The medial and lateral menisci are specialized fibrocartilage structures in the knee joint
that ensure congruence of the joint surfaces, stabilize the knee, and serve as shock
absorbers. Meniscus tears can occur either due to knee injuries or gradually over time as a
result of wear and aging, making the meniscus tissue brittle and prone to tears
(degeneration). Because the meniscus tissue has little to no blood supply, its repair
mechanisms are limited. Fresh tears should be arthroscopically sutured as soon as
possible. Degenerative tears that cause mechanical symptoms can be successfully treated
arthroscopically by removing and smoothing the impinging parts.
The most important ligaments of the knee include the cruciate ligaments (anterior and
posterior) and the collateral ligaments (medial and lateral). A tear of the anterior cruciate
ligament is one of the most common and consequential knee injuries. It not only
compromises the passive stability of the knee joint but also disrupts muscle coordination
due to the destruction of numerous sensory cells present in the ligament. Such instability
leads to a feeling of insecurity, repeated twisting incidents, and secondary damage to
internal knee structures such as cartilage and meniscus. Surgical treatment is performed
minimally invasively via arthroscopy using autologous tendon grafts for reconstruction. In
the first few days after a partial cruciate ligament tear, the remaining stump can sometimes
be reimplanted into the bone (healing response). For fresh knee injuries, you will therefore
receive an immediate appointment. We will help you obtain an MRI appointment as quickly
as possible.
The kneecap and its associated glide path form a functional unit of the knee joint (femoro-
patellar joint). The patella is stabilized by the extensor muscles and the surrounding lateral
ligaments (retinaculum). This balance can be disturbed either by a traumatic dislocation of
the kneecap or by misalignment (maltracking). Over time, this leads to cartilage damage
and painful irritation. A typical symptom is anterior knee pain – especially when going
downstairs – along with grinding sensations and joint effusions. The most important
prerequisite for successful treatment of patellar problems is restoring this balance through
muscle strengthening, braces, or surgery. Common surgical interventions include MPFL
reconstruction or bony realignment of the extensor mechanism (tibial tubercle transfer
according to Elmslie-Trillat).
Isolated cartilage damage is treatable and should therefore be detected early. Since
cartilage contains no pain fibers, early damage often goes unnoticed. In suspected cases,
MRI provides clarity. Treatment is either by stimulating the bone marrow (microfracture,
nanofracture, abrasion) or by transplanting autologous cartilage (minced cartilage). For
larger isolated cartilage defects, cell-based procedures such as matrix-assisted autologous
chondrocyte transplantation (MACT/MACI) can be used.
The knee joint consists of three compartments: medial (inner), lateral (outer), and the
patellofemoral joint (kneecap and glide path). Osteoarthritis most commonly begins in the
medial compartment. In such cases, a partial joint replacement (unicompartmental or
"sled" prosthesis) may be appropriate. When multiple compartments are affected, a total
knee replacement (TKA) is implanted. PD Dr. Basad primarily uses custom-made implants.
These are created like a tailored suit using a digital 3D scan based on CT imaging.
Advantages include anatomical fit, reduced bone removal, more natural joint movement,
and significantly lower blood loss after surgery due to precise coverage of bleeding bone
surfaces. Since 2021, robotic-assisted surgery (MAKO system) has also been available at
ATOS Clinic. This allows pre-planned bone cuts to be performed more precisely and with
less trauma using a robotic arm.