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Knee Instability - Best Hospitals, Doctors, Prices - Booking Health

Treatment of Knee Instability

Knee instability | Information about hospitals and doctors | Rankings | Clinics | Prices | Send request to the hospital

Best hospitals and doctors for knee instability treatment abroad

Leading hospitals

Cost for treatment

Knee instability diagnosis
1297
Arthroscopic or open surgical reconstruction of ligament with autotransplantation to treat knee instability
5246.1
Orthopedic rehabilitation
690.57
According to the prestigious Focus magazine, the Helios ENDO-Clinic Hamburg ranks among the top German clinics specializing in orthopedic rehabilitation, spinal surgery, and hip surgery! The clinic is one of the largest and most famous orthopedic medical facilities in the world. Performing more than 9,000 joint surgeries and tre
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According to the reputable Focus magazine, the Helios Hospital Munich West ranks among the best medical facilities in Germany! The medical complex has all the necessary resources to provide patients with excellent medical services – highly qualified doctors with long clinical experience, advanced medical technologies and h
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The ViDia Hospital Karlsruhe is a modern medical facility with a rich history and traditions. The medical complex is an academic hospital of the University of Freiburg, granting patients access to advanced university medicine and the very latest therapeutic developments. The hospital first opened its doors in 1851 and, since the
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According to the reputable Focus magazine, the Hospital Nordwest Frankfurt am Main ranks among the top German medical facilities! The hospital has a reputation of a modern multidisciplinary medical center with excellent quality of services. The medical complex is an academic hospital of the Goethe University Frankfurt, thanks t
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The Hirslanden Clinic Bois-Cerf Lausanne is a modern medical facility, which has gained an excellent reputation in Switzerland due to the high-level medical service, advanced infrastructure and a humane attitude towards patients. The medical center is part of the Hirslanden Private Hospital Group, which has high patient satisfac
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According to the prestigious German Focus magazine, the ATOS Orthoparc Clinic Cologne is one of the best medical facilities in Germany in the field of knee, hip, and shoulder surgery, as well as in the field of foot surgery and spinal surgery! The clinic specializes in conservative and surgical treatment of musculoskeletal patho
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The ATOS Clinic Heidelberg is a reputable medical complex with high standards of patient care. The clinic was founded in 1991. Since then, it has taken a leading position in the European medical arena in the treatment of diseases of the musculoskeletal system and many other pathologies. The clinic has a highly professional team
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The ATOS Orthopedic Clinic Braunfels is a specialized medical facility for the treatment of musculoskeletal diseases. The clinic provides high-quality medical care for patients with hip, knee, and shoulder diseases, and also treats the entire range of hand diseases and spinal pathologies. The medical institution enjoys the statu
The Assuta Hospital Tel Aviv was opened in 2009 and today it is one of the largest, modern hospitals with the highest treatment success rates in Israel. The сlinical practice is based on the use of the state-of-art technologies in the world of medicine. The compliance with the high level of medical care and cooperation with the
If you are looking for the best hospitals of the world, give Swiss hospitals a go. Swiss hospitals offer the most advanced equipment, high-quality service, care, as well as perfect organization, which are also cornerstones of our private hospital operating for over 85 years. This helps us lay a foundation for success treatment a
The Tel Aviv Sourasky Medical Center is the second largest and one of the most advanced healthcare and research facilities in Israel. It began its work in 1961, but it is still popular among the local population and attracts thousands of international patients. The multidisciplinary medical center covers an area of ​​150,000 m&s
Asan Medical Center is Korea’s largest medical institution, with 1,600 physicians and surgeons, 3,100 nurses, 2,680 beds, and 67 operating rooms, occupying more than four million square feet (about 371,600 square meters). A typical day at AMC sees 2,500 inpatients and 10,000 outpatients treated. The treatment of heart dise
The Samsung Medical Center was founded in 1994 and soon won the reputation of a medical facility of presidential standards, which it still preserves today. The hospital has 40 departments, 10 specialized centers and a huge Cancer Center with 655 beds. The medical facility is equipped with advanced equipment (for example, a 32-ch
The Hanyang University Medical Center was founded in 1972 and today is one of the largest and most advanced providers of medical services in Korea and around the world. The medical institution runs 9 specialized centers and 26 departments fitted out with state-of-the-art equipment. The most important component of successful trea
As a member of the Swiss Leading Hospitals, the Multispecialty Hospital Lindberg in Winterthur ranges amongst the leading medical facilities in Switzerland. With more than 100 accredited doctors of various specialties, the Lindberg Hospital offers a broad range of medical services. Focal areas of the Hospital are orthopedics inc
Some prefer to solve their health problems and receive healthcare abroad, for example, in Switzerland. Since 2002, Swiss hospital Klinik Birshof belongs to Hirslanden, the first group of private healthcare facilities in Switzerland. The merger of the former private hospitals of the country has given important impetus to the Swis
| from Booking Health GmbH

Knee instability is an impairment of the ability of the knee joint to maintain the correct axis of the lower limb. When walking, the knee can be deflected forward, backward, inward or outward, or abnormal rotation of the lower leg occurs. Joint movements are limited due to the ligaments. Most cases of instability are associated with their rupture. Pathology can also develop due to bone structure lesions. Doctors abroad successfully treat knee instability with minimally invasive surgery. Full rehabilitation allows patients to return to their maximum level of physical activity 4-6 months after a surgical intervention.

Content

  1. Causes of knee instability
  2. Diagnostics
  3. Conservative therapy
  4. Anterior cruciate ligament plastic surgery
  5. Damage to several ligaments
  6. Rehabilitation
  7. Why is it worth undergoing treatment of knee instability abroad
  8. Treatment in Europe at an affordable price

Causes of knee instability 

 

Knee instability is usually the result of the previous knee ligament injuries. This is the most commonly injured joint. Knee injuries account for 50% of all registered joint injuries.

The most common injury is meniscus tear. In second place is the cruciate ligament rupture. It is not uncommon for these two injuries to be detected at the same time. At risk are young people and adolescents who play sports and lead an active lifestyle.

Developed countries are making significant advances in the treatment of knee instability. Previously, after joint injuries, patients often received conservative treatment, which did not always lead to good functional outcomes. But in recent years, surgical procedures have become less traumatic thanks to the introduction of arthroscopy. Therefore, the frequency of their use is increasing. In the last 15 years alone, the number of operations for knee injuries in developed countries has quadrupled.

Athletes are most often injured. Each day, anterior cruciate ligament ruptures occur in 1 out of 1,500 skiers and 1 out of 1,700 football players. This is one of the most common injuries in sports. It accounts for 2.6% of all injuries of the musculoskeletal system.

Among patients with knee instability are more men, as they are more likely to play sports. However, among female athletes, knee injuries are more common in percentage terms. Their ligaments are weaker, they break more easily, so the risk of developing knee instability is 4-10 times higher, according to different authors.

Another cause of instability is external patellar dislocation. In 80% of cases, they occur due to congenital structural features of the knee. The most common prerequisites are a flat intercondylar notch, a dysplastic type of structure and a high position of the patella, displacement of the tibial tuberosity, or a generalized joint hypermobility syndrome. There are currently over 160 different surgical procedures to correct this cause of knee instability.

Diagnostics 

 

If instability develops, the doctor must find out the cause of this condition in order to choose the best therapy option. At the examination stage, the following diagnostic procedures can be carried out:

  • Functional tests – the doctor determines which movements in the knee are excessive or limited in order to find out which anatomical structures are damaged.
  • MRI – the best way to visualize structures within a joint.
  • Direct magnetic resonance arthrography – the procedure involves the introduction of a contrast agent into the joint, which makes the diagnosis more accurate.
  • Diagnostic arthroscopy is the most accurate, but invasive examination, involving the introduction of a thin tube with a video camera into the patient's knee.

Conservative therapy 

 

Conservative therapy is ineffective in knee instability treatment. If the stability of the joint is impaired, this indicates that the ligaments or bone structures are damaged. Anatomical defects can only be corrected with surgery.

Conservative therapy is of secondary importance. With its help, doctors can eliminate pain, swelling, and relieve joint inflammation. After the surgical intervention, doctors use both medicines and non-drug treatments to speed up the patient's recovery and ease the postoperative period.

Anterior cruciate ligament plastic surgery

 

Anterior cruciate ligament rupture is the most common cause of knee instability. There are more than 250 methods of surgical treatment of this pathology described in the literature.

The surgery should be performed as early as possible, preferably no later than 3 months after the knee injury. Otherwise, damage to the menisci, degeneration of the articular cartilage, damage to the joint capsule and other ligaments may occur. In recent years, specialists try to perform the surgical intervention in the acute period of trauma.

Although there are a variety of surgical treatment methods, their essence is similar. Doctors suture a torn ligament, suture other tissues to it (hybrid operations) or perform plastic surgery. In fact, they form a new ligament from other ligaments or tendons, donor tissues, and artificial materials.

The most commonly used group of surgical interventions is the anterior cruciate ligament plastic repair. The most widespread is autoplasty. It provides the most reliable results. The restored ligament turns out to be strong, the risk of its repeated rupture is very low, which is especially important for athletes and young physically active people.

The following materials can be used for autoplasty: 

  • Patient's own patellar ligament. 
  • Peroneus longus tendon. 
  • Patellar tendon. 
  • Hamstring tendon. 
  • Achilles tendon. 

There is no ideal option. Some surgical options provide more reliable results, while others have a lower risk of complications. Each method has its own advantages and disadvantages. Different countries use different types of plastic surgery. For example, in North America, doctors prefer to use the Achilles tendon or the patella's own ligament. Doctors in Europe often use tendons of the semimembranosus, thin, posterior tibial muscle for plastic surgery. Plastic repair of the patient's own patellar ligament can rarely be performed due to the risk of complications from the donor site: long-term pain, patellar tendonitis, and patellofemoral arthrosis.

To reduce the trauma of the operation, alloplasty can be performed. With this approach, doctors use a preserved donor ligament or tendon. The advantages of this approach are obvious: there is no trauma to the donor site, the operation is less traumatic, there are no scars in the incision area (a better cosmetic effect). In addition, the graft can be perfectly sized. Nonetheless, there is a big drawback: the new ligament will not be very strong. Therefore, this type of surgery is not suitable for athletes, but it can be used for elderly people with low physical activity.

Some hospitals use synthetic materials for ligament plastic surgery. Like allografts, they are less durable than the patient's own ligaments and tendons.

To fix the new ligament inside the knee, doctors use titanium screws, bone nails, compression impaction, and anchor clamps.

Damage to several ligaments 

 

With severe knee injuries, several ligaments can sometimes be damaged at once. In addition to the anterior cruciate ligament, it can be the posterior cruciate or lateral ligaments. Such concomitant injuries are rare. They usually result from a direct blow to the knee. As a result of falling from a height or traffic accidents, damage to the ligamentous apparatus can occur.

The damage to several ligaments can be corrected with the help of one or more surgical interventions. Whenever possible, preference is given to a single-stage correction. Doctors more often perform the single-stage plastic surgery of the anterior cruciate and lateral knee ligaments. With the posterior cruciate ligament damage, the two-stage correction is often performed. The interval between operations is 4 to 6 months. Compared to the single-stage intervention, this approach reduces the risk of some complications, primarily contracture (stiffness) and recurrence of knee instability.

Along with the cruciate ligament, the knee meniscus can often be damaged as well. The correction of these two pathologies can be carried out simultaneously or in two stages. The preference is given to the single-stage surgery to eliminate two consequences of the traumatic knee injury. Most doctors perform anterior cruciate ligament plastic surgery, resection or meniscus suture repair using the single-stage approach. Less commonly, the treatment can be performed in two stages. In this case, the intervention is first performed on the meniscus, and after a while the ligamentous apparatus is operated on. The time interval between two surgical interventions should be reduced to a minimum, since until the integrity of the anterior cruciate ligament is restored, the risk of repeated meniscus tear remains increased.

Rehabilitation 

 

After the surgical correction of knee instability, patients require long-term rehabilitation. Ligaments grow together very slowly. Some surgical procedures involve additional bone tissue intervention. Therefore, rehabilitation takes from 4 to 6 months, depending on the type of surgery performed, the patient's health status, the effectiveness of the rehabilitation program and the requirements for the final outcomes.

The main method of rehabilitation is physical training (therapeutic exercises). The volume of loads is selected individually and gradually increases. Medical facilities abroad use advanced types of special rehabilitation exercise devices, which help to quickly restore muscle strength and proprioceptive sensitivity.

Massage and physiotherapeutic procedures, passive movements in the joint, electrical muscle stimulation – all these procedures are important in the first few days after the operation. They help improve blood circulation, eliminate edema, and slow down atrophic changes in the muscles of the limb. In the following months, these methods are used in rehabilitation to recover from physical training.

After ligament surgery, rehabilitation takes place in 4 phases: 

  • Phase 1 lasts about 1 month. During this period, the mobility of the limb is limited by a bandage. Nevertheless, by the end of the first month, patients should restore the range of motion in the joint, learn to walk without crutches and work on strengthening the thigh muscles. Doctors use a variety of procedures and medications to relieve knee pain, inflammation and swelling.
  • Phase 2 lasts up to 2.5 months. The patient can already work out in the gym, swimming pool, and on rehabilitation exercise equipment. The objective of this stage is to bring the range of motion in the knee to the level that was before the injury. Other goals include complete control when walking, balance, increased muscle strength in the limb.
  • Phase 3 lasts up to 4 months. Limb strength reaches 90% of a healthy leg. The patient can already run and return to sports training. A person is working out on an exercise bike, treadmill, rowing machine.
  • Phase 4 lasts up to 6 months. This phase aims to completely relieve pain, swelling, coordination, and return the patient to the previous sports form. Upon completion of this stage, the person can return to maximum loads.

Why is it worth undergoing treatment of knee instability abroad 

 

In developed countries, modern minimally invasive procedures and surgical interventions are used to restore the stability of the knee joint. You can expect to return to your previous physical activity as soon as possible after treatment. In the long-term postoperative period there will be no pain, swelling, the strength and sensitivity of the limb will be fully restored. You can return to physical labor or sports. The relapses of instability after treatment are extremely rare in developed countries.

There are several reasons for you to undergo treatment abroad: 

  • Most of the surgical interventions are performed using minimally invasive techniques: through several punctures in the knee area instead of a large incision. 
  • Reliable methods of plastic repair of torn ligaments. 
  • Minimal risk of complications.
  • Possibility of simultaneous correction of several knee injuries at once: plastic surgery of several ligaments, restoration of the meniscus and knee ligaments.
  • Early rehabilitation to reduce the risk of complications and shorten the length of hospital stay.
  • Full rehabilitation will allow you to quickly return to the previous level of physical activity or reach the peak of sports form. 

Treatment in Europe at an affordable price 

 

To undergo knee instability treatment in one of the European hospitals, please use the services of the Booking Health company. On our website, you can find out the cost of treatment in different hospitals and compare prices in order to book a medical care program at a favorable price. The treatment of knee instability in a European hospital will be easier and faster for you, and the cost of treatment will be lower.

You are welcome to leave your request on the Booking Health website. Our specialist will contact you and provide a free consultation on treatment in Europe. Booking Health will take care of the organization of your trip abroad. We will provide the following benefits for you:

  • We will select a hospital for treatment in Europe, whose doctors specialize in the treatment of knee instability and achieve the best results.
  • We will solve the problem of the language barrier, and help to establish communication with your doctor.
  • We will reduce the waiting time for the medical care program. You will undergo treatment at the most suitable dates for you.
  • We will reduce the price. The cost of treatment in European hospitals will be lower due to the lack of overpricing and additional coefficients for foreign patients.
  • We will help you solve any organizational issues: we will draw up documents, meet you abroad and take you to the hospital, book a hotel, provide interpreting services.
  • We will prepare a program and translate medical documents. You will not need to repeat the previously performed diagnostic procedures.
  • We will help you keep in touch with the hospital after the completion of your treatment in Europe.
  • We will arrange additional diagnostic examinations and treatment in a European hospital, if required.
  • We will buy medicines in another country and forward them to your native country.

The world's leading doctors will take care of your health. The specialists of the Booking Health company will help reduce the cost of treatment, organize your trip, and you can fully focus on restoring your health.

Authors: Dr. Nadezhda IvanisovaDr. Farrukh Ahmed