Partial knee replacement is a great option for individuals suffering from arthritis in one compartment of the knee. Partial knee replacements exist for both the inner, outer and knee cap compartments. The medial (inner) compartment replacement is by far the most common partial knee replacement performed. When performed correctly, in the ideal patient, it can last as long as a total knee replacement.
Typically one suffering from medial compartment arthritis has pain limited to the inner side of their knee. They may have developed a bowleg deformity as well. Patients suffering from isolated patello-femoral arthritis will have pain on the front part of their knee and typically have the most difficulty getting up from a low chair or going up and down stairs. Ideal individuals for the partial knee replacement are of ideal body weight with medium to low physical demand.
What I personally like about the partial knee replacement is no ligaments are cut as a process of the performing the replacement. This gives a very natural feeling knee that does not feel artificial. I commonly hear patients stating that they feel as though they have their “old knee back” before they started having the pain and disability from arthritis.
A medial compartment replacement can be performed through a minimally invasive approach that allows for quicker recovery post-operatively. Most patients spend only one night in the hospital. The physical therapist will see the patient the morning after the surgery to help patients walk with an assistive device and teach the how to walk safely. Once patients are discharged home, a home health physical therapist will come to the patient’s home to help continue the healing process.
Patello-femoral (kneecap) replacements although can work well, unfortunately do not enjoy the same durability or quick recovery as a medial compartment replacement. Recovery of a patellofemoral replacement is closer to that of a total knee replacement, yet do not have the same durability as a total knee. I will typically reserve patello-femoral replacements for the younger patient who are not ready for a total knee, but understanding in 10 or so years will likely require a revision to a total knee replacement.
Every patient is different, and how quickly they recover differs significantly as well. At two weeks, most medial compartment patients can expect to be using a cane outside the home, and no assistive device in the home. Most patients are driving their vehicle at 3 weeks. Depending on work requirements, most patient who have a desk position are back to work at 4 weeks.
Risks of knee replacement include deep venous thrombosis, pulmonary embolus, infection, blood loss, neurovascular injury, fracture, anesthetic risks, medical complications (heart attack or stroke), possible need for revision surgery, and death.
In summary, partial knee replacements work very well in the ideal patient. It is a great option for isolated compartment osteoarthritis. If you would like to discuss to see if you are a candidate for medial compartment replacement, to set up an appointment with Dr. David Rhoads, please call 502-364-0902.