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Partial Knee Replacement vs. Total Knee Replacement

Published by Nanni on Saturday, July 21, 2012

Photo credit by Claude Morcos

The knee is composed of three individual compartments: the patellofemoral compartment (the front of the knee); the lateral compartment (the outside of the knee); and the medial compartment (located on the inside of the knee). As the knee represents the biggest joint in the human anatomy, it is also the most susceptible to injury and conditions such as arthritis.

Cruciate ligaments of the knee run from the tibia or shinbone to the femur (thigh bone) stopping at the intercondyloid notch or intercondylar fossa of that bone. They are referred to respectively as the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). In connection to the femur, the ACL is helpful in preventing the tibia from shifting forward out of place while the PCL acts to keep the bone from shifting backwards.

Therefore, a partial knee replacement, also referred to as a unicondylar replacement or unicompartmental knee arthroplasty (UKA), involves the surgical replacement of one aspect or compartment of the knee while a total knee replacement is more comprehensive and results in surgical replacement of the knee’s three compartments. During a partial knee replacement, the anterior and posterior cruciate ligaments remain intact while a total knee replacement calls for their complete removal.

There are a number of advantages as well as drawbacks if you are a candidate for partial knee replacement surgery or a UKA. Because the surgery is less intense, it involves a lower risk of complications with respect to the procedure itself and its ultimate outcome. As the surgery dictates a need for less tissue and bone dissection, the patient also experiences less blood loss and typically enjoys a swifter convalescence in restoring his range of motion. Nevertheless, there still remains the possibility that the procedure may have to be repeated and that the knee will not heal and function as anticipated. Also, certain complications can develop from both surgical procedures such as fracture, injury to surrounding nerves or infection.

Usually a candidate considered particularly well-suited for a partial knee replacement is less than 180 pounds, over the age of 60, has minimal knee deformity, is not exceptionally active and demonstrates a good range of motion before undergoing the procedure. If it is determined that the potential candidate has any type of inflammatory arthritis though, then partial knee replacement isn’t recommended as this type of arthritis usually affects more than one compartment in the knee.

While undergoing a partial or full knee replacement, the patient receives a local anesthesia in which the area is numbed, and he remains awake during the surgery or a general anesthesia where he sleeps without any sensation of pain during the procedure. In partial knee replacement, the doctor makes a small three-inch incision over the damaged area of the knee, removes the bone and replaces it with a plastic and metal prosthesis. The prosthesis is then cemented into place and the incision is stitched and closed.

The most common condition that gives rise to partial or total knee replacement is arthritis. While partial knee replacement is recommended for individuals with osteoarthritis, people afflicted with rheumatoid arthritis (which is an inflammatory type of arthritis) often benefit from total knee replacement surgery as this type of arthritis affects more than one compartment in the knee.

Incisions made for full knee replacement are typically around 10 to 14 inches in length. The artificial knee used in this type of procedure is made of metal and polyethylene materials, and is designed to reline the joints of the affected area. It brings pain relief and is highly suitable to individuals whose knee joint is injured to the extent that it can't be treated with conventional therapies.

If you find that knee pain affects your daily activities or your ability to rest, then some type of knee replacement may have to be considered. Also, if medications or corrective treatment options have proved to be unsatisfactory or if you haven’t seen any improvement in knee stiffness, inflammation or any deformity to the knee, then surgery may be your best option.

Whether only part of the knee needs to be replaced or full replacement is indicated, replacement surgery can make it possible for you to carry out your daily tasks with greater ease. Both partial knee replacement and full knee replacement are procedures that are proven to be helpful in achieving better range of motion for patients whose knee injuries can’t be treated by more conservative means.

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