Partial Knee Replacement

Most commonly osteoarthritis starts with wear and tear of the inner compartment. If the pain of arthritis cannot be relieved by conventional treatment i.e. pain killers, exercises, life-style modification, then one needs only to replace the worn cushion in the inner compartment. This is now possible by a high precision, minimally invasive procedure called unicompartmental knee arthroplasty (Partial Knee).

Thin layers of special polyethylene and metal are used to resurface the bone-ends of only one half of the joint. These prevent the bone ends from rubbing against each other and provide instantaneous pain relief. The rest of the joint, including all ligaments, is preserved unlike in total knee replacement. Partial replacement is beneficial for younger age group unlike total knee replacement which is best suited for those over the age of 65 years. The surgery is done by a very small cut (only 5-6 cm long) in front of the knee, all the ligaments are preserved, and the rest of the joint retains its normalcy. Patients can start walking the same day and can go home within 24 hours! Most importantly it is completely suitable for our lifestyle which requires sitting cross-legged and squatting on the floor. Many patients can participate in low impact sports.

Complications during surgery like blood loss, transfusion and blood clots tend to be less with a partial replacement; however, long-term studies show the lifespan of partial knee replacement components is not as long as the lifespan of components used in a total knee replacement. Because partial knee replacement retains most of your knee tissue, you are still susceptible to progression of arthritis in the rest of the knee. When a partial knee replacement fails, it can be converted to a full knee replacement with an excellent degree of success.

Benefits

• Less bone and soft tissue dissection
• Less blood loss
• Faster recovery of range of motion

Risks

• Higher revision (repeat/ redo) rate for partial knee replacement than TKR
• Potentially worse function after revision of partial knee replacement than total knee replacement

Partial knee replacement can only be offered in early stages of arthritis and is strictly avoided if other areas of joint are having advanced cartilage damage or inflammatory arthritis or in cases of torn ligaments.

Unicondylar knee replacement simply means that only a part of the knee joint is replaced through a smaller incision than would normally be used for a total knee replacement.

Unicondylar knee replacement has been performed since the early 1970’s with mixed success. Over the last 25 years implant design, instrumentation and surgical technique have improved markedly making it s very successful procedure for unicompartmental arthritis. Recent advances allow us to perform this through a smaller incision and therefore are not as traumatic to the knee making recovery quicker.

Need for surgery

Persons who can benefit from this type of joint resurfacing are usually age 45-50 and older and show one or more of the following symptoms:

• Pain while standing
• Pain while walking
• Pain changing position, such as sitting to standing
• Persistent knee swelling
• Giving out or locking of the knee
• Failure of the knee to respond to medication and injections
• Ideally should be over 50 years of age
• When pain and restricted mobility interferes with your lifestyle

Advantages of Partial / Unicondylar knee replacement

• Minimally invasive surgery
• Less amount of bone removed
• Early recovery
• Less blood loss
• Good range of motion
• Retained natural knee to a large extent
• Less need for Physiotherapy
• Quadriceps sparing
• Better cosmesis
• Specially designed instrumentation

The procedure with latest implant design & done minimally invasive provides very quick restoration to normalcy with walking same evening of surgery, least scars & pain because of preserving more of your normal bone.