Who is a Candidate for Partial Knee Replacement?

woman playing tennisKnee pain is the most common reason for which patients come to see me. They commonly tell me that their knee pain interferes with their everyday activities and the recreational activities they love.  Oftentimes, their sleep is affected too. My job is to identify the exact source of their knee pain, give them an accurate diagnosis, and recommend the best treatment option to meet their needs.

When non-surgical treatments fail to improve knee pain and function, I may recommend a partial knee replacement surgery for some patients. It’s not right for everyone, but for patients meeting specific requirements, it can provide relief from pain and also improve mobility.

Here are answers to some of the common questions that my patients have about the procedure.

What is a partial knee replacement?

This type of surgery selectively removes damaged bone and cartilage in a patient’s knee, replacing it with artificial components. As opposed to a total knee replacement, this type of surgery replaces only one “compartment” of the knee. The inside (or “medial compartment”), outside (or “lateral compartment), or the front of the knee (or “patellofemoral compartment”) can be resurfaced with metal and plastic, while healthy cartilage and ligaments are preserved.

What are the reasons for getting a partial knee replacement?

A partial knee replacement (also called a unicompartmental knee replacement) is performed when only one compartment of the knee is affected by osteoarthritis. This condition typically occurs in patients who are older than 45, and it’s characterized by the wearing away of cartilage, which serves as a shock absorber within the joint. Without enough cartilage, bones rub against one another, causing pain and stiffness.

For me to recommend partial knee replacement, a patient’s symptoms must be isolated to one knee compartment. X-rays must correlate to their symptoms, showing predominantly single-compartment disease.

What are the benefits of a partial knee replacement?

Partial knee replacement is less invasive than total knee replacement, involving a smaller incision and typically resulting in a more rapid recovery. Many patients are able to go home the same day as surgery. As part of the recovery process, you’ll need physical therapy, which will help strengthen the muscles around your knee and improve your range of motion. In just three or four weeks after partial knee replacement surgery, many patients can walk without the help of a cane, crutches or a walker.

Patients who have this surgery can resume their active lives and return to sports after a full recovery. I recommend avoiding impact activities for 6 months after surgery.

Who is a candidate for partial knee replacement?

You may be a good candidate for this procedure if your arthritis affects only one part of your knee, rather than your entire knee. Importantly, partial knee replacement requires intact and competent knee ligaments (i.e., the ACL, PCL, MCL and LCL), and the knee must not be significantly bowed or knock-kneed. Osteoarthritis affecting the medial compartment of the knee is the most common reason for partial knee replacement. However, select patients with osteonecrosis (bone death) isolated to one knee compartment can also qualify for partial knee replacement.

Patients with symptoms suggesting disease in more than one knee compartment, patients with inflammatory arthritis (e.g., rheumatoid arthritis), very heavy patients, patients with incompetent ligaments, patients with a lot of knee deformity, and patients with poor quality bone (i.e., osteoporosis) are not well served with a partial knee replacement, and they will benefit more predictably from a total knee replacement.

If you have knee pain and want to find out if you’re a good candidate for partial knee replacement, make an appointment today for a consultation at my New York City or Stamford office. I’ll talk with you about your medical history as well as your activity level. After a thorough evaluation, which includes a physical examination and possible imaging tests such as an X-ray or magnetic resonance imaging (MRI) scan, I’ll discuss your treatment options with you.

If surgery is recommended, I’ll make sure you understand exactly what’s involved and what your recovery period will be like and answer any questions you may have.

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