One of the most asked questions I get from people experiencing chronic knee pain is "how do I know if I am a candidate for a partial knee replacement instead of a total knee replacement?"
First, let's clarify the difference between a partial knee and a total knee replacement surgery.
Your knee is a joint made up of three different compartments: the inside knee, the outside knee, and the front of the knee called the patella. Generally speaking, your knee pain is caused by the wearing-away of cartilage as a result of arthritis or an injury. Once the cartilage is damaged, there is no longer a cushion between the bones so your knee becomes painful and inflamed. If the cartilage is only wearing away in one part of your knee you will feel pain in only one of those three compartments. The best way for me to diagnose how much disease is in the knee joint is by an x-ray. If I see that only one of your knee compartments is diseased, you may be a candidate for a partial knee replacement. If you have pain and more arthritic damage in two or three compartments of your knee, it is more likely you would benefit from a total knee replacement (also called a total knee arthroplasty). For a video recorded interview I did with more details, click here.
What are the benefits of a partial knee replacement?
A knee replacement surgery consists of a small implantable device made of metal that will replace your diseased bone, and a smooth piece of specialized plastic so that you are no longer bone-on-bone. For people who have a partial knee implant, those two implanted devices are smaller than you would need for a total knee replacement. While most patients say their arthritic knee-pain is immediately gone following a knee replacement, a partial knee procedure may feel more natural when walking. Other typical benefits of a partial knee are less time in surgery, less blood loss, less scarring, and quicker recovery time. Perhaps most exciting for healthy patients is that a partial knee replacement surgery can now be done with no overnight hospital stay.
So, why don’t all orthopedic surgeons offer partial knee replacements? Prior to robotics (such as Mako robotic surgical systems), 3-D imaging, and other technologies, getting perfect alignment and balanced ligaments during partial knee replacement procedures were difficult for even the most experienced surgeons. Technology has dramatically improved in the past ten years or so, making partial knee procedures a great option. However, not all surgeons are trained in these newer technologies, or the hospitals where they practice may not
have invested in these more advanced technologies. In the surgical centers where I practice, I have the benefit of using Mako robotic surgical systems which creates a 3-D surgical plan of your knee prior to surgery. The Mako’s advanced robotic technology assists me in only cutting to those exact specifications during surgery, creating a knee that's as perfectly aligned as possible. At a minimum 3-year follow-up of 51 patients by Stryker, Mako Partial Knee patients showed no implant failure or implant-related complication or revision surgery, as well as excellent overall patient satisfaction for 96.1% of patients (patients who reported very satisfied or satisfied).
If you still aren’t sure if you’re a candidate for a partial knee replacement, consider getting x-rays during your next office visit where we can discuss your options to alleviate knee pain. Or, visit my website or call my office at (248) 626-0135 for more information.
Robert Ference, M.D. is an orthopedic surgeon in Farmington Hills, Michigan. He specializes in hip, knee and shoulder pain treatments. He has performed over 6000 joint replacements using Mako SmartRobotic systems.