Knee surgery in Zurich? Artificial knee-joint

 

The knee is one of the most complex joints. It requires very delicate work – A watchmaker’s hand to treat it.

 

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Matthias Schmied

- Doctor of Medicine, MD. Specialized
in Orthopaedics and Traumatology. He studied medicine at the University of Zurich (Universitätsspital, Zürich) and has been practicing since 2000. Dr. Schmied has worked in leading healthcare institutions in Switzerland, Germany and Scotland. Since 2016, he has run his own practice. Among others, he is a member of the International Society for Hip Arthroscopy (ISHA) and the Swiss Medical Association (Vereinigung der Schweizer Ärztinnen und Ärzte, FMH).

Dr. med. Matthias Schmied

Our knees determine how easy or diffcult our journey through life will be. Dr. Matthias Schmied told us how to efficiently treat a knee joint by non-surgical means and how new Swiss technologies help to improve the results of knee prosthesis.

Dr. Schmied, what’s the most common diagnosis you give to your patients?

Osteoarthritis, meaning degenerative changes. ere are a wide range of causes, including age, activity, trauma, anatomic abnormalities, in ammatory conditions and other diseases.

What should a patient do in this situation? What kinds of treatment can you recommend?

First of all you should remain active if possible, and supplement your physical exercise with physiotherapy. The second step includes painkillers and injections – traditionally cortisone. Modern methods involve injections of autologous conditioned plasma. A patient's blood is taken and processed. The healing elements are separated from the blood and are injected back into the joint. e advantage of this method is that the patient's own healing potential is used. There is no risk of allergy. It is the client in case of mild to moderate arthritis, sports injuries and in ammatory diseases a ecting ligaments. If conservative treatment does not help, the next step is surgery. For early stage arthritis and a damaged meniscus, arthroscopy is a possible option as a minimally invasive procedure.

If joint preserving treatments fail and degenerative changes are too advanced, artificial knee-joint is an excellent option. Patients spend a week in hospital and then they need to undergo rehabilitation. In a high percentage of cases we are very satisfied with the results. A new Swiss invention involves special surgical techniques to improve the stability of the artificial knee-joint. The results are very promising and many patients are able to go back to taking part in sports.

What are the most common knee operations?

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In 80–90%

of cases we are satisfied with the results
of the artificial knee-joint

Knee-joint arthroscopy to address meniscal damage or to treat ruptured cruciate ligaments is very common. Another focus in our clinic is the treatment of arthritis. Patients with advanced degenerative changes are often given artificial knee joints. Revision of primary knee implants are increasing in number. Old or non-functional implants need thorough clinical examination and X-ray investigation to end the reason for the problem.

What is the right time for surgery?

This is a very important question. In the case of a damaged meniscus, it depends very much on the symptoms. Articular constrictions are mostly very painful and demand immediate surgical intervention. Sometimes the meniscus can be sutured, sometimes a part has to be removed.

Degenerative lesions of a meniscus with moderate pain can be treated conservatively at first with the aim of leaving as much of the meniscus as possible to preserve its function. Concerning artificial knee joints the psychological strain is very important. If the patient is suffering and their quality of life is impaired one shouldn’t wait too long.

Some people suffer from pain as a result of local cartilage damage. Are there options for repairing cartilage?

Yes, we carry out a process known as microfracturing, or drilling of the a ict- ed area. Bone marrow cells can colonize the defect and form cartilage-like tissue. These cases demand post-operative partial weight-bearing and bracing of the knee.

What sports are not recommended for people with knee problems?

Generally speaking, any sport that results in pain should be avoided. Contact sports as well as stop-and-go movements are usually not good for damaged joints. Joint conserving activities include hiking, biking, swimming etc. If running is vital, choose so paths and use cushioned running shoes. It’s important to realize that moderate activity is good, even for arthritic joints. e joint surface is covered by cartilage and moving the joint helps to nourish this layer.