The partial knee replacement surgical procedure has generated significant interest because it entails a smaller incision and faster recovery than traditional total joint replacement surgery. Partial knee replacement, also called unicompartmental knee replacement' and 'minimally invasive knee surgery,' removes only the most damaged areas of cartilage, and replaces these surfaces.
Who is a good candidate for partial knee replacement?
The minimally invasive partial knee replacement is indicated in patients who have severe arthritis of the knee that have failed conservative treatments may consider this procedure. Conservative measures may include, but are not limited to, medications (such as Advil, Naprosyn, Celebrex, and Vioxx), cortisone injections, strengthening exercises, and weight loss. If these treatments are not adequate, and you as a patient are not satisfied, then surgical procedures may be considered.
The partial knee surgery may be possible if the arthritis in the knee is confined to a limited area. If the arthritis is widespread, then the partial knee replacement is NOT appropriate, and should not be considered. In addition, the partial knee surgery is recommended in patients who are:
- Older than 55 years
- Not obese
- Relatively sedentary
- Have intact ligaments (specifically the ACL)
What is the problem with most patients for the partial knee replacement?
Most patients who seek surgical management have arthritis that is too advanced for the minimally invasive partial knee replacement procedure. Because surgical treatment is considered a 'last-resort' by most patients, by the time surgery is necessary, their arthritis is too advanced to consider this minimally invasive procedure. If partial knee replacement is done in a patient who is a poor candidate, failure rates can be high, and conversion to a traditional total knee surgery may be more difficult.
What is the benefit of the partial knee replacement?
- Smaller Incision
A traditional knee replacement surgery involves an incision about 8 inches over the front of the knee. There is more significant dissection necessary to complete the procedure compared to the unicompartmental knee surgery. In the minimally invasive partial knee replacement, the incision is about 3 inches, and the amount of dissection and bone removal is much smaller. - Less Blood Loss
Because of the extent of dissection and bone removal necessary for a total knee replacement, the need for a blood transfusion is relatively common. With the unicompartmental knee procedure, a blood transfusion is infrequently needed, and patients do not need to consider giving blood preoperatively. - Shorter Recovery
Both the time in hospital and the time to functional recovery are less with the partial knee replacement. Patients are known to have been discharged on the day of the procedure, although most often patients are discharged on the first or second post-operative day. With traditional total knee replacement, patients seldom leave before three or four days in the hospital, and often require a stay in an in-patient rehabilitation unit.
