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may be indicated with cruciate ligament surgery
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depends on cartilage and meniscal condition
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Risk of arthrofibrosis is least if knee has good function before surgery, with limited swelling and adequate gait pattern
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injuries also occur in children
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For instability and osteoarthritis
Women suffer more anterior cruciate ligament injuries than men
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A joint with multiple facets
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Hamstring tendons regenerate after cruciate ligament surgery
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Medial collateral ligament heals if diagnosed and treated early
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Knee osteoarthritis may lead to severe limitations in daily function. A knee prosthesis (knee arthroplasty) may be an adequate solution for pain and improvement of life, especially if the pain occurs day and night with a limited walking ability despite pain medication. A case report of a 50 year old woman with knee osteoarthritis treated by a total knee arthroplasty is illustrated.
As a relatively young woman of 50 years of age, I was referred to dr Janssen due to incapacitating knee pain. Dr Janssen takes ample time during the consultations and outlined all possible methods of treatment of my diagnosed knee osteoarthritis. After the X-rays and scans as well as various consultations, we both agreed on an operation of my knee: a total knee prosthesis. The subjects of our conversations were: my (relatively young) age at time of surgery; the benefits and risks of a knee prosthesis; the limited survival of a knee prosthesis; eventual limitations after surgery; my own expectations of the surgery.
Dr Janssen was honest and sincere in all our consultations. He has a clear and professional opinion and will consult colleagues if deemed necessary. He will only decide to operate until he is fully assured that the surgery will help to solve the problem and if no other alternatives are available.
Before surgery, I was also informed on the procedure and rehabilitation by the physiotherapist as well as orthopaedic assistants at a meeting organised by the Orthopaedic Center Máxima twice a months. This provides ample information for one to know what to expect during the hospital stay and period thereafter at home. The hospital stay at the Máxima Medical Center Eindhoven was a very positive experience for me. The nursing staff took good care of me from day of admittance till the day of discharge (5 days). The doctors visit daily and I felt very safe.
The joint care project (all patients rehabilitate in a comfortable room once they can leave bed) was a pleasurable experience for me. Patients stimulate one another in their healing process and rehabilitation. Rehabilitation exercises start as soon as possible, usually the second day after the operation. The physiotherapist of the Máxima Medical Center was of great assistance to me. Rehabilitation takes place individually or in the joint care setting with other patients.
After hospital discharge, I was accompanied in the rehabilitation by physiotherapist, mr Frans Brooymans. Mr Brooymans and dr Janssen cooperate closely in the treatment of patients with knee disorders. Mr Brooymans is also specialized in the treatment of knee problems. Primary focus in the beginning is leg extension, followed by knee bending exercises and restoration of an adequate gait pattern. This sounds easier than it is in practice. In the final phase of rehabilitation, knee training is done to increase the load capacity of the knee. The physiotherapy treatment starts individually. Later on, training is done in groups of patients with similar rehabilitation. The rehabilitation after a knee prosthesis is hard work but the result is worth all the effort.
In retrospect, I am very happy with the decision to operate my knee osteoarthritis with a knee prosthesis. I am pain free and regained all my life's energy. It feels great. I am back to work and can make long walks and bicycle tours. I am convinced that this is largely due to the expertise of my orthopaedic surgeon and physiotherapist, not to forget also my own efforts and perseverance.