Dnepropetrovsk state medical academy
Chair of Orthopaedics and Trauma
ORTEN Ltd
COMPLICATED KNEE JOINT
REPLACEMENT
Professor, Dr Med.
ALEXANDER E. LOSKUTOV
2008
OSTEOARTHROSIS
About 8.3 million people of Northern America are
suffering on osteoarthrosis of large joints .
Salter R.B. et al., 1986.
In France every year about 3.4 million patients are
visiting doctors due to osteoarthrosis.
Vignon E., 2000.
The degenerative diseases of locomotor system are
revealed in half of adult population in Germany.
Насонова В.А., Фаломеева О.М., 2001
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
OSTEOARTHROSIS
In 1999 about 12 million Russian people were suffered
from degenerative diseases of joints.
The morbidity of osteoarthrosis in Ukraine was increased
from 420 per 100,000 in 1999 to 519,3 per 100,000 in
2002.
Коваленко В.М., Шуба Н.М., 2003
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
Joint replacement is only one radical
method of medical rehabilitation of
patients with severe pathology of knee
joint.
In Ukraine about 60 or 75% of patients
with degenerative diseases of knee
have to be considered as a category of
complicated and not standard joint
replacement.
It is caused by following factors:
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
COMPLICATED JOINT REPLACEMENT
1. The absence
treatment.
of
succession
of
2. Untimely determination of indications
for surgical treatment.
3. «Accumulation» of big amount of
patients with indications for knee joint
replacement which have aggravation of
clinical and functional disorders. This
is resulting to the significant changes
of forms of knee elements.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
The complicated knee joint replacement
is considered as following clinical
situations:
1. Knee involvement in rheumatoid
arthritis.
2. Severe deformity of axis of lower
extremity.
3. Severe restriction of motions or
ankylosing of knee joint.
4. Condylar defects and deformities.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
RHEUMATOID ARTHRITIS
X-ray films of female patient K., 56 years old, before and after bilateral
two stage knee replacement with interval 5 month.
RHEUMATOID ARTHRITIS
X-ray films of male patient P., 63 years old, before and after left
knee replacement
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
RHEUMATOID ARTHRITIS
X-ray films of male patient T., 57 years old, before and
after left knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
RHEUMATOID ARTHRITIS
X-ray films of female patient V., 53 years old, before and
after left knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
RHEUMATOID ARTHRITIS
The result of treatment of female patient H., 32 years old. 7 years after
the replacement of fourth joints. Cemented bilateral hip joint
replacement with ORTEN system in two stages. Simultaneous bilateral
knee replacement.
RHEUMATOID ARTHRITIS
The result of treatment of female patient H., 32 years old. 7 years after
the replacement of fourth joints. Cemented bilateral hip joint
replacement with ORTEN system in two stages. Simultaneous bilateral
knee replacement (continued).
CONDYLAR DEFECTS AND DEFORMITIES
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
CONDYLAR DEFECTS AND DEFORMITIES
X-ray films of female patient A., 60 years old, before and
after left knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
CONDYLAR DEFECTS AND DEFORMITIES
X-ray films of female patient G., 70 years old, before and
after left knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
CONDYLAR DEFECTS AND DEFORMITIES
X-ray films of female patient K., 64 years old, before and
after left knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
CONDYLAR DEFECTS AND DEFORMITIES
X-ray films of female patient L., 64 years old, before and
after left knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
CONDYLAR DEFECTS AND DEFORMITIES
X-ray films of female patient D., 56 years old, before and
after left knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
CONDYLAR DEFECTS AND DEFORMITIES
X-ray films of female patient M., 63 years old, before and
after left knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient R., 58 years old, before and
after left knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient Ya., 62 years old, before and
after right knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient Ch., 65 years old, before and
after right knee replacement.
Orthopaedic Clinic of
UKRAINE
Dnepropetrovsk medical academy
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient A., 66 years old, before and
after right knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
After performing knee
joint replacement patients
with severe deformity of
axis of lower extremity are
required additional
stabilization of lateral
ligament apparatus using
hinged orthoses.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient V., 63 years old, before left
knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient V., 63 years old, after left
knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient G., 65 years old, before and after
left knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient I., 73 years old, before and
after right knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient E., 63 years old, before and
after right knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient N., 73 years old, before and after right
knee replacement. First stage of bilateral knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient N., 73 years old, before and after
left knee replacement. Second stage of bilateral knee
replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient N., 68 years old, before and
after left knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of male patient P., 59 years old, before and
after right knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient S., 66 years old, before
bilateral knee replacement
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
DEFORMITIES OF AXIS OF LOWER EXTREMITY
X-ray films of female patient S., 66 years old, after
bilateral knee replacement
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
JOINT REPLACEMENT AFTER TIBIAL
OSTEOTOMY
X-ray films of female patient K., 80 years old, before and
after right knee replacement
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
JOINT REPLACEMENT AFTER TIBIAL
OSTEOTOMY
X-ray films of female patient K., 48 years old, before and
after right knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
JOINT REPLACEMENT AFTER TIBIAL
OSTEOTOMY
X-ray films of female patient K., 61 years old, before and
after left knee replacement
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
JOINT REPLACEMENT AFTER TIBIAL
OSTEOTOMY
The functional result of female patient K., 61 years old,
before and after left knee replacement
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
JOINT REPLACEMENT AFTER TIBIAL
OSTEOTOMY
3 years after
operation
X-ray films after
trauma (falling)
JOINT REPLACEMENT AFTER TIBIAL
OSTEOTOMY
JOINT REPLACEMENT AFTER TIBIAL
OSTEOTOMY
Functional result 1 year
after knee revision
Severe restriction of motions and knee ankylosis
X-ray films of male patient R., 31
years old, before and left knee
replacement
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
Severe restriction of motions and knee ankylosis
X-ray films of female patient A., 55
years old, before and after right knee
replacement
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
Severe restriction of motions and knee ankylosis
X-ray films of male patient P., 64 years old, before bilateral knee
replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
Severe restriction of motions and knee ankylosis
X-ray films of male patient P., 64 years old, after two stage
bilateral knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
Severe restriction of motions and knee ankylosis
Functional result of male patient P., 64 years old, after two stage
bilateral knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
Severe restriction of motions and knee ankylosis
X-ray films of male patient Zh., 40 years old, before
and after right knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
Severe restriction of motions and knee ankylosis
X-ray films of female patient Ch., 69 years old,
before and after right knee replacement.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
Severe restriction of motions and knee ankylosis
X-ray films of female patient O., 68 years old,
before and after left knee replacement
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
KNEE REVISION SURGERY
X-ray films of female patient Ch., 58
years old, before and after right knee
revision
KNEE REVISION SURGERY
Functional result of revision knee surgery 2 years after
The result of knee joint replacement with
Ukrainian system MOTORSYCH (Zaporozhye).
X-ray films of female patient A., 64 years old, before and after
right knee replacement with native Ukrainian endoprosthesis.
Orthopaedic Clinic of
Dnepropetrovsk medical academy
UKRAINE
Patient А., third day after surgery. Active flexion and
passive training with STRYKER devise.