Unicompartmental or Partial Knee Replacement Surgery
In a knee replacement surgery, damaged bone and cartilage is resurfaced with plastic and metal components. During Unicompartmental knee replacement (partial knee replacement), only a part of the knee is resurfaced. This method is an alternative to total knee replacement for patients whose disease is just limited to only one area of the knee. Because a partial knee replacement is done through a smaller incision, patients generally spend very few time in the hospital and get back to normal activities sooner than total knee replacement patients. There are a number of treatments for knee osteoarthritis and the doctor will discuss these various options & determine as to which will give the best relief to the patient having osteoarthritis symptoms.
Merits of Partial Knee Replacement
Multiple studies show that most of the patients who are ideal candidates for knee replacement procedure have much better results with unicompartmental knee replacement. The merits of partial knee replacement over total knee replacement are as follows.
Less blood loss
Quicker recovery
Less pain after surgery
Also, because the bone, ligaments and the cartilage in healthy parts of the knee are kept, many patients proclaim that a unicompartmental knee replacement feels more natural than a total knee replacement. A unicompartmental knee also bends better.
Demerits of Partial Knee Replacement
The demerits of partial knee replacement compared with total knee replacement are as follows.
Slightly less predictable pain relief
Potential requirement for more surgery. For example, a total knee replacement might be necessary in future if arthritis develops in parts of the knee that has not been replaced.
Ideal Candidates for Partial Knee Replacement Surgery
When osteoarthritis has advanced and nonsurgical treatment options are no longer relieving symptoms, the doctor will recommend undergoing knee replacement surgery. In order to qualify as the right candidate for unicompartmental knee replacement, arthritis should be limited to one compartment of the knee. In addition, if the patient has any of these following characteristics, the person wouldn’t be eligible for the partial knee replacement procedure.
Ligament damage
Significant knee stiffness
Inflammatory arthritis
With proper selection of the patient, modern unicompartmental knee replacements has demonstrated excellently in medium and long–term results in both older and younger patients.
Orthopedic Evaluation of Patients
A rigorous evaluation with an orthopaedic surgeon will find out whether the person is a right candidate for partial knee replacement.
Medical History – Doctors will ask several questions to the patient regarding general health, knee pain and the ability of joint function.
Location of Pain – The doctor is specifically concerned about the location of pain. If the pain is located almost completely on either the inside or outside portion of the knee, then the candidate is suitable for partial knee replacement. And if the pain is throughout the complete knee or in front of the knee (under the kneecap), then the person is suitable to go for a total knee replacement.
Physical Examination – The doctor will closely study the patients’ knee. They will then try to determine the location of the pain. The doctor will test the patients’ knee for ligament quality and range of motion. If the knee becomes too stiff, or if the ligaments in knees feel torn or weak, then the doctor will perhaps not recommend unicompartmental knee replacement.
Imaging TestsX – Rays: These images help to determine the extent of deformity and damage in the knee joint. The doctor will order several x–rays of the knee to see the pattern of arthritis.Magnetic Resonance Imaging (MRI) Scan: Some surgeons will also order an MRI scan to better assess the cartilage.
Risks & Complications Associated with Partial Knee Replacement Surgery
Like with every surgical procedure, there are risks involved with partial knee replacement surgery as well. Orthopedic surgeon performing the operation will discuss each of these risks with the patient and will take necessary measures to help avoid potential complications.
Though rare, the most common risks are as follows.
Injury to Blood Vessels or Nerves
Continuous Pain
Risk of Anesthesia
Need for Additional Surgery
Recovery Following Partial Knee Replacement Surgery
Discharge from Hospital: Patients of partial knee replacement generally experience less post-operative pain, less swelling and have easier rehabilitation than patients going through total knee replacement. In many cases, patients go back home in 1 to 3 days after the operation. Some patients go home on the day of surgery itself.
Pain Management: After surgery, the patient will feel some pain, but nurses and the orthopedic surgeon will make every effort to help the patient feel as secure as possible. Most of the medicines are available to help control pain, which includes opioids, not-steroidal anti-inflammatory drugs (NSAID’s), and local anesthetics. Treating pain with medications can also help the patient feel more comfortable & which will help the body recover and heal from surgery faster. Opioids provide the best pain relief as it is narcotic but at the same time, it can be addictive too. It is therefore vital to use opioids only as prescribed by the physician. As soon as pain starts to decrease, stop the intake of these medications immediately.
Weight Bearing: After surgery, the patient is likely to gain weight. In that case, a patient may require a walker, crutches or cane for the first week till the patient becomes comfortable enough to walk without assistance.
Rehabilitation Exercises: A physical therapist will give some exercises to the patient to perform which will help him or her to maintain the range of motion and regain strength.
Follow-Up Appointments with Doctors: The patient needs to take regular visits to his or her orthopedic surgeon for follow-up. Patients are strictly advised not to resume all regular activities for at least 6 weeks after surgery.