.

Injecting synovial fluid into the prosthetic joint also helps relieve inflammation.

In addition to the main treatment, you need to adhere to the recommendations of doctors regarding the orthopedic regimen:

wear comfortable low-heeled shoes;
try not to sit for a long time in a cross-legged position;
strengthen your muscles and relieve stress on your knees using the “bicycle” exercise as soon as possible;
dress for the weather.

Physiotherapy

Physiotherapeutic techniques for inflammation of the knee joint are aimed at combating swelling, pain and trophic disorders, normalizing blood circulation and metabolism, strengthening muscles and ligaments, and restoring mobility to the joint. For this we use:

low frequency pulse currents (amplipulse);
UHF therapy (ultra-high frequency currents);
electrophoresis (with drugs for inflammation of the knee joints);
ultrasound therapy;
radon, hydrogen sulfide baths and other balneological procedures;
cryotherapy;
paraffin therapy.

Before a course of physical therapy, you need to get a doctor's referral: some techniques can only increase inflammation.

Massage

Massage for inflammation in the knee is indicated only after the exacerbation has resolved. If the skin is sensitive and painful, there is an untreated injury, any massage effect is strictly contraindicated!

In other cases, patients are recommended to undergo therapeutic classical and lymphatic drainage massage from a rehabilitation specialist. The standard therapeutic course is 10 sessions.

With the doctor's permission, light self-massage with external medications for inflammation in the knee joints can be done at home to improve tissue trophism. You need to massage not the sore knee itself, but the entire leg from the hip to the ankle joint, performing rotational movements without strong pressure for 10-15 minutes. Even if inflammation was diagnosed in only one knee, both need to be massaged. The massage should be performed once a day and stopped at the first discomfort.

Exercise therapy

Therapeutic exercises after inflammation of the knee joint are performed with the greatest care and under the supervision of an instructor. You can start exercises in the complete absence of pain (including when bending) and muscle atony, as well as effusion in the joint. The loads are constantly increasing, and rehabilitation involves 3 stages.

Passive strengthening (up to 1.5 months).
- The patient sits on the floor with a straight back, legs straight. The kneecap slowly rises up by the tension of the femoral muscles, and is fixed at the top point for several seconds.
I.p. - lying on your stomach, legs straight, arms along the body. Bend the leg at the knee joint 45-90 degrees and hold for 5 seconds.
Active rehabilitation (1.5-2 months).
- We perform shallow squats as far as the condition of the joint allows.
Preferably: swings with an expander (we fasten the loop on the foot, and fasten the expander at a level of approximately 20 cm from the floor). I.p. - standing, hands on your belt, back straight. When performing, we try to pull the toe towards ourselves.
Final rehabilitation (up to 4 months).
At this stage, training on a simulator is recommended. If this is not possible, do the following exercises:
- I.p. - sitting on a chair, back straight. Bend and straighten your legs until a burning sensation or pulsation appears.
I.p. - standing in front of a chair, hands on the back. Holding your back, gradually squat so that your thigh is perpendicular to the floor.

Therapeutic actions

Immediately after blocking the knee joint, you need to put a heating pad with ice on the sore spot and give an injection of an anesthetic. You cannot try to straighten the joint; it must be fixed. In this situation, wait for the arrival of doctors or transportation to a medical facility.

Knee reduction

Removal of the knee joint block is carried out using conservative or surgical methods. Reduction will be attempted first. It occurs under local anesthesia using a specially developed technique. Reduction is carried out by a chiropractor or a trauma surgeon. The joint is then fixed with a plaster cast for about a month. If the injury is fresh, the duration of immobilization may be longer.

In some cases, manual reduction does not bring results, it is not possible to remove the blockage of the knee joint, and hardware traction is used. The effectiveness of this method is quite high, but healing will take a long time.

To improve health, physiotherapeutic procedures are prescribed - treatment using laser, ultrasound, magnetic therapy. To restore the damaged surface of the meniscus, drugs are prescribed - chondroprotectors. If swelling and inflammation persist for a long time at the site of the injury, corticosteroids are used. For some injuries, patients are forced to wear bandages.

Types of Minisk Damage

If severe damage to the meniscus or major injury to the bone, cartilage or joint has occurred, then surgical treatment is possible. Arthroscopy gives good results. During this surgical procedure, a meniscal transplant is performed. Donor or artificial cartilage is used. Engraftment occurs quickly, and rejection is rare.

After the operation, a course of drug treatment is carried out to restore health. Rehabilitation of the knee joint takes approximately 4 months. Functionality will be restored within six months. All terms are approximate and depend on the individual characteristics of the body, the person’s age, and the presence of chronic pathologies of the musculoskeletal system.

Medicines for inflammation of the knee joints

How to relieve inflammation from the knee joint? To treat inflammation, local agents and oral medications are used in parallel. For generalized or extremely severe inflammation, the doctor may add injections. When a joint becomes infected, antibiotics, antimicrobial agents, and sulfonamides are prescribed.

There are several groups of drugs that are prescribed for inflammation of the knee joints.

Anti-inflammatory drugs

Nonsteroidal drugs and glucocorticoids (in severe cases) are used to treat inflammation in the knee joint.

The following NSAIDs are taken in courses of 10-12 days:

meloxicam;
ketoprofen;
ibuprofen;
diclofenac;
indomethacin;
Nurofen;
nimesil.

Among the GCs for the treatment of joints, the most effective are:

dexamethasone;
hydrocortisone;
prednisolone;
methylprednisolone.

Chondroprotectors

Chondroprotectors for knee inflammation are designed to protect cartilage tissue from damage and supply the necessary substances to strengthen synovial cartilage and ligaments. They help reduce pain and inflammation, prevent further exacerbations, and maintain range of motion.

Doctors prescribe drugs based on chondroitin and glucosamine sulfate to treat inflammation in the knee joint:

artracs;
arthra;
chondroguard;
structum;
chondroitin complex;
elbon;
artradol;
teraflex.

You can take them in advance, for prevention - then the question of how to relieve inflammation from the knee joint will most likely bypass you.

Antispasmodics

Spasms during inflammation are expressed in involuntary contractions, which can cause severe pain, as well as persistent muscle tension. They impair tissue trophism and joint mobility.

drotaverine (no-shpa);
papaverine;
pentalgin;
mydocalm;
sirdalud.

Local irritants and microcirculation correctors

Warming and local irritants are very important in the treatment of inflammation of the knee joint: they dilate blood vessels and increase blood flow to the affected area. This means that more immune cells and nutrients will reach the target, swelling will decrease, and pain will decrease. To support stressed vessels (especially with massive inflammation), angioprotectors are taken in parallel - in the treatment of inflammation in the knee joint, drugs play the role of maintenance therapy.

Warming ointments, gels and creams:

finalgon;
viprosal and apizartron (in the absence of an allergy to bee venom);
capsicam or espol;
nicoflex;
efkamon;
balm “Star”;
gel “Horse Power” for joints.

Angioprotective agents:

pentoxifylline;
cinnarizine;
horse chestnut extract;
troxerutin;
troxevasin.

Nutrition for inflammation of the knee joint

For inflammation of the joints, a diet is recommended that normalizes the production of prostaglandins and antibodies - the main agents of inflammation in our body. Therefore, the menu should contain a large amount of vitamins A, B, C and E, polyphenols and flavonoids, and essential fatty acids. To do this you need to eat:

eggs;
fish;
dairy products;
vegetables (except potatoes) and fruits;
legumes;
whole grain products and sprouted wheat dishes.

Meat is also important for joint restoration, but you only need to eat lean meat (preferably poultry or rabbit), steamed or in foil. During inflammation, it is best to avoid fried, salty, sweet, spicy foods - snacks, sausages, confectionery.

It is important not to starve: divide your daily food intake into 5-6 meals. Be sure to drink clean water - over 2 liters per day.

Now that you know everything you need to know about the treatment of inflammation in the knee joint, we recommend that you take up prevention - after all, it’s easier to prevent the disease!

Images designed by Freepik

Description of the process of intra-articular blockade of the knee joint.

In any situation, it is necessary to exclude the possibility of carrying out the blockade yourself at home. Improper implementation of the blockade can significantly harm the patient’s health, aggravating existing problems. The procedure requires special skills, so it is carried out only under the supervision of specialists in this field. That is why it is not recommended to use the services of uncertified attending physicians, whose responsibility is not completely certain.

So, the methods of blockade:

The first treatment option is used in many cases. This method is safe and relatively simple. It involves introducing the drug into the joint from the side of the joint capsule. To remove the maximum load from the area of the procedure, the patient is placed on a horizontal surface. For greater stability of the knee, use a cushion placed under it. The specialist injects 6-15 ml of the drug under the patient’s kneecap. If necessary, changing the indicated dose of the drug is acceptable.
The second option is used exclusively in severe cases when the patient experiences significant pain. The method is called “bilateral blockade”. It helps relieve attacks of pain more quickly.

Indications for replacement

Look at the x-ray, you can see the extent to which, with advanced gonarthrosis, the hyaline cartilage, which ensures smooth gliding of the articular surfaces, is worn out. The end sections of the bones are grossly deformed, disrupting the functions of flexion and extension of the limb, causing intense pain.

Comparison of a healthy and affected joint.

Risks of surgery

The probability of complications, as we previously mentioned, does not exceed 2%. In Russia - 6%, this is:

local infectious process;
deep vein thrombosis of the legs and pulmonary thromboembolism;
loosening and instability of the prosthesis;
dislocations, subluxations, fracture of the endoprosthesis;
periprosthetic bone fracture;
persistent pain and contracture.

Infection is one of the most difficult complications to treat.

Why are all these negative reactions happening? They are mainly due to non-compliance with technological principles when installing an implant, incorrectly selected type of prosthesis, unsatisfactory conditions in the operating room, poor-quality rehabilitation, all kinds of limb injuries at any time after surgery and ignoring the rules regarding the physical regime.

Classification of meniscal injuries

Meniscus injuries are divided into several groups:

traumatic (separation and rupture of the meniscus);
degenerative;
cystic;
combined.

Meniscus tears can be incomplete or complete, longitudinal (they are called “watering can handle”) and transverse, oblique and radial, crushed and flap-like. During injury, the severed part may move or remain in place.

There are 3 zones in the meniscus: red, red-white and white. The fewer blood vessels, the whiter the area. Accordingly, the closer to the joint capsule, the greater the chance of fusion if a meniscal suture is performed. Tear of the red-white-white zone is a contraindication for meniscal suture. In the case of a degenerative process or old damage to the meniscus, especially in the red-white or white zones, only the damaged part of the meniscus is removed. We aim to leave as much shock absorber in the knee joint as possible.

Contraindications

Neither age nor high body weight are grounds for refusing surgery. The procedure is contraindicated if there are:

uncontrolled diabetes mellitus and diabetes in the stage of decompensation;
severe defects of the cardiovascular system;
renal diseases characterized by impaired nitrogen excretion function of the kidneys (renal failure, etc.);
liver and pulmonary failure grade 2-3;
any chronic diseases in the acute phase;
local and general infectious-inflammatory, purulent focus;
serious conditions of immunodeficiency;
paresis or paralysis of the limbs;
severe forms of osteoporosis;
severe blood clots in the veins of the lower extremities;
severe neuropsychiatric disorders.

This is what a diabetic's wound might look like.

Surgical technique

According to the diagnosis, age and weight criteria, physical characteristics and concomitant diseases, the specialist chooses the most effective implantation tactics:

partial replacement (unicondylar) - only one of the semicircular eminences of the femur with the underlying proximal fragment of the tibia is subject to prosthetics (used in elderly patients and people with low physical activity);
total surgery (complete) – the entire knee joint is changed, it is completely removed, and an endoprosthesis is implanted in its place;

Incomplete implants installed during partial replacement have a short lifespan. Such models are produced 2 times faster than total structures, while their strength potential is not designed for high levels of physical stress. The advantages of partial prosthetics are that only a certain part of the joint is replaced with an implant, the rest of the area remains untouched. Thus, gentle intervention allows you to shorten the rehabilitation period and endure the recovery period relatively easily.

Two surgical techniques in one patient.

Preparing for surgery

We will talk about how to prepare so that after undergoing endoprosthetics you can easily recover.

Firstly, start studying physical therapy, at least 2-3 months before the scheduled procedure. It is better if you attend classes under the supervision of a physical therapy instructor. Swimming in the pool and aqua gymnastics are excellent for increasing muscle endurance, so be sure to take note of this.
Make at least minimal movements.
Secondly, lose weight, if your weight parameters do not correspond to normal values. Even by losing a few kilograms, you will significantly ensure a more harmonious rehabilitation period, which will not be complicated by extra loads aggravating the operated area. Losing weight will extremely reduce the risk of developing unpleasant consequences in the form of premature failure of the prosthesis.
With excess weight: the suture heals worse, anesthesia is more difficult, rehabilitation is more difficult and longer, and the endoprosthesis wears out faster.

Fight bad habits. Quit smoking within 3 months, eliminate alcoholic beverages, and never return to them again. Both the first and second are evil enemies, inhibiting the body’s natural abilities to regenerate tissues injured during surgery, including resisting all possible intra- and post-operative negative phenomena.

Smoking slows down regeneration processes, stop smoking.

Prepare your home:

The first thing you need to do is securely attach grab bars in the toilet and bathroom , which will serve as safety elements until your recovery.
in your house or apartment should interfere with movement and should not be a potential cause of injury. Therefore, remove rugs, telephone and electrical cables from the floors, and pieces of furniture standing in the middle of the rooms.
To take the correct posture when sitting on a chair or taking a lying position, without bending the limb more than 90 degrees, you need to elevate all surfaces for lying and sitting.
All essential items and things should be at an accessible level so that it does not occur to you to suddenly reach for them, bend over, squat and, God forbid, stand on stools and other supporting elements.

A very useful thing in everyday life.

What types of endoprostheses are there?

Prosthetic systems come with a movable or fixed platform, and also provide for the preservation or removal of the posterior cruciate ligament. They differ in the type of fixation; it can be cemented, cementless or combined.

Movable and fixed platforms .
Most patients receive an implant with a shock-absorbing liner that is tightly connected to the tibial element, that is, products with a fixed platform. The presence of a mobile insert inside the metal tibial component requires good condition of the muscular system and capsular-ligamentous apparatus, otherwise displacement of the prosthesis may occur. The implant allows movement in two planes.
Related and Unrelated Designs. Unconnected models are implanted more often in young people, physically strong, with satisfactory condition of the knee ligaments. Bound, if the ligaments of the knee are seriously damaged.
Implant diagram.
Fixation methods . It is always made using bone cement.
Friction unit materials. Combinations of friction pairs, such as metal-polyethylene, or black ceramics-polyethylene. Metal parts are usually titanium-based alloys, cobalt-chrome alloys or steel alloys. Ceramic prostheses in combination with high molecular weight polyethylene have better wear resistance and durability, but they will be more expensive than systems from the metal-polyethylene classification. Typically, ceramic-polyethylene is placed on patients leading an active lifestyle.
Increasingly, a ceramic femoral component is being used instead of a metal one. The image shows the degree of surface wear. The ceramics are not damaged at all.

Attention! The implant can last from 15 to 30 years, but subject to high-quality knee replacement and rehabilitation.