Dear People , Liebe Mitpatienten,
I would like to take a minute of your time to warn you about the practices and controversial procedures used by a particular knee surgeon in Munich. The surgeon's clinic, the AlphaKlinik, was closed in 2008 after many German's sued for malpractice. The surgeon has since setup practice in a basement of a business club.
This surgeon is promoting a highly controversial procedure called Thermal Shaving Chondroplasty. He claims on wikipedia to have „made his name“ with this revolutionary technique to 'save a severely arthritic knee from total knee arthroplasty (replacement)'. He even wrote a book on it, advertising its amazing results - and how success highly depended on experience, and how he was the most experienced surgeon in the world to perform said procedure (i.e., you must have the procedure done by him). This is easy to claim, since there are basically no other surgeons approving of this procedure, yet dozens who have done studies and shown it leads to chondral necrosis (death of cartilage). In fact, there is a study done by Dr. Dr. Max J. Kääb from Berlin specifically regarding RF Thermal Shaving Chondroplasty (his studies can be found on the internet). Dr. Dr. Kääb reported that 24 weeks after RF shaving of Grade II chondral defects: "grade IV cartilage defects were detected in all radiofrequency-treated samples". The medical community reports repeatedly that "the procedure leads to artificial knee replacement". Even for those few surgeons who do not reject it completely, it is ONLY indicated for cartilage with Grade III-IV Chondromalacia (meaning, hanging fronds and fissuring of the worn-out cartilage). Never is this procedure done on smooth, clean, but slightly softening cartilage – as was done to mine!
In November 2005 ... I went to the AlphaKlinik to find out why my knees had begun to have a sharp pain when I climbed stairs. I was 31 years-old, thin, and had never had an injury in my knees. I had simply been immobilized for the prior six months due to a lumbar disc herniation. The AlphaKlinik suggested that I might have a 'medial meniscus' tear, but that they could not see anything on the MRI. I received a medical diagnosis report that an 'arthroscopic look' was URGENT! I was told, if they didnt fix it now, it could be permanent. They said the procedure would be minimally invasive, and I would be on my feet in 2 to 3 weeks. They even wanted to do both knees, and took MRI's of both.
After the surgery, we read in the medical report that the surgeon had shaved the cartilage under my Patella with a thermal RF-probe. This procedure was NEVER discussed or even hinted at, and we had no idea what it meant. So, of course, we started researching it. Only one surgeon is seen in the media and literature repeatedly promoting the merits and miracles of Shaving Chondroplasty. He states: "Although this concept is largely rejected by the mainstream of orthopaedic surgeons, there is irrefutable proof that grade III chondral lesions that underwent shaving-chondroplasty will recover themselves with a reparative tissue consisting of fibrocartilage." This is true - that fibrocartilage will likely grow, but it does not tell what happens after the fibrocartilage starts to rub off (inflammation). All researchers say this fibrocartilage is short-lived, wears out and creates inflammation - and thus triggers osteoarthritis. The thermal probe initially damages the cartilage, and then the fibrocartilage wear-off particulates and inflammation contribute to further degradation of the cartilage. Most studies report that the thermal shaving chondroplasty results in a deep chondral lesion.
After 3 months my knee was still severely inflamed and not healing. In fact, it was getting much worse. I still could'nt put any weight on it without severe sharp pain under the patella, and my quadriceps muscles were atrophying. We took the arthroscopic video to a local orthopedic doctor in Freising - and he told us the Patella cartilage shown in the surgery video was perfectly healthy, and he had no idea what the surgeon was doing. We took the video to three other orthopedic doctors in the Munich area, and they each said the retro-patellar cartilage was perfectly healthy, and there was no sign of any medial meniscus tear in the surgery video. We reviewed the MRI reports, and found that the pre-operative radiologist report specifically stated "kein enhalt der kondromalasia" - or, "No sign of Chondromalacia."
Now, over 3 years later, I still have a swollen knee and I cant put any pressure on it. I used to be an athletic person who could walk all day, and now-I am crippled for life. Before the knee surgery, I could walk up and down stairs (three floors). Three years after the surgery, I can not even step up ONE stair with my ruined knee. Before the surgery, the MRT on the knee showed no defects. After three years, the latest MRT shows I have a huge lesion under the patella ... just as Dr. Dr. Kaab's research reported would happen.
The surgeon claims 'irrefutable proof in 300 patients'(public data in his own web page). He also claims he has performed shaving and abrasion arthroplasty on over 5000 patients with 'amazingly good results'. Who is checking these trials? Who is controlling the study? I dont think, finding 300 good results out of 5000 experiments is amazing and irrefutable proof.
In my interpretation, this was nothing other than an experiment on a healthy knee of a young woman. I can not get my knee and my life back BUT, I can at least warn other people about 'shaving chondroplasty'. The below is one of many emails from the doctor who looked at my knee images after the operation at Alpha Klinik:
Sehr geehrter Herr X, ich beziehe mich auf Ihre e-mail vom 02.01.2008, wo Sie die Knieprobleme Ihrer Frau schildern. Sie beschreiben sehr detailiert die Knorpelschäden an der Patellarückfläche. Das Shaving von Knorpelschäden ist in der Literatur sehr umstritten und wird deshalb auch von uns in meiner Klinik nicht durchgeführt, da ein zerrissener, aufgerissener Knorpel sei es Grad III oder IV höchstens begradigt, aber niemals positiv beeinflußt werden kann. Allenfalls lassen sich freie Knorpelstücke oder freie Fetzten, die herunterhängen mit einem Shaver entfernen. Ich glaube deshalb, dass ein Shaving eines Grad II- oder Grad III-Schadens wie von Ihnen beschrieben keine Besserung bringen wird.
Ich verbleibe mit den besten Grüßen
Univ.- Prof.
Links:
Surgery video: http://www.youtube.com/watch?v=4IsLpCtcJ6E
Anti-Chondroplasty: http://www.geocities.com/javanoginn/Chondroplasty_Rejection.htm
Pro-Chondroplasty: http://www.geocities.com/javanoginn/Toft_Chondroplasty.htm
Dr. Kääb study: http://www.ncbi.nlm.nih.gov/pubmed/16009983
Patient’s Story: http://www.youtube.com/watch?v=hrG1O_6-s7o
2 Kommentare
Den folgenden Links zufolge praktiziert dieser Arzt schon lange nicht mehr.
Er würde natürlich nicht zugeben, andere Menschen kaputt gemacht zu haben.
Jemand der einst auf einem sehr hohen Ross saß, ist scheinbar unehrenhaft gefallen.
Pleite! Münchner Promi-Arzt abgetaucht
http://www.tz-online.de/aktuelles/muenchen/pleite-muenchner-promi-arzt-abgetaucht-tz-906555.html
Promi-Arzt wegen Untreue verurteilt
http://www.abendzeitung-muenchen.de/inhalt.gericht-promi-arzt-wegen-untreue-verurteilt.d0fe6d0d-0234-43ac-9fbf-a2c037dcb6cc.html