In case of a massive arthrosis of the knee joint (mostly caused by former injuries and joint wear off) and if medicaments, conservative therapy or minimal-invasive operational methods (for example knee arthroscopy) are not possible and effective anymore, then one has to think about more extensive operational steps. First of all one has to check, whether a severe malpostion of the leg axis and/or an instable ligament situation exists.

Afterwards it has to be checked, whether all parts of the joint or whether only a joint section of the knee is affected. Therefore a careful clinical examination, X-rays in upright position and images of the complete and urightly positioned legs as well as images of the kneecap are essential. 

An MRT or also a preceding arthroscopy (endoscopic examination) can improve the situation decisively.