“I cycle as often as I can and even returned to participating in weekend firefighter competitions, my favorite hobby, without complications.”

My name is Inka Thormann, I’m 32 years old, and I work as a paediatric nurse. I’d like to share my experience with the knee distraction treatment using an external fixator—an intervention that has significantly improved my quality of life and helped me delay a total knee replacement.

The Beginning of My Knee Journey

My knee issues began back in 2012 when I tore my meniscus during a ski course. Unfortunately, the tear was not diagnosed immediately, and it took a full year before it was treated.

• January 2013: First surgery – meniscus bucket-handle tear, repaired with sutures.
• 2015: Second surgery – repeat suture due to failure of the first.
• November 2016: Third surgery – meniscus implant (performed by Prof. Frosch in Hamburg).
• February 2017: Fourth surgery – removal of the rejected implant and treatment of a resulting knee infection.

After this, my doctor and I agreed to wait and see how things developed.

When the Pain Returned

I managed relatively well until fall 2023. Then, without any specific incident or injury, my knee started to deteriorate rapidly. I was in constant pain, had limited mobility, and even simple tasks like getting up from the floor became a struggle. It became clear I needed help.

Local orthopedic specialists recommended a total knee prosthesis (TEP), but I found it hard to accept that solution at just 30 years old. I returned to Prof. Frosch in Hamburg, who introduced me to a new surgical option—knee distraction using an external fixator. It sounded promising, and I decided to go for it.

The Procedure and Recovery

In August 2024, the external fixator was applied to my right knee and removed six weeks later.

• My hospital stay was planned for four days, but I was discharged after just three (effectively after two nights). In hindsight, this may have been too early considering I had to travel 270 km back to Göttingen.
• The fixator was placed quite high on my thigh, making it impossible to sit in a regular chair. A wheelchair with leg support was a lifesaver.
• I initially had leg-lifting weakness and required assistance to move my leg.
• One pin site (high on the inner thigh) was very close to a nerve and caused significant pain. Near the end of treatment, it became slightly inflamed, but this was managed with sterile dressing changes every two days.
• Calf cramps were the most distressing part—up to 15 a day at times.
• I received physiotherapy and lymphatic drainage two to three times a week.

The fixator removal was done on an outpatient basis. For patients traveling long distances, I would recommend an inpatient setting instead—it’s simply more manageable.

Rehabilitation and Results

After removal, we followed the rehabilitation protocol provided by the device manufacturer regarding joint angles and weight-bearing. I initially struggled with regaining knee flexion and nearly needed an additional surgery to remove scar tissue. But at my follow-up appointment in December, I had reached the expected range of motion.

Since then, my chronic pain is completely gone.

• Occasionally, I experience discomfort with heavy use (especially due to my work), but this is manageable with minor pain relief.
• Activities like kneeling are tolerable for short periods.
• I can now get up from the floor much more easily and walk stairs smoothly.
• Flexion while lying down is now at 140°, nearly matching my other knee.

A New Lease on Life

Since early 2024, I’ve lost 15 kg and plan to continue improving my fitness. My scars from the arthroscopies are barely visible now. The pin sites from the fixator were initially deep and raised but have since flattened out, though the coloration is still quite red.

I cycle as often as I can and even returned to participating in weekend firefighter competitions—my favorite hobby—without complications, despite the fast, jerky movements involved.

Running is only comfortable for short distances and still feels strange, but overall, my knee looks and functions much better than before. The swelling is gone, and my knee is once again visibly recognizable as a knee.

My Message to Other Patients

I am deeply thankful for the opportunity to undergo this treatment. It helped me avoid a total knee replacement and significantly improved my quality of life. I no longer worry about how I’ll survive the day after work.

To anyone still undecided: Do it.
Yes, the six weeks are tough. Yes, there is pain. And yes, you will need help—daily support from family or friends is absolutely essential. But the outcome is worth it.

Just make sure you have adequate support at home—things like sterile dressing changes, shower access (a shower chair is a must), someone to help with stairs and grocery shopping. If that’s in place, then I wholeheartedly recommend this path.

I wish every patient undergoing this treatment as much success as I’ve had.

The Knee Joint Distraction helped me avoid a total knee replacement and significantly improved my quality of life. I no longer worry about how I’ll survive the day after work.