At our last installment we considered the following question …
Dear Dr. Olsen,
I am being told it is time for a total knee replacement. For years I have worn a brace and taken injections in my knee but it doesn’t work anymore. I have heard about a “partial knee replacement”. What is the difference? Which is better?
Last time we looked at the option of total knee replacement, now let’s look at partial knee replacement.
It is appropriate to divide the knee into 3 parts: the medial compartment, the lateral compartment and the patellofemoral compartment (figure 1).
If osteoarthritis involves more than one compartment of the knee, total knee replacement is usually indicated. However, if the osteoarthritis is located only in one compartment while the other 2 compartments are healthy, partial knee replacement may be indicated. (figure 2).
It has been estimated that 30% of people who are ready for a knee replacement are good candidates for partial knee replacement.
If a partial knee replacement is indicated, the potential benefits are many. It is less invasive (figure 3) which leads to a quicker recovery, typically half of the recovery associated with total knee replacement. The knee also feels more like a natural knee rather than a mechanical knee because 2/3 of the knee remains natural and healthy. Also, depending upon implant design, it is possible that the partial knee replacement has a better chance of lasting 20 years than a total knee replacement. If a partial knee replacement is being offered, be sure to ask your doctor if the partial knee implant has a 20 year track record of success.
Not all patients are good candidates for partial knee replacement, and not all surgeons offer partial knee replacement as a part of their practice. A careful evaluation of the location of the osteoarthritis and the location of the pain in the knee is necessary before that decision can be made. However, the benefits of partial knee replacement can be many and it is an option worth considering if it is time to commit to knee replacement surgery.
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Dr. Olsen, Olsen Orthopedics
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