Knee prosthesis/total knee prosthesis/knee endoprosthesis/knee joint prosthesis/artificial knee joint

Knee osteoarthritis can progress so far that therapy is not able to alleviate the symptoms (e.g. pain) and that a joint replacement is the only solution. Even though this operation is virtually routine today, it is still a major intervention. After a knee operation with the implantation of an artificial joint, careful knee rehabilitation is essential for the prosthesis to last as long as possible. Gait, coordination and strength training, and improving mobility are just some therapy focal points. Avoiding impact that could damage the new joint is of particular importance. Read more under ‘Application tips’.

Definition

An artificial knee is an implanted prosthesis (endoprosthesis) to replace the functions of the knee joint and/or its supporting apparatus after a loss of functionality. Artificial knees are used as a surgical therapy mainly in cases of severe degenerative joint disorders (knee osteoarthritis) and after knee injuries in order to restore the ability to move without pain and to improve knee joint stability (in case of ligament instabilities). Partial or total knee prostheses are used, depending on the severity of damage. After the prosthetic hip joint, the artificial knee is the second most common endoprosthesis with about 175,000 operations carried out in Germany each year (first-time implants, 2009).

Causes

Osteoarthritis can be caused by excessive weight and excessive strain, such as occurs during extreme sports or when performing heavy physical labour. Causes also include changes in the cartilage metabolism with advanced age, metabolic disturbances, congenital malformations and acquired joint deformities, for example due to inflammatory joint diseases or after an injury.

Years of improper strain on the knee joint while walking is another possible cause (see Fig. 1 and 2). The greater the impact while walking and the less precise the movement, the faster the cartilage will wear. The main cause of improper strain on the knee joint is the long periods of time we in industrialised western nations sit every day, something that nature did not intend. Sitting for hours leads to the progressive shortening of the hip flexors. As a result, the person is no longer able to achieve a physiologically correct gait with the upper body upright. This in turn leads to excessive strain on the neck and back musculature, incorrect knee position, and therefore to increased cartilage wear.

Non-physiological walking

Fig. 1: Feet restricted by conventional shoes. Leads to hip gait and bent upper body --> severe knee strain

Walking that is easy on the joints

Fig. 2: Walking with the kyBoot. Impulse comes from the feet.--> Upright gait and minimal knee strain

Long-term consequences – trapped in a vicious circle

Pain caused by osteoarthritis can lead to relieving postures, subsequently causing excessive strain on the joints and other body structures or leading to secondary disorders or secondary osteoarthritis. Furthermore, pain leads to a reduction in exercise and those who move less automatically put on more weight. This in turn has a negative effect on osteoarthritis complaints. Many of those affected by degenerative joint disease are caught in a downward spiral. The main therapy objective is to break free from this downward spiral.

When the knee joint is severely worn, a knee replacement operation is often the last chance to escape the vicious circle of the downward spiral and regain quality of life.
But beware, an artificial knee wears faster than a natural joint when the body/knee is put under improper strain. This makes it especially important to place only gentle loads on the body with a joint replacement, so that it does not get caught in a downward spiral again!

Conventional therapy

After a knee operation to implant an artificial joint, careful treatment with rehabilitation of the knee musculature is essential:

  • Physiotherapy: Reduction of swelling, coordination and strengthening of the musculature, improved mobility, scar mobilisation and more.
  • Reduction in body weight if overweight
  • Massage, heat/cold applications
  • Pharmacological treatment

The kybun principle of operation – being proactive

The kyBounder and kyBoot are ideal for bringing more movement to everyday life, and for rehabilitating the knee after an operation – all this without expending any additional time. Acute pain is alleviated quickly and, thanks to the gentle load on the knee joints due to the soft, elastic material, the knee that is still sensitive is protected against impact and the muscle tissue can develop gradually without overloading the ‘freshly’ operated knee.

The soft, elastic foam material acts as a ‘crumple zone’, effectively dampening impact on the joints during running and walking. As a result, the swelling in the recently operated knee is more readily alleviated and healing is promoted (gentle mobilisation of the knee joint, improved circulation, reduced swelling).

Movement becomes more comfortable again and knee complaints are reduced, usually after just a few minutes. Those who like to exercise frequently find it much easier to shed extra pounds, which in turn reduces strain on the joints. Virtually all customers with knee osteoarthritis or an artificial knee report a reduction in pain since they started wearing the kyBoot.

At the outset with conventional shoes

Fig. 3: Ankle joints restricted by shoes, folding in with virtually no dampening of impact, knee highly flexed during heel strike, causing improper strain.

After 6 weeks with the kyBoot

Fig. 4: Ankle joints free, making a physiological rollover possible with the knee extended. --> Strain and the risk of osteoarthritis are minimised

It’s not only the cushioning effect that helps alleviate pain. When standing the soft, elastic supporting underlay, one automatically keeps moving very slightly. When standing and walking on soft, elastic materials, the core stability musculature has to make a major contribution in order to stabilise the joints. Strong core stabilising musculature ensures an upright posture, resulting in more precise movements in the joints. Lack of exercise due to pain results in long-term muscle loss (amyotrophia). Signs of excessive strain in the knee joint can develop more quickly as a result. The ability to stabilise the joints under load can be improved further through proprioceptive, sensorimotor and coordination training on an unstable surface. This also prevents the knee from wearing as quickly after the operation. Training the core stabilising musculature is easy to integrate into everyday life by wearing the kyBoot.

Attention! Short-term effects are often confused with lasting effects.

The adjustment processes in the body triggered by the kyBoot can take months or even years. Achieving lasting change is a protracted process.

Despite that, the effect of the soft, elastic material can also be felt quickly, for example in the relaxation of tense muscles and the alleviation of pressure points. These short-term effects must not be confused with the effects in the long run, since the long-term adjustment process cannot progress far enough in a week to be perceptible.

Short-term effects, on the other hand, can disappear again just as quickly as they came, or can even turn into complaints if you do not take the necessary breaks in the beginning.

Therefore, it is important to understand that an initial reaction and a reduction of the positive feeling in the first few weeks with the kyBoot does not mean that the kyBoot is no longer working, but merely that the short-term sense of well-being is declining!

Prevention with kybun

Everyone knows that the body exhibits signs of wear over time , and that problems while walking and running are bound to occur sooner or later. Yet most people only start to consciously perceive their body as a fragile and transient structure once they experience problems. In most cases, however, it is already too late because irreversible damage such as cartilage wear has already occurred.

Therefore it is important not to wait until you experience pain before you act. The kyBounder and kyBoot help protect the joints and prevent osteoarthritis even in youth.

Initial reactions

Specific initial reactions after operations for implanting artificial knees:

Even though kybun training places intense demands on the operated joint, kyBoot/kyBounder training can begin just a few days after the operation (unless a doctor or physiotherapist advises against this). If the operation was performed only recently, it is important to slowly increase the development training with the kyBoot/kyBounder. If the period of use is too long, the swelling may increase or you may even feel more pain. In such cases, it is important to reduce the period of use and to take a short kybun break before the symptoms occur, so the knee can recover from training.

 

 

Click here for the general initial reactions experienced by kyBounder and kyBoot beginners: Initial reactions

kybun exercises

For information about the special kyBoot exercises or the basic kyBounder exercises , please click here: kybun exercises

Application tips

After having an artificial knee implantation, it is important to avoid exposing the new joint to harmful impact. It is therefore important to observe the following points when walking in the kyBoot/standing on the kyBounder:

  • Walk upright
  • Do not make your steps too long
  • Extend the knee joint in the stance phase as well as possible (not to be confused with over-extension!)
  • Everyday/leisure: Walk with the kyBoot or use the kyBounder as much as possible. Take note of fatigue > perform the kybun exercises regularly and take a short break if needed.
  • Job: Sit as little as possible. Alternate sitting and standing in the beginning, and take along replacement shoes to change into
  • If you feel unsafe/too unstable in the kyBoot even after a test walk, we recommend a second generation kyBoot model. These have a somewhat wider sole in the area of the midfoot, providing added stability. Seek advice from your local kyBoot expert.
  • If you find the second generation kyBoot model too unstable for you as well, we recommend the kyBounder. You can choose the thickness you are comfortable with (the thicker, the less stable, the more intensive the training). You can also hold on to a fixed object. This can be helpful especially in the beginning after the operation, until you regain confidence in the knee.
  • Precise movements are essential with artificial knees. Pay attention to exact movements and be sure to take a break in case of fatigue or weakness. Lateral/medial rolling of the ankle joint on the soft, elastic material has to be corrected so that the load is applied to the foot and knee with proper axial alignment. Read more under ‘Lateral/medial rolling of the ankle joint’.
  • Contact a kybun dealer you trust if you have further questions, feel insecure or if there is no alleviation of pain when using the kyBoot even though you are following the tips.

Opinions/customer testimonials

At 66 years old, I have had two hip replacements, a right knee replacement, and have undergone two major back operations. My knees had always been swollen, but once I tried kyBoot, they became normal again after two days. Now I can walk for hours without limping. I feel truly alive again.

Experiences/further questions on artificial knees

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[1]:Pschyrembel, medizinisches Wörterbuch, 261st edition