PD Dr. med. Sandro Fucentese
The knee joint is the largest joint in the human body. Its complex anatomy means that it is very susceptible to injury and disease.
PD Dr Sandro Fucentese and his team use the possibilities of arthroscopy (keyhole surgery), minimally invasive surgery, computer-assisted navigation and individualized patient-specific surgery.
Areas of expertise
The knee joint is an extremely complex joint that is subjected to multiple stresses and strains. For this reason, injuries from accidents and sporting injuries are common.
Our expertise in accident and sports injuries
- Meniscus and cruciate ligament injuries
- Lateral ligament injuries
- Cartilage injuries
- Complicated and combined injuries of ligaments, menisci, and cartilage
- Treatment of kneecap instability (patella instability)
Our expertise in diseases and chronic complaints
- Correction of the axes and rotation in the treatment of malalignment and deformities
- Treatment of arthritis induced by trauma, rheumatoid disease, or simply wear and tear
- Knee joint replacement surgery (artificial knee): from partial prostheses to complex total joint prostheses
- Revision surgery for problems with knee prostheses
Quality control, innovation and scientific approach as well as the application and expansion of the latest knowledge and techniques are the standard of the clinic.
Animated knee videos
Together with the posterior cruciate and lateral ligaments, the anterior cruciate ligament (or ACL, as it is known) stabilizes the knee joint. In this way, it protects structures such as cartilage and menisci inside the joint. ACL tears are usually caused by accidents when skiing, playing football or during similar sporting activities. They are often associated with injuries to the menisci, lateral ligaments, and cartilage. The initial pain and swelling is followed by a feeling of instability.
Knee joint replacement
Various diseases and injuries may lead to typical wear and tear of the surfaces of the knee joint. The result is increasing pain and restricted mobility. If all possible conservative treatment has been tried, an artificial knee joint has to be considered. If the entire joint is affected, as you can see in the video, the only remaining option is often a total knee joint replacement, which is also called a total prosthesis or total knee implant.
During a person’s lifetime, changes in the leg axis may occur from natural causes or due to disease or injury. Malalignment of the leg axis may lead to osteoarthritis of the inner or outer side of the knee joint – often with resultant pain in the damaged area. This video shows you how the axis can be corrected by a wedge osteotomy when, for example, only the inner side of the knee joint is affected by arthritis.
Information for referring doctors
The knee team at Balgrist University Hospital specializes in the treatment of musculoskeletal pathology in the knee. The high case numbers and the focus on the knee joint speak for the broad experience of our highly qualified surgeons, which works to advantage in the treatment of our patients.
Treatment of osteoarthritis
Operating on a large number of cases, we cover the entire spectrum of procedures from joint preservation to prosthetic revision surgery. Our joint preserving procedures range from the treatment of cartilage problems to corrections of the leg axis. Together with the in-house CARD team, we use 3D-assisted analysis of the leg axis malalignment and 3D-simulated surgical planning prior to these corrective procedures. Joint replacement surgery involves the use of various techniques including computer-assisted and patient-specific implantation procedures. We use this technology routinely in primary joint replacements.
Sports injuries are treated in close cooperation with our sports medicine centre Balgrist Move>Med. Here we emphasize the value of personalized treatment plans. Isolated and complex multi-ligament injuries such as anterior and posterior cruciate ligament tears are just part of the spectrum. A large number of lateral ligament injuries and repeat tears are also treated with the corresponding expertise. We also work closely with the University Children’s Hospital to treat injuries sustained during childhood and adolescence. This routine cooperation works to the advantage of our patients.
Another particular medical and scientific focus is the treatment of patella instability. Rare diseases such as hemophilia are treated in cooperation with national and international hospitals, to provide as personalized treatment as possible.
Indications and range of services
The knee team led by Dr. Sandro Fucentese specializes in the following
- Osteoarthritis of the knee
- Sports injuries: anterior cruciate / posterior cruciate / lateral ligament tears, meniscus injuries
- Leg axis malalignment (varus malalignment, valgus malalignment, complex malalignment as the result of trauma)
- Fractures around the knee
- Patella instability
- Trochlear dysplasia
- Painful knee prostheses or prosthetic revisions for: loosening, infection, instability, frac-tures, extensor mechanism deficiency, polyethylene wear, malrotation of the prosthetic components.
- Localized cartilage damage (osteochondrosis dissecans, sequalae of trauma)
- Haemophilia-induced osteoarthritis of the knee
We offer the following medical services
- Interdisciplinary conservative and surgical treatment
- Computer-assisted primary knee joint replacement (total joint prosthesis, partial joint prosthesis)
- Prosthetic revisions due to infection, loosening, instability, malrotation of the components, joint fibrosis, polyethylene wear, extensor mechanism deficiency
- 3-D planned (CARD planned) and simulated correction of painful leg axis malalignment
- Sports medicine procedures: anterior and posterior cruciate ligament repairs, lateral ligament repairs, partial meniscus repairs, meniscus transplants
- Revision of cruciate ligament repairs in the case of repeated tears
- Surgery for localized, single-compartment cartilage damage: microfracturing of the cartilage, autologous matrix-induced chondrogenesis (AMIC procedure)
- Stabilisation of the patella in cases of instability
- Trochleoplasty for trochlear dysplasia
- Joint-preserving surgery for single-compartment wear and tear and associated leg axis malalignment
- Prosthetic revisions: prothesis exchange due to instability, malposition of the components, wear and tear, polyethylene wear, extensor mechanism deficiency, fracture and infection; biological reconstruction of bone defects (our own bone bank)
- Care of fractures around the knee (tibial plateau fractures, distal femoral fractures, patella fractures)
The benefit to your patients
Our medical services offer your patients the following advantages
- Treatment of all pathological musculoskeletal conditions affecting the knee in adults, as well as in children and adolescents
- Treatment of the whole range of complications and revision surgery (e.g. repeat cruciate ligament rupture, etc.) and prosthetic revision surgery (due, for example, to infection, fracture, extensor mechanism deficiency or avulsion, etc.)
- Interdisciplinary treatment, working together with orthopaedic surgeons from other specialist teams (spine, shoulder, hand, hip and pelvis, foot, technical orthopaedics, tumor orthopaedics, pediatric orthopaedics), as well as sports medicine experts, physiotherapists, pain therapists, chiropractors, hematologists and specialists in general internal medicine or infectious diseases
- Computer-assisted 3D planning for personalized procedures for knee joint replacement and leg axis correction
- Our own prosthetic implant registry for systematic quality control and optimization of therapeutic options
- Our own bone bank for sustainable biological reconstruction of bone defects during prosthetic revision surgery
- Patient-centred clinical research at the Balgrist Campus (in collaboration with biologists, engineers, and biomechanical engineers from the ETH in Zurich) for the continuous improvement of treatment