The most up-to-date remedy for arthritis and overload problems is arthroscopic surgery. During arthroscopy, the joint is mirrored and restored at the same time with an optical device. Recovery is easier with a less invasive surgical procedure that takes place through a small incision using special tools. The advantage is that during the procedure, the joint is not opened, so the chance of injury to the surrounding ligaments and muscles is drastically reduced. In addition, since only small incisions are made during the procedure, the time of recovery after arthroscopic surgery is much shorter than with conventional procedures. Thus, in most cases the patients can leave the clinic on the day after surgery.
Arthroscopic knee surgery
Restoration of joint surface
A well-defined loading cartilage defect of less than 1.5-2 cm is treated with a micro factor method to form a healthy cartilage surface from the patient’s own tissues. The formation of cartilage can be greatly facilitated by a PRP treatment after micro facture. If the knee joint isn’t unstable, we can expect good results after the micro facture. In the case of debridement of full-thickness cartilage damage exceeding 1 cm2 but not more than 2.5-3 cm2, mosaic plastics can be used to reconstruct the load-bearing cartilage surface. In this case, the cartilage - bony cylinders removed from the non -loading part of the knee joint are transferred to the cartilage - depleted area. In the case of mosaic plastics, we can also expect good results if the knee joint isn’t unstable. On the day after arthroscopic joint regeneration the patient may leave the clinic, but the joint load should be reduced to a minimum during 4 weeks after the intervention. In addition, for rehabilitation purposes is important the movement of the joint without load.
Meniscus surgery due to injury
Meniscus are important components of the knee joint. They balance the incompatibility of the femur and tibia and play an important role in the distribution of the load. In meniscus, only ½ part of the joint sack has its own blood supply but the other ⅔ part of the joint hasn’t. Therefore, depending on where the injury occurs, we can treat them in different ways. If there is a rupture in the two-thirds of the outside of the joint without blood supply, we cannot apply stitching because healing is not expected in this area. In these cases, partial meniscus removal is required: removal of the disconnected part of the cartilage is a solution to the possible pinching of the dislocated parts without causing further damage to the intact cartilage surface. If the lesion is formed in the one-third part of the joint with its own blood supply, we need to examine whether it is technically feasible to fix it with a seam. This depends on the direction of the lesion. After inserting the meniscus suture, we will also check the stability of the cartilage. If the meniscus is not found to be unstable, i.e. the cartilage cannot be drawn towards the center of the joint, it is not necessary to fix it with a suture. At this point, meniscus trepanation is performed, i.e. the area where the tear is seen is pierced by a thick injection needle from the joint towards the skin. This leads to the formation of hematoma, and hence to healing and restoration of the meniscus. It is necessary to relieve the joint for 4 weeks after meniscus surgery, but for the purpose of rehabilitation it is important to move the joint without load.
Cross ligament replacement:
The front ligament is one of the most important stabilizers of the knee joint. It prevents the tibia from moving forward in the femur and turning in the anterolateral direction, being also responsible for the protection of the meniscus. Those who have torn off their frontal ligament are most likely to expect their strongest complaints during activities with sudden change of direction (e.g. sports activities). The posterior ligament is the strongest band in our knee joint. Its function is to prevent the tibia from moving backwards towards the femur in a bent position. Patients who suffer from a rupture of the posterior ligament are most likely to feel their complaints in slow motion, sudden change of direction, and when they are climbing the stairs. This condition is also typical for sports activities such as handball, basketball, and football or skiing. In both cases it is possible to restore the previous quality of life and continue the sports career by replacing the cross ligament. In our clinic, the replacement of the front and back cross ligaments is also performed by arthroscopic surgery. After the arthroscopic reconstruction of the ligament, there is a close, predetermined rehabilitation. Postoperative rehabilitation lasts 6 months after the intervention. After that period we allow starting the specific sport grounding exercises and training.
Anchor of inner side ligament:
In the knee joint, most often the inner side ligament is damaged, which typically occurs when performing sports activities. It is also the largest and most important part of the internal knee joint structure. If we start treating it in time, the injury of the inner side ligament can often be managed successfully without surgery. However, failure to follow strict treatments, or if other ligaments are damaged during the accident, may require the reconstruction of the side ligament by arthroscopic surgery. After arthroscopic knee surgery, 6 to 8 weeks are required before returning to normal routine activities.
Treatment of arthrosis
Arthrosis is the most common joint problem. It causes thinning and fragmentation of the cartilage layer covering the joint and its absorption. This involves joint pain, stiffness, joint swelling and whoever suffers from this degeneration knows that it has a destructive effect on the quality of life. However, with the application of today's therapeutic technologies, pain can be reduced and our patients can return to their previous active lifestyle. If arthrosis affects the knee joint, arthroscopy can be used to cure it. If the degenerative joint disease does not yet reached the stage when prosthetic implantation is needed, we can significantly reduce the complaints of our patients by cleaning the joint. During the cleansing process, the knee joint and its cartilage is thoroughly investigated during an arthroscopic examination, and any splits and/or cartilage parts in the detaching half are removed. With this procedure we will eliminate any entrapments that may cause more serious problems later on. Complaints can be significantly reduced also by refreshing the joint surface combined with other medication treatments, supplemented with PRP treatment. If during the examination an axial deformity is seen in the knee joint, but the joint is not yet in such a bad condition as to require the implantation of the prosthesis, an axial correction surgery can stop further cartilage destruction and eliminate previous complaints. This axis correction surgery is called round knee osteotomy. If the knee pain increases to such an extent that it greatly impairs the quality of life, there may be no other way to improve joint status and reduce pain, but only to remove the patient's joints and replace them with an artificial joint - knee prosthesis. These prostheses have an average life of 15 years, but it is greatly influenced by the lifestyle and weight of the patient.
Treatment of patella (knee cap) diseases
The instability of the knee cap can be caused by the break of the internal patellofemoral tape (MPFL), which is also reconstructed by arthroscopic knee surgery. In this case, the gracilis muscle is replaced with a thin tendon of MPFL. Even inadequate positioning of bony anatomical formulas can cause instability. It may then be necessary to move the knee joint adhesion. This is a knee surgery which involves the removal of the bone base, and reorienting it in a frontal and inside position. Usually, after arthroscopic knee surgery our patients can return to their daily activities after 8 months of rehabilitation.
Arthroscopic hip surgery
Treatment of hip disorders
Hip joint arthrosis is a degenerative disease associated with cartilage destruction that causes great pain, congestion, and joint swelling. If these symptoms increase to such an extent that they hinder the performance of everyday activities, causing a significant deterioration in the quality of life - and we will no longer find the right way to relieve the pain with other surgical or non-surgical procedures, it will be necessary to insert a hip prosthesis. This is nothing more than removing the patient's joints and replacing them with artificial joints. The same intervention may be needed to treat hip fractures, benign and malignant bone tumors, rheumatoid arthritis, avascular femoral degeneration, and hip injuries. The implantation of the prosthesis results in a significant improvement in the quality of life, but in the future, those who undergo surgery should keep in mind some restrictions. The prosthesis consists of moving parts, so keep in mind that these parts will wear out over time and need to be replaced later. The life span of moving parts is generally 15 years, but this lifespan depends on the weight and lifestyle of the patients.