Knee joint has a complex shape with three main compartments (femoral-tibial internal, external, and patella-femoral) subjected to a load, with two degrees of freedom (flexion-extension and automatic rotation between thirty degrees and full extension), where the slightest imperfection in shape or intrinsic stability creates the conditions for a more or less early and fast arthritic degeneration (gonarthrosis).
Traumatic sequelae (traumatic fractures and dislocations as a result of road accidents, meniscal and ligament injuries as a result of sports injuries, etc.) cause or accelerate osteoarthritis of the knee, the main cause of which is still represented by the inevitable force of gravity acceleration, more or less in synergy with physical activities, sports and works (especially heavy), and the excess of weight.
More subtle disorders, vascular related to the phases of bone growth or cartilage diseases, as well as traumatic injuries of various severity of the complex capsule-ligamentous of the knee too – not only because of transient knee pain and functional limitation of varying severity – can promote the early onset of osteoarthritis of the knee.
Many rheumatologic diseases (rheumatoid arthritis, metabolic arthropathy including gout) and inflammation can also cause acute or chronic arthritic degeneration of the articular surfaces of the three compartments of the knee.
Physical therapy and physical rehabilitation, along with medical care, can sometimes be enough to solve or reduce appreciably and sustainably symptoms; in other cases, when joint damage is more advanced and knee pain more rebel with functional bind severe, arthroscopic minimal surgery (eg ‘arthroscopic debridement’ with motorized instruments) can be used to temporarily solve patient discomfort procrastinating more radical surgical decisions.
When the severity of joint damage demands it, total knee prosthesis (mono-compartmental or total), that Dr. Vassoney has been implanting for over 25 years, eliminates the problem: with tissue sparing technique, the replacement of the diseased articular surfaces takes place by means of the implantation of the prosthetic elements (cemented metal components, tibial and femoral, and joint insert made of polyethylene), with new joint surfaces perfectly and painlessly sliding.
Functional recovery after such surgery is fast, with load concession already on the second day; continuous passive motion assisted and hydrokinetic tank, then, allows acceleration of clinical course sometimes surprising, especially in the elder patients.