- The valgizing high tibial osteotomy (HTO)
This is only a good option in case of adequate changes of the TBVA (Tibia Bone Varus Angle) like for example malposition/erroneous angle of the upper shin.
- KineSpring®-System of the Fa. Moximed
Since 2011 there is a shock absorbing system available, which relieves the inner joint gap via an implantable spring.
Depending on the severity code of the arthrosis the relief spring can be an alternative to the joint replacement or can clearly delay it, especially for younger patients.
A relief spring attached to the side of the joint reduces the pressure inside the inner joint gap with every step up to 13 kg. During extension the spring is compressed and thus takes over a part of the external load. During the genuflection the spring has no function and exercises no pull. The reduction of the joint load is supposed to relieve the arthrose pain decisively and to work against the progressive degeneration and loss of function. The system consists of a base plate at the thigh and lower leg as well as the relief spring placed inbetween and it is implanted directly under the skin and on the outside of the joint capsule on the inner (medial) side of the knee and positioned above the internal sideband. The base plates are attached to thigh and lower leg with 4 bone screws each. The connection to the spring is made by a ball joint each, which preserves the normal movement range of the knee. The intervention needs no opening of the knee joint capsule or bone removal or bone changing and is thus completely reversible apart from the access scars.
Concerning durability, late complications and long-term results no final statement can be made due to the newness of the system. A first examination on 100 patients revealed, that the severity code of the knee pains improved up to 60% over one year (p < 0,001) and 76% of the patients achieved an improvement of at least 30% concerning the knee pains. A statistically provable improvement in the following criterias was achieved: An improvement of pain up to 56%, an improvement of function up to 57% and an improvement concerning the sensation of stiffness up to 39%. The percentage of patients, who reached an improvement of at least 20%, was 74% concerning pain, 83% concerning function and 67% concerning stiffness. In a current international Multicenter-study (GOAL-Trial) the efficiency of the relief spring implantation compared to the valgizing high tibiaostomy (HTO) is examined.
As the leader of the GOAL-Studienzentrums in Werneck I perform KineSpring®-implantations since 2011.
Via the following images I would like to show patients I have operated: