Partial Knee Replacement

Patients with osteoarthritis that is limited to just one part of the knee may be candidates for unicompartmental knee replacement (also called a “partial” knee replacement). In a unicompartmental knee replacement, only the damaged compartment is replaced with metal and plastic. The healthy cartilage and bone in the rest of the knee are left alone.

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Partial Knee Replacement

Multiple studies have shown that modern unicompartmental knee replacement performs very well in the vast majority of patients who are appropriate candidates.

ADVANTAGES OF PARTIAL KNEE REPLACEMENT OVER TOTAL KNEE REPLACEMENT

  • Quicker recovery
  • Less pain after surgery
  • Less blood loss

Also, because the bone, cartilage, and ligaments in the healthy parts of the knee are kept, most patients report that a unicompartmental knee replacement feels more “natural” than a total knee replacement. A unicompartmental knee may also bend better.

DISADVANTAGES OF PARTIAL KNEE REPLACEMENT

The disadvantages of partial knee replacement compared with total knee replacement include slightly less predictable pain relief and the potential need for more surgery. For example, a total knee replacement may be necessary in the future if arthritis develops in the parts of the knee that have not been replaced.

In a partial knee replacement, only the damaged compartment is replaced with an artificial device.

Candidates For Surgery

Your doctor may recommend surgery if you have more advanced osteoarthritis and have exhausted the nonsurgical treatment options. Surgery should only be considered if your knee is significantly affecting the quality of your life and interfering with your normal activities.

In order to be a candidate for this procedure, your arthritis must be limited to one compartment of your knee. Patients with inflammatory arthritis, significant knee stiffness, or ligament damage may not be ideal candidates. Your surgeon will help you determine if this procedure is suited for you. With the proper patient selection, modern unicompartmental knee replacements have demonstrated excellent medium- and long-term results in both younger and older patients.

Knee Replacement FAQs

How do I know when I am ready to have a knee replacement?

The primary reason to have a joint replaced is pain. Patients that have pain that limits their daily activities and X-ray findings of arthritis generally are candidates for replacement surgery. Other indications for surgery include deformity and stiffness.

When will I start PT?

Typically we will try to start PT the day of surgery. That may involve moving from your bed to the chair with assistance, performing exercises while seated, or possibly walking with a physical therapist using a walker. You will continue to work with PT in the morning and afternoon the day after surgery. In those sessions, you will complete exercises, walk with a walker, and practice going up and down steps.

How long will a knee replacement last?

Artificial knees are mechanical parts that have a limited lifetime. The lifetime of an artificial knee is dependent on the amount of force placed across the joint as well as the activity level. Highly active patients tend to have higher wear rates. It is recommended that patients avoid engaging in high-impact activities. These activities include running and jumping. Studies show some implants have lasted beyond 15 years.

Will my implant set off metal detectors?

The majority of implants do set off metal detectors. Unfortunately, there is no identifying document or card that the TSA recognizes.

Will I get a card or letter to allow me through the airport?

Cards are available if requested but they are not recognized by the TSA or any other government agency.

Does a partial knee replacement last longer than a total knee replacement?

Not necessarily. All implants have a limited life expectancy depending on an individual’s age, weight, and activity level.

Can I have a total knee replacement after a partial knee?

Yes. The conversion of a partial knee replacement to a total knee replacement is very similar to a first-time knee replacement.

Why would I have a partial knee replacement?

A partial knee is typically used for patients who have osteoarthritis in limited parts of their knee. Studies suggest partial knee replacements may give the individual a more natural feel to their knee.

Will I need a walker of cane at home?

Yes, if you do not have them already, we will supply you with a walker and cane in your pre-op visit.

How much motion should I have after a knee replacement?

The biggest predictor of motion after the replacement is the amount of motion a patient has prior to surgery. If you have limited motion, your doctor may prescribe outpatient PT or home exercises prior to surgery to try to improve your range of motion. We strive to have every knee bend at least 90 degrees. In knees that are stiff and lack significant bend prior to surgery, achieving full motion can be a challenge. Most often this is due to the stiffness of the ligaments and tendons which can be improved to some degree with surgical releases. Participation in a comprehensive PT plan following surgery is essential in order to maximize motion.

What if I live alone or do not have help at home?

The majority of patients go home after their hospital stay. You will require someone to be available to assist you with your daily needs for at least one week. It is important to make these arrangements with your family or friends prior to surgery. Patients who do not have assistance at home may qualify for an inpatient rehabilitation center. It is best to arrange this prior to your surgery.

How do I arrange for inpatient therapy?

A counselor from the hospital will contact you prior to your surgery and review your situation to determine if you would qualify.

How long will I be at the hospital?

The typical stay is 1-2 nights. For example, Patients having surgery on Monday would go home either Tuesday afternoon or Wednesday morning.

When can I shower?

Once the incision is dry, patients can shower. You will be given specific instructions upon discharge from the hospital.

Is it normal for my knee to feel warm after surgery?

Isolated warmth of the skin after knee replacement is not unusual and can persist for up to six months. This is thought to be due to increased blood flow during the healing process.

How do I know if I have an infection?

If you are concerned about an infection, you should see your surgeon. Signs of infection include drainage from the incision, redness, pain, and swelling.

Will I need a blood thinner after surgery?

Yes, a medication to protect against blood clots is necessary for up to 35 days after a Total Hip Replacement. We will give you this prescription at your pre-op visit. You will not need to fill this prescription if you are going to an inpatient rehab facility.

How do I avoid a blood clot?

While blood clots are a risk factor after surgery, there are things you can do to help prevent them. It is important to complete your full prescription of blood-thinning medication and to perform exercises that are shown to you in your class prior to surgery and taught to you in PT.

Do I need to attend the class before surgery?

Attending the joint replacement class allows patients to familiarize themselves with the hospital, nursing staff, and physical therapist. The class includes: reviewing the operation, scheduling therapy, and pain management. Studies have shown that patients who attend class have shorter more productive hospital stays.

How do I know if I have a blood clot?

If you are concerned that you may have a blood clot, you should see your surgeon. Signs of blood clots include pain and swelling in one or both of your lower legs.

How will my pain be controlled?

Pain is typically well controlled with oral and IV medications while in the hospital. Once a patient goes home after surgery, their pain will be controlled with oral medication. You will receive a prescription for pain medication after surgery at your pre-op visit.

When will I be able to drive?

Most patients can return to driving in one month, however, we ask that you do not drive until we see you at your first follow-up appointment after surgery.

When will I be able to return to work?

This varies on the type of work you are returning to. Most patients can return to non-strenuous work activity in 4-6 weeks. It will take longer to return to work that requires climbing, squatting, and heavy lifting.

When will I see my doctor after I leave the hospital?

You will have a follow-up appointment scheduled 2 ½ – 3 weeks after surgery. If you have any questions during that time, please contact your doctor’s office.

Lowcountry Orthopaedics’ Hip & Knee Team

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