Partial knee replacement is a minimally invasive surgical treatment option that replaces only the damaged portion of the knee while conserving unaffected cartilage and knee ligaments. Partial knee replacement surgery may also be referred to as unicompartmental knee replacement, partial knee resurfacing, unicondylar knee arthroplasty or unicondylar knee replacement.
When Less Is More: Still the surgery that is most reliable is the total knee replacement and the longevity, as well as the durability of totals, may be slightly better than partials. However, in recent times, the partial knee replacement surgical procedure has generated substantial awareness because it uses a smaller incision and has a faster recovery than total knee replacement surgery. The purpose is to remove only the most damaged areas of cartilage from the joint and preserve any healthy parts of the joint, undamaged cruciate ligaments or uninvolved compartments for continued use. It can be the best alternative for patients with osteoarthritis with a true perception of the biologic and physiologic knees.
A new research from Weill Cornell Medical College and Hospital for Special Surgery investigators revealed that Partial knee replacements are economically superior to total knee replacements in older adults, and can be an attractive option for younger patients with a few small improvements in the near future.
The study published in the Journal of Bone and Joint Surgery has stated that Knee replacement surgeries are expected to surpass one million annually by 2020, with half of these surgeries being performed on patients younger than 65. Traditionally, physicians have recommended total knee replacements for all adult patients including those who have end-stage osteoarthritis in part of the knee joint. Partial knee replacements provide greater economic value to patients over the age of 65 compared to total knee replacement, as they are less likely to face surgical complications and need less physical therapy than those who undergo total knee replacement surgery.
Who Can Benefit from Partial Knee Replacement?
Partial knee replacement is appropriate for patients who have severe arthritis of the knee that has not found relief with conventional non-surgical treatments if the arthritis of knee is confined to a single compartment and is generally restricted to patients who are not morbidly obese.
The partial knee replacement is recommended in patients:
- The surgery is not suitable for patients with a significant angular deformity or marked stiffness in the knee.
- Patients with rheumatoid arthritis are not good candidates as inflammatory-type arthritis typically involves the entire joint.
- Have intact ligaments (particularly the ACL)
- Older than 55 years
What Happens during Partial Knee Replacement?
During partial knee replacement, the orthopaedic surgeon makes a small incision (four and six inches) at the front of your knee to gain access to the affected compartment of the knee. Then, he will remove damaged cartilage and bone tissue from the surfaces of the tibia and the femur in the arthritic area. All surrounding tissues and structures are restored to their actual anatomic position when the incision is closed.
The surgeon will use either a unicondylar fixed bearing knee replacement or a mobile bearing unicondylar knee replacement. A fixed bearing knee replacement is where the tibial (lower leg) plastic insert is affixed to the tibial bone and does not permit movement of the bearing surface. Patients with disease isolated to only one compartment, those who do not have significant deformity and those who are are able to bend the knee more than 90 degrees are considered a candidate for a fixed bearing unicondylar knee replacement.
The speculative benefit of a mobile bearing knee replacement is a greater contact surface between the metal component and plastic insert. In the knee arthroplasty, larger contact surfaces have proven to reduce the amount of linear wear. For the mobile bearing “uni” replacement, Patients with mild patellofemoral disease may be considered candidates only if they do not have significant pain in the front of the knee.
Results of partial knee replacement:
More recent studies, which focus on new designs for fixed bearing knee arthroplasties, have provided much better long term results, largely because of more careful selection of appropriate patients, improvements in implant designs, better material quality and better instrumentation.
When performed by experienced surgeons the mobile bearing unicondylar knee arthroplasty has shown success rates at ten years of up to 95% at specialized centers. The success rate of the mobile bearing knee replacement in younger population has also been comparatively high. In a recent study comparing older and younger patients, the overall success rate for patients older than 60 years of age is 96% and for patients under 60 years of age has been 91%. In obese and older patients with patellofemoral arthritis, the results have been better with the mobile bearing knee replacement than with other unicondylar knee designs.
Benefits of Partial Knee Replacement Surgery
- Less bone and soft tissue dissection
- Following surgery, most patients undergoing partial knee replacement can expect to spend one to two nights in the hospital.
- Faster recovery of range of overall motion
- Most patients can expect to be back to their daily activities within three to six weeks.
- Lower probability of early complications
Dr. Raj Kanna Knee & Ortho Clinic is located at Anna Nagar, Chennai, delivering the most advanced, yet affordable treatment for arthritis and Sports injuries of the Knee Joint. The clinic offers specialized care for arthritis, ligament injuries, various other knee disorders and Knee Replacement in Chennai by delivering the latest and best in knee care for every patient. Dr. Raj Kanna is an Orthopaedic and Knee care expert in Tamilnadu, who have made a mark in the field of Orthopedics with his success stories and is a consultant in various reputed hospitals in Chennai. He is one of the very few prominent surgeons in Asia, who performs knee replacement surgery using computer navigation technology.
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