By: Ali Dalal, M.D.
For patients that have long standing degenerative joint disease (DJD) of the knee, life can be very painful. There are times when the knee feels stiff, swells, or gives way, causing constant pain. Walking, standing and in severe cases even sleeping, can be difficult. Once these patients have tried all of the available treatments short of surgery and their x-rays show “bone on bone” changes they become a candidate for knee replacement. At this point patients require a complete discussion of their options.
Not all knee replacements are made the same. There are alternatives to the traditional “Total Knee Replacement” (TKR) or complete replacement of all parts of the knee. The knee has three distinct compartments. Total knee replacement involves removing all of the destroyed cartilage in every compartment and resurfacing it with a smooth and durable metal and polyethylene (plastic) parts. Almost all TKR requires removing the Anterior Cruciate Ligament (ACL) to perform the procedure. For many patients, TKR is the best option as they have multiple compartments with DJD in the knee. However, another option for the right patient is partial knee replacement, also known as uni-compartmental knee replacement (UKR). This procedure replaces only the cartilage in the diseased compartment with metal and plastic. The remaining healthy cartilage and the ACL are preserved.
For select patients, partial knee replacement offers an excellent solution to disabling knee DJD. Studies have shown that partial knee replacement leads to shorter hospital stays, better knee function, shorter recoveries, and a lower risk of blood clots after surgery. It is thought that the preservation of the ACL also leads to a more “normal” feeling knee. Long-term studies performed in Europe have shown that in 91% of patients, partial knee replacements had lasted for at least 16 years or more.
Is a partial knee replacement right for you? There are many individualized factors that influence this decision. The best place to start is by consulting with a UKR trained orthopedic surgeon – your best resource in helping you choose the right treatment for your knee.