Knieprothese und mögliche Alternative: alle Infos auf einen Blick!

Eine Knieprothese kommt meist dann zum Einsatz, wenn die Gelenkflächen des Kniegelenks, also Oberschenkelknochen, Unterschenkel und ggf. Kniescheibe zerstört sind.

Knieprothese
Knieprothese: zum Einsatz kommt hier ein metallischer Oberflächenersatz

Zum Einsatz kommt dabei eine Art metallischer Oberflächenersatz.

Eine Knieprothese wird meist dann benötigt, wenn eine fortgeschrittene Arthrose (Abnutzung) des Kniegelenks beobachtet wird.

Die Abnutzung ist meist Folge von altersbedingten Knorpelschäden, aber auch Unfälle können zur teilweisen oder ganzen Zerstörung des Kniegelenks führen.

Auch über einen längeren Zeitraum hinweg bestehende Instabiliäten des Kniegelenks führen dazu, dass sich der Knorpel abnutzt.

Solche Instabilitäten werden zum Beispiel hervorgerufen durch angeborene oder antrainierte Fehlstellungen (O-Beine oder X-Beine).

Schließlich kann Arthrose auch durch rheumatische Erkrankungen hervorgerufen werden. Auf der Liste der eher seltenen Ursachen für Arthrose stehen: die „Bluterkrankung“ (Hämophilie), eine erhöhte Harnsäure (Gicht), Entzündungen der Gelenkschleimhaut oder das Absterben von Bereichen des Oberschenkelknochens.

Die Folge in allen Fällen: eine Knieprothese wird benötigt.

Jährlich werden in Deutschland rund 150.000 Knieprothesen eingesetzt

Die Operation am Kniegelenk gehört zu einer der häufigsten in Deutschland durchgeführten Operationen.

Während im Jahr 2005 rund 129.000 Knieprothesen eingesetzt wurden, so erhöhte sich diese Zahl vier Jahre später bereits auf 159.000. Innerhalb von nur vier Jahren kam es also zu einer 23%-igen Steigerung bei der Einsetzung von Knieprothesen.

Die Kosten einer Knieprothese liegen zwischen 8.000 und 16.000 € und werden von den Krankenkassen bezahlt. Wer in Deutschland lebt hat Glück. Im Gegensatz zu anderen Ländern in der europäischen Union müssen Patienten in Deutschland in der Regel nicht auf die Operation warten.

Schlittenprothese

Schlittenprothese
Die Schlittenprothese: die einfachste Form der Knieprothese

Die Schlittenprothese wird auch einseitiger (unikondylärer) Oberflächenersatz genannt.

Es handelt sich dabei um einen Teilersatz des Kniegelenks.

Synonyme für die Schlittenprothese sind Monoschlitten, Uniknie oder Hemischlitten.

Bei dieser einfachen und in der Regel schnell durchführbaren Variante der Knieprothese wird entweder nur der innere oder äußere Teil des Kniegelenks ersetzt.

Bei einseitger Kniegelenksarthrose kann die KNEO gut eingesetzt werden.

Die Totalendoprothese

knieprothese2Wenn ein Kniegelenk so verschlissen ist, dass es dauerhafte Schmerzen verursacht, dann wird meist eine Kniegelenksendoprothese nötig.

Wenn andere Behandlungsmethoden wie zB. Medikamente oder Physiotherapie nicht mehr helfen, um dauerhaft Abhilfe zu schaffen, dann kommt meist nur noch eine Implantation einer Kniegelenksendoprothese als Lösung in Frage.

Wenn die Gelenkflächen des Kniegelenks zerstört sind, dann werden diese durch metallische Oberflächen ersetzt.

Betroffene Stellen, die ersetzt werden sind Oberschenkelknochen, Unterschenkelknochen und die Kniescheibe.

Während dem Eingriff können auch „X“ – oder „O“-Beinfehlstellungen mit Hilfe der Knieprothese korrigiert werden.

Die Operation findet bei Arthrose des Kniegelenks oder in Folge eines Defekts der Gelenkfläche statt.

Deutschland belegt übrigens laut Organisation für wirtschaftliche Zusammenarbeit und Entwicklung (OECD) einen Spitzenplatz bei der Vergabe von Knieprothesen.

Die achsgeführte Knieprothese

Wer sich ein wenig mit der Funktionsweise des Knies auskennt, der weiß, dass das Knie von stabilisierenden Kniebandstrukturen umgeben ist. Wenn diese durch Zerschleiß oder in Folge eines Unfalls zerstört werden, dann ist ein 100%-iger Oberflächenersatz des Kniegelenks mit einer achsgeführten Knieprothese notwendig.

In vielen Fällen kommt diese Art der Knieprothese zum Einsatz wenn eine vorher eingesetzte Knieprothese versagt hat oder wenn diese durch eine neue ersetzt werden muss.

Wenn das gesamte Knie von Arthrose betroffen ist, dann ist KNEO keine Alternative!

Die Bioprothese

Im Unterschied zu herkömmlichen Knieprothesen wird bei einer Bioprothese kein Metall, Fremdmaterial oder Plastik verwendet. Bei der Operation selber muss außerdem kein Knochen entfernt werden. Ziel der Operation ist es, die Bildung von Ersatzknorpel anzuregen.

Das passiert dadurch, dass die gefäßführende Knorpelschicht unter dem zerstörten Knorpel angefräst wird. Der hierdurch neu entstehende Knorpel – auch Faserknorpel genannt – übernimmt die Aufgaben des beschädigten Knorpel nahezu perfekt. Die Bioprothese ist aus mehreren Gründen eine der fortschrittlichsten Verfahren:

  1. Die Operation ist minimal invasiv, d.h. es entstehen keine größere Narben
  2. Der neu gebildete Knorpel hat eine Lebensdauer von 10 Jahren oder mehr und
  3. der Eingriff kann später immer wiederholt werden.

Gründe, die gegen eine Operation sprechen!

Bei einer akuten Infektion des Kniegelenks oder bei Begleiterkrankungen, die eine Narkose verhindern, darf nicht operiert werden. Durchblutungsstörungen, eine stark ausgeprägte Osteoporose oder Weichteilverletzungen sind Gründe, die gegen eine Operation sprechen.

Schließlich ist auch die Nachbehandlungszeit ausschlaggebend für den Erfolg der Operation. Wenn jemand aufgrund seines Alters oder mangelnder Einsichtsfähigkeit voraussichtlich nicht mit dem behandelnden Personal kooperiert, dann ist das ebenfalls ein Ausschlussgrund für den operativen Eingriff.

KNEO wirkt schmerzlindernd bei medialem (innerem) oder lateralem (äusserem) Kniegelenksverschleiß und kann helfen, wo nicht operiert werden darf!

Risiken einer Operation: Neben den allgemeinen Risiken sollte der Patient über mögliche Infekte, Wundheilungsstörungen oder Gefäß-Nerven-Verletzungen aufgeklärt werden. Nach der Operation kann es außerdem zu einer Prothesenlockerung oder Bewegungseinschränkung kommen.

Mitunter kann ein Wechsel der Knieprothese nötig werden. Eine nicht seltene Folge der Operation am Knie ist eine fehlerhafte Einstellung der Beinachse. In selten Fällen kommt es zu Verrenkungen der Kniescheibe, dem Absterben von Hautgewebe oder Knochenbrüchen während der Operation.

Aufklärung sollte auch hinsichtlich der erforderlichen Nachbehandlung (zB. Physiotherapie) erfolgen.

Eine Behandlung mit der KNEO Knieorthese ist eine gute Alternative für alle, die auf Risiken bei einer Knieprothesen-Operation verzichten möchten!

knieprothese3Weiter oben wurde bereits der starke Anstieg beim Einsatz von Knieprothesen beschrieben.

Die Vermutung könnte nahe liegen, dass die zunehmende Alterung der Bevölkerung dafür verantwortlich ist.

Die Barmer Gesundheitskasse geht allerdings davon aus, dass die Alterung der Bevölkerung nicht die Hauptursache dieses Anstiegs ist.

So gibt es Hinweise darauf, dass Knieprothesen heute zunehmend auch da eingesetzt werden, wo vor 10 oder 20 Jahren noch darauf verzichtet wurde.

Der Fortschritt in der Medizin, die zunehmend bessere Aufklärung der Patienten sowie das wirtschaftliche Interesse von Kliniken sind weitere Gründe dafür, warum die Anzahl der Kniegelenksoperationen in den letzten Jahren angestiegen ist.

 

Quellenangaben

https://www.chw-technik.de

www.operation.de

www.miniop.de

OPERATION-ENDOPROTHETIK.DE

http://www.knieschmerzen.de/fileadmin/Patientenvortrag_Endoprothesen.pdf

https://faktencheck-gesundheit.de/fakten-zum-gesundheitswesen/interaktive-karten-zu-regionalen-unterschieden/knieoperationen/

http://www.spiegel.de/gesundheit/diagnose/knieoperationen-mehr-kuenstliche-kniegelenke-in-reichen-landkreisen-a-928223.html

Dieser Beitrag hat 34 Kommentare

  1. Helga Dose

    Hallo, ich habe alles sorgfältig gelesen und mir auch die Seiten zum nochmaligen Durchlesen
    ausgedruckt weil bei mir beide Kniegelenke wegen starker Arthrose in Kürze ersetzt werden sollen. Eine zweite Meinung habe ich mir schon eingeholt und beide Orthopäden fanden die
    Schmerzquelle auf den Innenseiten meiner Knie. Würde bei mir denn eine Schlittenprothese
    angebracht sein? Ich danke Ihnen für eine zeitnahe Antwort.
    PS: bin wbl., 75 und in gutem AZ.
    Vielen Dank
    Helga Dose

  2. Werner Trescher

    Guten Morgen, habe soeben von der Bioprothese gelesen – es ist eine Knieob. bei mir geplannt ( Lkh Zwettl) Befund : dtl. Varusgonarthrose rechts. St.p. re.Knie 2013.
    Geplante Operation: Knietotalendoprothese re.(31.Jänner 2018)
    Frage: Wann macht man eine Bioprothese und wo – zahlt es die Krankenkassa.
    Wäre das sinnvoll bei meinen Knie?

    Mfg Trescher Werner

    1. Chw

      Sie schreiben, dass Sie eine dtl. Varusgonarthrose rechts haben. Mit dem Befund alleine würde sich es sich schon lohnen nach einer Alternative zur Totalendoprothese zu gucken. Die ersetzt das komplette Knie obwohl nur der innere Bereich tatsächlich betroffen ist.

      Fragen Sie Ihren Arzt oder googlen Sie, wo in Österreich Sie solche Ops (Bioprothese) durchführen lassen können.

      Alternativ dazu können Sie sich natürlich auch die Funktionsweise unserer Orthese nochmal genauer ansehen. Auch sie könnte in Betracht kommen und würde Ihnen eine Op ganz ersparen oder zumindest in der Ferne rücken lassen. Bzw. bei eine Bioprothese könnte sie das Op-Ergebnis unterstützen.

  3. Maria

    Ich habe in beiden Knien sowohl Athrose wie auch Osteoporose. Kann da eine Knie OP helfen.

    1. Chw

      Vielen Dank für Ihre Anfrage zum Thema Knieoperation. Mit einer Neigung zur Osteoporose halte ich eine Operation für noch riskanter als es sowieso schon ist. Da würde ich erst alle anderen Optionen austesten.

      Wir vertreiben ja eine Knieentlastungsorthese, die eine Operation durchaus überflüssig machen kann.
      Wenn Sie die Wirkung unserer Orthese einmal ausprobieren wollen, dann bitte ich Sie den Test unter folgendem Link mal an sich durchzuführen. Der ist sehr effektiv und zeigt auf ganz einfache Weise, wie KNEO funktioniert: https://www.chw-technik.de/kneo-test/

  4. Petra Patzer

    Ich habe im linken Knie ein fortgeschrittene Arthrose. Bei einer vor 4 Wochen durchgeführten Spiegelung wurde ich darauf hingewiesen, das nur noch eine Vollprothese meine Beschwerden beheben würde. Nach der Spiegelung haben sich meine Schmerzen sehr verstärkt und ich kann kaum noch gehen.Ich bin 62, in gutem Allgemeinzustand und eigentlich sehr aktiv. Würde für mich eine Bioprothese in Betracht kommen und welche Klinik, möglichst in NRW käme da in Frage? Vielen Dank in´m voraus für eine Antwort.

  5. Jaredned

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