Everything you need to know about knee replacement

The joints of the legs bear a huge load. It is not surprising that it is with this type of joint that problems arise. Modern medicine offers a solution that allows you to return to an active life even with serious damage to these joints.

Knee arthroplasty is an operation to replace natural joint tissues with artificial ones. The result is a restored and fully functional limb, the patient’s return to a full active life.

At CELT you can consult an orthopedic traumatologist.

• Initial consultation – 3,000
• Repeated consultation – 2,000

Make an appointment
Non-standard, complex knee replacement (without the cost of the endoprosthesis) - 295,000 - 335,000 rubles.

Total or unicondylar standard knee replacement (without the cost of the endoprosthesis) - 180,000 - 220,000 rubles.

Included in the price:

the operation, consultation with an anesthesiologist and anesthetic care, dressings, medications, food and hospital stay, postoperative observation by the attending physician for a month (longer if necessary). The price of the endoprosthesis (it may vary depending on the manufacturer) and preoperative examination are not included in the indicated price.

1-3 hours

(duration of operation)

5-8 days

Indications

• arthrosis and arthritis of any etiology;
• complications after joint bone fractures;
• ligament damage that cannot be restored conservatively;
• tissue necrosis in the joint;
• tumors of various nature.

Contraindications

• presence of decompensated chronic diseases;
• autoimmune diseases;
• severe form of diabetes mellitus;
• the presence of infectious or inflammatory diseases.

The knee joint is the largest joint in the body. It bears a significant portion of the body's weight when walking, and when running and playing sports it experiences colossal loads. Unfortunately, he does not always cope with them.

Anatomically, this joint is formed by the articulation of two bones - the femur and the tibia. It consists of many tendons and ligaments, as well as hyaline cartilage. This system provides strength, stability and sufficient mobility of the joint. On the side of the femur there is the patella, which is also considered part of it.

Thanks to this anatomical structure, a person can not only bend and straighten the leg, but also perform rotational movements. It is precisely because of its high mobility and heavy loads that this joint is considered one of the most vulnerable.

When pathology of the knee joint is detected, doctors initially prescribe conservative treatment. It has several disadvantages: it cannot help with all diseases, that is, such therapy does not solve the main problem, but only relieves symptoms. In some cases, it is impossible to restore the former mobility of the joint with the help of medications and physical therapy. Therefore, in the absence of effect from conservative treatment, as well as in the presence of irreversible damage, surgical intervention is prescribed.

Advantages of endoprosthetics

Knee replacement surgery is considered technically complex. To carry out the intervention, you need a surgeon with a narrow specialization - a professional who specializes in endoprosthetics.

There are two main options for the operation:

• Unipolar prosthetics This is the name for installing an implant in only one damaged area. It often happens that the pathology does not affect the entire joint and unipolar prosthetics are enough to restore functional mobility.
• Total arthroplasty is the replacement of a complete joint.

The prosthesis is developed after an X-ray examination, taking into account the patient's anatomy. The essence of the operation is that the surgeon removes the damaged fragments and instead installs a biocompatible endoprosthesis that takes over the functions of the removed tissue. After completing the main part of the operation, drainage is installed on the wound. This is necessary in order to avoid blood accumulation in the joint area. In addition, they prevent infections and, if necessary, replace blood loss.

The operation is complex, but safe when performed in a modern clinic. And an endoprosthesis allows you to live an active and fulfilling life, forgetting about joint pain.

When should you choose a total or partial denture?

During knee arthroplasty, the surgeon may choose to install a total (3-compartment) or partial (1-compartment) prosthesis depending on the condition of the knee joint and ligaments.

• 3-compartment prostheses: Replace all of the damaged knee cartilage (eg, arthrosis) and sometimes require removal of some of the cruciate ligaments. This can be the entire femoral cartilage, and sometimes the patella. There are three-compartment dentures with sliding or hinged joints, the latter being less common.
• Single-compartment dentures: Also known as hemoprostheses or partial dentures, these replace only part of the cartilage of the damaged compartment without touching other knee compartments or ligaments. This may be the internal or external femortobial compartment. They are used for osteoarthritis limited to one compartment. Other compartments and ligaments must not be damaged.

Rice. Single compartment knee joint

Types of knee replacement surgeries

Specialists use 2 types of surgery – partial and total.

With partial arthroplasty, new joint elements are installed and destroyed tissue is removed. This method is prescribed only when the functionality of the articular ligaments has not been impaired after injury. Partial surgery is recommended for adult patients who do not play sports and do not place additional stress on the knee joints. After the procedure, rehabilitation takes a minimum of time, because the trauma is low and serious tissue damage and extensive blood loss can be avoided.

A positive result is complete restoration of functionality and mobility one month after surgery. Rehabilitation often takes more than 60 days, after which the patient can again squat, walk, climb stairs, etc. Discomfort and pain disappear a week after the procedure. Additionally, surgeons perform balancing of the cruciate and collateral ligaments.

The only disadvantage of this method is the fragility of the implant. Repeated surgery and replacement are performed after 5 years, provided that the person avoids increased physical activity and does not play sports.

In total arthroplasty, a complete joint replacement is performed with an implant consisting of composites, ceramics and metal alloys. The increased strength and wear resistance of the materials make it possible to use the implant for more than 20 years without replacement or restoration. Now in modern medicine, models with a movable platform are used, in which the polyethylene insert moves strictly along the physiological trajectory of the joint. Therefore, this element performs the function of a meniscus and provides 100% functionality.

Complete replacement of a joint with an implant is recommended for athletes and active people, since the service life of the structure is enormous and it confidently withstands loads. This method cannot be used for weak ligaments, osteomyelitis, osteoporosis. Additionally, difficulties with rehabilitation may arise due to high trauma, extensive blood loss, and long-term adaptation to the implant.

What type of fastening should I choose?

When implanting a prosthesis, there are three types of anchorage to choose from: neutral mechanical alignment, kinematic hinge, or hybrid anchorage. What are their differences:

• Neutral mechanical alignment : Bone cuts and components are aligned to the mechanical axis of the lower extremity (femur + tibia). Previously, this technique was considered the only correct one; it helped to avoid premature failure of the prosthesis and the need for its early replacement. But this was true in the early years of knee arthroplasty, when the quality of implants and fixation techniques were less advanced than they are today. Kinematic or hybrid fastening methods are also now accepted and widely practiced.
• Kinematic hinge : cuts match the kinematics of the knee in motion, maintaining the alignment of the limb in its original deformity. The alignment angle is determined individually for each patient.
• Hybrid fixation : One part of the incisions is aligned with the mechanical axis of the lower extremity, and the other part is aligned with the kinematics of the knee.

Diagnostics

Before surgery, diagnostics are performed to determine the stage of the disease. Conservative methods are relevant only at the initial stage. If MRI reveals coxarthrosis, ankylosing spondylitis, hip fracture and rheumatoid arthritis, partial or complete joint replacement with an implant is recommended. Before the operation, a general blood test and coagulogram are performed to avoid thrombosis and extensive blood loss. Additionally, the presence of contraindications and allergic reactions to medications and painkillers is clarified.

Advantages of Aesculap prostheses

When using endoprostheses produced by Aesculap, it is possible to restore full mobility of the damaged joint. Implants do not affect muscle fibers, tendons or blood vessels.

Main characteristics of Aesculap products

• sustainability;
• strong fixation;
• Full compatibility with bone.

Increased resistance to wear makes it possible to re-replace the prosthesis much less frequently compared to lower quality products. The material does not cause allergic reactions in patients. After the operation, joint mobility is restored as soon as possible.

Types of Aesculap endoprostheses

The company's products are divided into categories depending on the functions they perform.

• Recovery systems. This includes artificial joints used to work on the hip joints.
• Partial replacement. Implants are used in operations on the knee joint and for reconstruction of its structure.
• Systems for the treatment of fractures of the humerus and femur. Damaged areas heal and restore functionality thanks to the use of rods.

The company's products can completely replace a damaged joint even with very poor bone tissue condition. Aesculap endoprostheses will restore the ability to move in cases where other prostheses cannot cope. Innovative developments of various coatings significantly reduce the wear of the prosthesis. When creating each implant, numerous tests are carried out to reduce friction between the parts.

You can purchase Aesculap® endoprostheses at BOSTI offices in Bishkek, Osh and Jalal-Abad. Also, all Aesculap® products are available for order throughout Kyrgyzstan.

If you have any questions about knee replacements, you can consult with Dr. BOSTI by calling 0551717713. We look forward to your call!

Preparing for surgery

The decision on the need for surgery is made only after a face-to-face consultation with a specialist in the appropriate field. There are a number of tests and examinations to determine the degree of wear of the joint, as well as to find out what functional load it can bear. Based on these data, as well as in the absence of contraindications, surgery is prescribed. For each patient, the type of endoprosthesis is individually selected, taking into account the anatomy and current condition of the bones.

Preoperative examination is required to prepare for surgery. It is customary to undergo it in the same clinic where the operation is planned to be performed. In addition to this examination, a consultation with an anesthesiologist is required.

There are several types of anesthesia - your doctor will help you choose the right one. Either general anesthesia or spinal anesthesia is used. In any case, the operation itself is painless for the patient, and discomfort can only arise at the rehabilitation stage and is considered a normal stage in the body’s recovery process.

Contraindications

• Local knee infection or sepsis,
• malignant tumors,
• excessive bone fragility (severe osteoporosis),
• obesity stage 3 - 4,
• remote (extra-articular), active, current infection or bacteremia,
• pathology of the circulatory system (clotting problems),
• severe metabolic disorder of the bone tissue of the legs,
• infectious disease in the acute stage,
• allergy to implant material,
• HIV infection,
• severe cases of vascular, renal, pulmonary dysfunction,
• age up to 25 years,
• mental illness,
• muscle paresis on the side of the intended operation,
• varicose veins of the legs.

How is the operation performed?

Endoprosthesis replacement is performed early in the morning. First, compression bandages are applied to the legs to prevent the expansion of deep veins and blood clots. Next, spinal anesthesia or general anesthesia is performed (the method of pain relief is selected taking into account the individual characteristics of the patient). After this, the catheter is slowly inserted into the bladder to take control of the kidneys. Surgery is performed with or without a tourniquet, depending on the complexity. As soon as the equilibrium concentration of the anesthetic drug in the blood is reached and it begins to act, the surgeon begins the operation:

• An incision is made down the center of the knee.
• The fabrics are moved apart and fixed.
• The kneecap is displaced.
• The tension of the ligaments fixing the joint is reduced.
• Damaged bone tissue is removed.
• The cut edges are polished.
• The lower part of the femur is replaced with a metal prosthesis.
• A titanium plate is fixed to the upper part of the tibia.
• A polyethylene liner is installed on the plate.
• A test prosthesis is attached to check its functionality.
• After successful testing, the endoprosthesis is attached.
• Surgical sutures are placed and drainage is created.
• The bandage and splint are attached.

All procedures take no more than 3 hours. After the anesthesia wears off, additional pain relief will be required after 5 hours to avoid acute pain.

Contraindications for surgery

There are a number of conditions in which surgical intervention is very dangerous - it can lead to serious complications and even death. Among the absolute contraindications to knee replacement are the following:

• severe pathologies of the cardiovascular and respiratory systems;
• acute somatic diseases, as well as exacerbation of chronic diseases;
• myocardial infarction or stroke less than 8 months old;
• varicose veins and deep vein thrombosis of the legs;
• bleeding disorders, moderate and severe anemia;
• immunodeficiency states;
• diabetes mellitus in the stage of decompensation;
• acute and chronic infectious diseases of local and general nature;
• an infectious process in the knee area less than 3 months old;
• paresis of the lower limb on the side of the planned surgical intervention;
• immaturity of bone tissue, as well as its congenital defects, leading to the inability to maintain an artificial joint;
• tuberculosis of the joint - less than 1.5 years from the moment of relief of the active process;
• absence of the medullary canal of the femur;
• epilepsy with seizures at least once a month, persistent mental and neurological diseases;
• individual intolerance to the materials from which the endoprosthesis is made.

Knee replacement surgery is not performed on bedridden patients or patients with significant muscle atrophy. Extreme obesity, diseases of internal organs and blood vessels in the subcompensation stage, oncological process of various localizations, ankylosis, hormonal osteopathy and osteoporosis of the knee joint are relative contraindications - in this case, the decision on the possibility of intervention is made on an individual basis.

Recovery after surgery

No less important than the operation is the rehabilitation period. At this time, it is necessary to ensure proper and complete healing of the wound. According to statistics, pain after surgery is moderate, which allows you to begin rehabilitation measures the next day. The rehabilitation is carried out by a rehabilitation doctor. Under his supervision, patients begin to walk with partial or full weight bearing on their legs. In addition, it is customary to develop the joint passively: with the help of special exercises or hardware complexes. This is necessary in order to restore full range of motion and avoid knee stiffness.

As a rule, discharge from the clinic occurs after a few days. And by this point, patients are able to move independently, some with additional support. If all recommendations are followed, a return to previous activity is possible within a few weeks. And after a month you can even play sports, with virtually no restrictions.

If any complications arise, longer rehabilitation in a hospital is recommended.

Progress of knee replacement surgery

Before the operation, there will be an extensive clinical examination, including the heart, lungs, kidneys, stomach (ruling out ulcers), even teeth (the presence of caries can hide an infection).

Before knee surgery, the surgeon:

• Reviews the patient's medical history, asks the patient what medications they are taking (including blood thinners, aspirin, or other drugs), determines if there is a history of infections, allergies, bleeding, or blood clots,
• conducts a medical examination, which includes x-rays, to find out what damage to the joint looks like,
• prescribes blood tests, MRI, and other diagnostic tests if necessary.

8 hours before surgery, the patient must stop eating.

The operation consists of four main steps:

1. Bone preparation. The damaged cartilage surfaces are removed along with a small amount of bone.
2. Installation of implants with metal, plastic or ceramic parts. The removed cartilage and bone are replaced with special components that recreate the surface of the joint. These parts may be cemented or "pressed" into the bone.
3. Preparing the surface of the patella
4. Insert plastic liner. It is placed between metal/ceramic components to create a smooth sliding surface.

The operation of installing an endoprosthesis takes from 1 to 2 hours. Afterwards, it’s hard to get back on your feet at first. Parallel bars, crutches, walkers, or canes are used for support. A sick leave certificate is issued after endoprosthetics, because recovery after surgery lasts almost six months. It is important to exercise your knee frequently, relieve swelling and strengthen the muscles.

Reviews of doctors providing the service - Knee replacement

Several months ago, Igor Grigorievich performed arthroscopic surgery on my acromioclavicular ligament.
Installed dogbone implant. Everything is great, I lead an active lifestyle and play sports. I already forgot which side it was from! Read full review Alexey

25.11.2019

Dear employees, dear management of the Endosurgery and Lithotripsy Center, good afternoon! 2 months ago I had hip replacement surgery performed by specialists from the Center: Vladimir Sergeevich Zubikov - orthopedic traumatologist, doctor of medical sciences, doctor of the highest category, ... Read full review

Pershin Vladimir Alekseevich

20.08.2018

Endoprosthetics of the hip and knee joint. Treatment of coxarthrosis and gonarthrosis.

Joint endoprosthetics.

Do you need artificial hip or knee replacement?
Where to have the operation? Public medicine or private. What is the difference? In the first case, only what is expected for free awaits you. In the second, you choose what you want to receive.

In the first case, free means many years of waiting, painful waiting, daily pain, denial of many former joys and physical activity. The world is narrowing, its space is being limited. And the years pass, but there is only one life... Paid - you choose everything, and this is not only an operation without a queue, it is also the time, place, conditions. But even paid healthcare is different.

In our clinic, everything is arranged so that patients are as comfortable as possible, from the first visit to us until recovery.
Why our clinic?

• Specialists are available from Monday to Friday
  .
  All the patient needs to do is make an appointment by phone. No referral required. Nonresident patients can receive an initial consultation via the Internet.
• We operate on patients aged 18 years and older, without restrictions. Among our operated patients are patients over 85 years of age.
• During the first appointment, all issues
  related to the operation are resolved,
  including x-ray examination
  .
• The patient can have surgery
  at any convenient time,
  within 7-14 days after the first contact
  with us, upon completion of the examination.
• We perform a comprehensive preoperative examination
  within one day before surgery.
• The patient receives a personal anesthesiologist and attending physician (surgeon)
  , who guides the patient until he goes to work until the end of treatment.
• The most modern technologies
  are used in treatment .
• hip joint endoprostheses
  (ceramics-ceramics), designed for a long service life, ensure full functioning.
  Functional knee joint endoprostheses
  provide long-lasting results of up to 30 years!
• It is no secret that surgery to replace the hip and other joints
  is traumatic and requires blood transfusions.
  We use blood-saving techniques
  , which allows our patients to do without blood transfusions.
• A unique orthopedic operating room, designed specifically to our specifications, ensures safe intervention and the best conditions for success.
• Our single and double rooms provide a home-like feel with delicious food and all the amenities. The staff knows how to care for patients.
• During and after surgery, our patients do not experience pain - they are reliably protected from suffering.
• Working patients receive sick leave and all the necessary documents to receive financial compensation.
• Rehabilitation.
  The postoperative period (appointments, dressings, manual massage, physiotherapeutic procedures, etc.) before returning to work or until the end of treatment is controlled by the operating surgeon.
• The most gentle methods, highly qualified specialists, and proper rehabilitation
  provide our patients
  with a short recovery period
  .
• Everything you need can be purchased at the orthopedic salon and pharmacy within the clinic.

WE ARE WAITING FOR YOU AT MOSCOW 19! Just call tel. registry

Among diseases of the musculoskeletal system, joint diseases occupy one of the first places in terms of adverse consequences. They cause severe suffering, including the impossibility of moving without crutches or assistance.

The most common causes of chronic pain are osteoarthritis, rheumatoid arthritis, avascular necrosis, etc. The articular cartilage covering the surfaces of bones softens, thins and breaks down, leading to pain, limited joint mobility and lameness (lower limbs). In the terminal stages, the patient is forced to use additional support in order to be able to move. All this affects the psycho-emotional state of the patient (even physiological functions are hampered).

The patient has two options: self-medication (and, therefore, independent choice and responsibility for the result) or seeing a doctor. However, in the second option there may be a problem.

After the intervention, freedom of movement returns. Each patient is selected with an endoprosthesis that best suits his lifestyle and habits. View hip replacement results.

The fact is that EVERYONE treats patients with joint pain. Up to 50% of patients are treated for a long time by a neurologist, and only years later (!) they go to an orthopedist. Another typical situation is when they are treated without an x-ray. As a result, when the patient sees an orthopedist, the specialist has to ascertain the condition of the neglected joint.

In the first and second stages of the disease, the orthopedist offers medication and physiotherapeutic measures, in the second and third - surgical treatment.

Thus, timely diagnosis is the first thing that determines the outcome of treatment. It is equally important to obtain qualified advice based on the diagnostic results. The high competence of an orthopedic specialist means your personal access to the most reliable information about the nature of the disease and the prospects for its development, and about existing treatment methods. Only on the basis of a clear understanding is it possible to choose the optimal treatment tactics aimed at stabilizing the disease or curing it. After all, the choice is ultimately yours.

What is joint replacement, and what are its goals?

This is the replacement of a diseased joint with an endoprosthesis. The joint affected by the disease is removed and an artificial one is placed in its place; it allows you to get rid of pain, restore the ability to support the diseased limb up to the absence of lameness, and restore normal or as close to normal range of motion as possible.

Coxarthrosis of the hip joint

— degenerative-dystrophic disease of the joints; This is a dystrophic process in which degeneration of articular cartilage is observed with subsequent changes in bone articular surfaces, the development of marginal osteophytes, deformation and limitation of movements.

There are primary and secondary coxarthrosis. Primary coxarthrosis is an independent disease, secondary coxarthrosis is a consequence of other diseases ( femoral neck fracture

, congenital subluxation of the femoral head, etc.).

Hip replacement surgery. Treatment of coxarthrosis

The video is the property of the S. V. Nudelman Center for Cosmetology and Plastic Surgery.
Copyright infringement is punishable by law.
The result depends on a number of circumstances:

1. patient awareness of the upcoming replacement, all its pros and cons
2. timeliness of intervention
3. type of anesthesia
4. surgical techniques
5. quality of the endoprosthesis
6. postoperative patient management tactics

Hip replacement. Patient history

The first stage is information.

There are many myths and misconceptions about joint replacement surgery. Therefore, the most reliable material is an explanation from an orthopedic surgeon about the essence and nature, expediency of the intervention, immediate and long-term risks, models of endoprostheses, proposed anesthesia, surgical technique, features of the immediate and long-term postoperative period and the timing of full restoration of physical and psychosomatic health.

The next stage is preparation

. It is advisable to learn how to use additional support, lie, sit, stand up in the way that will be needed later, learn how to do gymnastics correctly and behave in everyday life. No brochure can replace the help of a doctor. And only a patient who is correctly oriented in all aspects of the upcoming operation becomes an ally of the surgeon and can count on success.

Endoprosthesis replacement surgery

joints belongs to the category of radical interventions. The main misconception that has taken root in the minds of many, including some doctors, is that intervention should be done as late as possible.

Neither medication, nor electro-, nor balneotherapy can stabilize the process. The disease progresses, leading to disability and psycho-emotional stress. The quality of life suffers: a person is forced to give up many of the joys of life, many patients call their lifestyle “defective”.

At the same time, harm is caused to general health, because medications cause or aggravate existing diseases of the cardiovascular system, gastrointestinal tract, etc.

The longer the operation is postponed for any reason, the longer the postoperative recovery period and the more difficult it is to achieve the desired functional result. After all, changes affect not only the articular surfaces, but also the muscle-tendon formations and the joint capsule. Changes occur both at the organic level (scar degeneration, atrophy) and at the reflex level (sick gait stereotype, etc.).

The next myth is that surgery is not advisable to do in the summer. Is it so? In the postoperative period, the patient uses additional support (crutches, cane) for some time. Based on this, the ideal option for the patient is to move on a dry surface (no slush or snow). Most likely, the appearance of this myth is due to the fact that in ordinary hospitals it is uncomfortable to be in a ward during the hot season. However, in single and double wards of modern clinics, normal temperature conditions and comfort of stay have long been ensured.

A fairly common misconception that orthopedic surgeons hear from patients is: “I’ll go to a sanatorium first and get treatment.” This is absolutely wrong. The resulting treatment will lead to an increase in blood flow to the area of ​​the diseased joint, which can complicate the operation and rehabilitation. The appropriate time interval between sanatorium treatment and surgery is at least six months.

Thus, the operation must be done WHEN IT IS NEEDED.

Joint replacement surgery

is a severe traumatic intervention. It is important to determine the level of health and those risks that may complicate the treatment process or even make it impossible. Based on this, conducting a comprehensive examination allows you to make a decision about its feasibility.

Anesthesia.

The level of anesthesia means a lot in terms of achieving the result: modern anesthesia allows you to reliably anesthetize not only the operation, but also the immediate postoperative period, ensure a high level of patient safety, and reduce blood loss. The modern level of anesthesiology and drug provision allows us to minimize the risks of the operation and the postoperative period.

Knee replacement surgery. Treatment of gonarthrosis

The video is the property of the S. V. Nudelman Center for Cosmetology and Plastic Surgery.
Copyright infringement is punishable by law.
Operation technique

. There are many technical solutions that an orthopedic surgeon uses: the size of the surgical approach, its type and traumatic nature, a gentle approach to the muscles, and features of the installation of the endoprosthesis. All this determines the severity of the intervention, the characteristics of the postoperative period, and the speed of restoration of the function of the diseased joint.

Endoprosthesis

. The fundamental differences between them are due to the use of a friction pair: metal-polyethylene; metal-reinforced polyethylene; ceramics–polyethylene; ceramics-strengthened polyethylene; pottery-ceramics; metal-ceramics, metal-metal. Today, the ideal friction pair is metal-to-metal, ceramic-to-ceramic, or a combination of both.

Another aspect is the size of the head (ball) of the endoprosthesis. The larger the size of the head, the lower the coefficient of friction, the greater the range of movements, and the lower the risk of dislocation of the endoprosthesis. And these are other functionality. In other words, there are “ordinary” endoprostheses, and there are those for life “without restrictions.” Accordingly, the models differ significantly in cost. That’s why there are “budget” and “advanced” ones. And the difference between them is fundamental both in the functional aspect and in terms of long-term survival.

The Russian medical market presents products from the world's leading manufacturers. The main thing that a patient should be interested in when talking with an orthopedist is how well the endoprosthesis proposed by the specialist meets his needs (habitual lifestyle, occupation, activity, temperament, etc.).

Postoperative period. Rehabilitation.

Methods of managing patients are varied: long stay in bed - short stay in bed; forced gymnastics - activation without coercion; using additional support for a long time or leaving it early, etc. It all depends on what problems are being solved, what is the priority: installing an endoprosthesis or obtaining the fastest functional result using the endoprosthesis method. As a result, the difference achieved in recovery time is 2-3 months. or 6-12 months.

Of course, a simple declaration of results cannot be achieved. To achieve the desired result, there is a well-developed system of measures.

This is an orthopedic surgical treatment method that SOLVES THE PROBLEM: it relieves suffering and allows you to maintain quality of life, giving results both instantly and in the long term. THE CHOICE IS THE PATIENT'S.

Once again about knee replacement surgery: On your feet - from day one!

When knees darken life with pain and do not allow active movement, knee joints are replaced with artificial ones. The pain goes away, freedom of movement, muscle strength and the ability to stand firmly on your feet return.

Knee replacement

- a frequent operation, it is performed in many orthopedic departments, free of charge and for a fee.
But the number of operations performed does not always indicate the quality of the result. Mikhail Naumovich Pollyak Head of the Department of Traumatology and Orthopedics, Orthopedic Traumatologist, Candidate of Medical Sciences, Honored Doctor of the Russian Federation
Three decades ago, having become one of the first in the Urals to master the technology of joint replacement, while working in this area, I followed world achievements. It is no secret that abroad, after surgery, patients are discharged from the hospital much earlier than in our country. There are many explanations and opinions on this matter, but the reality is this: the patient is able to leave the hospital for 2-3 days. He simply does not need hospital treatment.

How is this possible, thanks to what?.. Endoprostheses, both in our clinic and in foreign ones, are the same... So, it’s a matter of technology.

I wanted to improve our results that we have achieved to date.

Foreign colleagues shared their experience of so-called gentle knee replacement. This is not a “small incision”, this is a fundamentally different approach in which the muscles are not injured. From the first (!) day the patient gets on his feet, and from the 2nd-3rd day he walks

, and not with crutches, but with a cane, or without it at all. Recovery is different in every way.

Stories about patients walking on their own feet on the second or third day after surgery became a reality at the S.V. Center for Cosmetology and Plastic Surgery. Nudelman. We hope that the length of stay in the hospital will not be longer!

Patients come to the clinic not only from Yekaterinburg, but also from other cities - Tyumen, Perm, Chelyabinsk and the CIS countries.

Replacing with an artificial joint relieves those suffering from coxarthrosis from pain, limited movement and lameness.

The X-ray image on the left shows a diseased joint, the image on the right shows an installed endoprosthesis, which allows you to restore the function of the joint without restrictions.

The result after six months: movements were restored in full, the patient returned to normal life, without restrictions.

Reviews from our patients

Name: Lyudmila Date: February 9, 2021 Review: Every day I remember orthopedic surgeon Mikhail Naumovich Pollyak with great gratitude! This is a doctor from God! I hesitated for a long time to have the operation, but after talking with the doctor there was no doubt left. This ability to find an approach to a person is worth a lot. In addition to medical arguments, sharp words and humor are used, and all this can instill optimism in the patient. And how he cares for patients immediately after surgery and monitors them for several months! He gave me back the joy of movement! (there was a skew of the pelvis, shortening of the leg, long-standing arthrosis, night pain, pain when walking, etc.). Now after endoprosthetics all this is gone - the quality of life is incomparably better. True, there is still some work to be done. Gymnastics, changing the usual gait and developing a new one, special exercises are necessary. Many thanks to all the doctors and nurses who took part in the operation and my rehabilitation, as well as to all the staff of the Center. Wonderful people who work here are attentive, responsive, and smiling! Health and best wishes to everyone!!! Thank you!!!

Name: Vadim Date: August 13, 2015 Review: I would like to express my enormous gratitude to your clinic and staff. To Mikhail Naumovich first of all! I never dreamed of running anymore. Thanks to him and everyone who tried to replace my hip joint, I am back on track. Thank you for your hospitality and care.

Name: Margarita Date: December 31, 2014 Review: At the beginning of August of this year, I had surgery - hip replacement. I'm doing very well now and just enjoying being able to move without pain. I would like to say a huge thank you to my beloved Doctor Mikhail Naumovich Pollyak for his highest professionalism, for his extraordinary kindness and love for his patients, for his wonderful sense of humor, which is very helpful and supportive during the recovery period. For me this was another healing factor. I would like to thank the massage therapist Gennady Ivanovich Sinelnikov and the physical therapy doctor Ekaterina Yuryevna Bechevina, who really helped me recover. Many thanks to everyone who took part in the operation and, of course, to the nurses from the hospital who looked after me so carefully, attentively and kindly for a whole week. I congratulate all the staff of the clinic on the upcoming New Year, health, prosperity and all the best to everyone. Your clinic is the best. Excellent specialists and simply good people work here.

Name: Andrey Date: October 4, 2014 Review: Good afternoon. On September 25th I had surgery to replace my left hip joint. The operation was performed by Mikhail Naumovich Pollyak. During the entire time he was in the clinic, he was under the constant attention and control of the staff. Before the operation there were fears and doubts, but once we got to the clinic and the orthopedic department, all fears went away thanks to the professional approach and organization of the process. Now I am in the recovery stage, every day I return to my former active life. Many thanks to Mikhail Naumovich for the successful operation, tireless optimism and phenomenal performance!!! Thanks to the entire clinic team. Sincerely, Potapov A.V.

Name: Valery Date: December 22, 2013 Review: Mikhail Naumovich, with all my heart and gratitude I congratulate you on conferring the title: Honored Doctor of Russia. What you do, and what you did for me personally, is a miracle, magic. It's been 10 months since my hip replacement surgery and I still can't enjoy freedom of movement and a pain-free life. In a word, life has become more interesting. Like being born again. I congratulate you and all your staff (especially your dear nurses) on the New Year, I wish you success in your work and personal life.

THERE ARE CONTRAINDICATIONS, SPECIALIST CONSULTATION IS REQUIRED

Before surgery

Before the operation, the surgeon at the hospital will plan the operation and also make the choice of anesthesia based on your opinion.

• Surgical planning uses X-rays or other imaging techniques as a basis for deciding which type of knee replacement is best for your knee.
• Anesthesia can be either general or local. Your anesthesiologist will choose the right form of anesthesia for you, taking into account the extent of the operation and your condition, as well as your own preferences.

You should be in the best possible health before surgery. Try to lose excess weight because this increases the chances of the surgery being successful.

Knee arthroplasty is a bloodless procedure. This allows blood loss during surgery to be kept to a minimum. However, a blood transfusion may be necessary with any surgery, and for this reason many hospitals offer the option of autologous blood donation (donating your own blood for possible subsequent transfusion) before surgery.

• When donating blood, the patient should not have infections or inflammations.
• For this reason, every effort must be made to avoid anything that could lead to the presence of infections in the body at the time of admission to the hospital.

In knee arthroplasty, the joint is opened through an incision on the front of the knee. Minimally invasive surgery may be used as an alternative. The surgery usually takes between an hour and an hour and a half and generally follows the same steps regardless of the type of knee replacement:

• First , remaining cartilage and bone deformities are removed depending on the type of joint replacement - the meniscus on the affected side or both menisci.
• then prepared for installation of the endoprosthesis.

LINK ® offers a special set of tools for the implantation of knee replacements, which allows the operating surgeon to plan bone resections very precisely in three dimensions and then perform them with the required precision.

Sometimes it happens that the surgeon can see the full extent of the damage to the joints only after opening the knee and only then decide that a more extensive joint replacement may be required. To do this, he can choose from a variety of different models of the LINK ® knee replacement that is just right for you . Before installing the knee replacement in place, a trial knee replacement is used to check the correct size and fit of the knee replacement. Once testing is completed, the appropriate knee replacement is installed in the correct position. The surgeon checks that it is fully functional before suturing the surgical incision.

If your knee surgery is performed under general anesthesia, you will wake up in the recovery room under the supervision of medical staff. Any pain from a surgical wound can be treated with medication.

Once you have recovered from surgery , early mobilization begins. Typically, the first part of the exercises will begin on the day of surgery or the day after. You will be shown how to get out of bed and how to sit back down correctly.

• You will be asked to bend and extend your knee. This can be done at first with the help of passive exercises, gradually increasing the degree of movement.

• A physiotherapist will teach you, while in hospital, how to walk with two crutches under your armpits. On the day you leave the hospital - either home or to a rehabilitation center - you will be mobile enough to carry out daily activities such as washing and dressing yourself.

The basis of rehabilitation is physiotherapy.

• Intensive physiotherapy will help you quickly restore your full walking ability. Your active participation will help you achieve this quickly.
• Therapeutic exercise is designed to help strengthen muscles. Various exercises train specific muscles in the hip and leg. Strong muscles actively stabilize the joint and protect it from improper movement. This condition is usually achieved after about 6 to 8 weeks of muscle training.

The surgeon and physical therapist jointly decide what rehabilitation procedures may be required. In any case, during rehabilitation you will have to relearn movements that were once completely automatic - everyday movements should not put undue pressure on the new knee joint.

For the success of the surgery and the stability of your new knee, it is important that you continue to follow your doctor's and physical therapist's instructions and do regular exercise while you are at home.

general information

The movements produced by the knee joint are more complex and demanding than those of any other joint in the human body. On the one hand, the knee joint must provide stability when a person stands, walks, runs, stands, and bears body weight, but on the other hand, it also provides high degree of mobility when moving.

To achieve both stability and mobility, the knee has a very complex structure, and this makes it vulnerable to injury. It’s just that how great and how important normal mobility of the knee joint is and how important the impact it has on a person’s quality of life is only noticed when it is lost or accompanied by pain.

The knee is where the cartilage-covered articulation joints , or condyles , of the femur form a joint with the head of the tibia, which is also covered with cartilage. In between these two bones lie the menisci - internal articular discs that act as additional shock absorbers.

The ligamentous apparatus makes mobility safe through rolling and sliding movements that occur in at least five axes.

The patella is the third bone of the joint, its backward facing outer layer, also covered with cartilage, is a separate part of the joint.

Diseases of the knee joint - the first signs

Articular changes in the knee joint are the result of wear and tear, in which the body of cartilage covering the joint becomes increasingly worn away. As a consequence of these degenerative changes in the articular cartilage, parts of the joint bones and stabilizing ligaments are also susceptible to damage.

Gradually, the joint continues to degenerate, the layers of cartilage, which are now thinner, begin to rub painfully against each other, and deformation of the bones begins to occur. Every step becomes torture. Eventually, the friction of bone on bone causes excruciating pain even at rest.

The X-ray image shows an image of the anterior part of the left knee, the medial gonarthrosis is clearly visible. The joint space has decreased, there is a narrowing of the lumen and the disappearance of cartilage.

Medial gonarthrosis (arthritis of the knee joint), visible on x-rays. The joint space has decreased due to the disappearance of cartilage.

Signs of wear and tear on articular cartilage increase with age . This disease is known as osteoarthritis and affects almost everyone over the age of 75. However, the degenerative disease can also progress well beyond this age. People who exercise a lot often develop knee arthritis at an earlier age. sports activities such as running or roller skating together with rheumatic diseases lead to a wider spread of the disease.

The main causes of knee arthritis are:

• overvoltage
• joint inflammation or injury
• deformity, whether congenital or acquired
• genetic predisposition
• rheumatic or metabolic diseases
• overweight

Incorrect position of the bones with crooked legs (knees closed or apart) leads to a constant one-sided load on the knee joint, which wears out the cartilage earlier than expected at the load points.

Typical symptoms of knee arthritis:

• Knee pain, especially when moving or carrying heavy objects. Exercise will soon become painful, difficult, and completely impossible.

Movement disorders:

• Early signs of deterioration in movement include difficulty walking, such as your legs feeling like they don't belong when you get up in the morning or after sitting for a long time. At a further stage, it is impossible to squat or sit cross-legged without pain.

As the disease progresses and gets worse, the following may happen:

• joint effusion
• joint deformity
• instability (“shaky knees”)
• muscle tension and muscle weakness

The distance that can be covered is becoming shorter and shorter. Over time, every step will be accompanied by severe pain that even rest can hardly relieve.