Knee Surgery: Choosing Between Total or Partial Knee Replacement
April 5, 2017
The knee joint is designed to absorb the shock that results from running, jumping, bending, and hundreds of other movements. But aside from simply allowing us to play a round of golf, tennis, or many of the other activities that we enjoy, the health of our knee is invaluable to everyday living. In fact, when you experience severe knee pain, even the ordinary motions of standing up, walking, and climbing stairs become a challenge. Worst of all, this pain often becomes more severe – if not debilitating – over time.
Approximately 19% of adults suffer from knee pain with incidence steadily rising with age, according to the Center for Disease Control and Prevention and the National Center for Health Statistics. Osteoarthritis, which is sometimes called “degenerative joint disease” or “degenerative arthritis,” is both the most common joint disease and most common reason for a knee replacement. This is primarily due to the fact that osteoarthritis can cause cartilage within the joint to wear away faster than it can be rebuilt.
If you have not been able to achieve relief for your pain with conservative methods, the next step is to talk to an orthopedic specialist about your options. Dr. Haleem Chaudhary is a fellowship-trained physician specializing in solving hip and knee pain at Beacon Orthopedics and Sports Medicine. He can determine if surgery would be beneficial to you and whether a minimally invasive knee replacement or partial knee replacement would be the best option.
Identifying the Cause of Your Knee Pain
The knee is one of the most complex joints in the body. It consists of three major bones: the femur (thigh bone), the tibia (shin bone), and patella (knee cap). Like other joints in your body, these bones are held together by ligaments, stabilized by muscles, and lined with a firm and flexible connective tissue called cartilage. The knee also features an additional piece of cartilage called the “meniscus” which is located between the femur and tibia. The meniscus provides a cushion between these bones and protects the surface of the joint.
Damage to any of these structures can result in pain. The most common types of damage include but are not limited to:
- Osteoarthritis (wearing down of cartilage)
- Rheumatoid arthritis (excessive synovial fluid)
- Traumatic arthritis (cartilage damage due to injury)
- Fractures (cracking or breaking of a bone)
- Ligament strains and sprains (overstretching or twisting)
- Tendonitis and bursitis (inflammation due to overuse)
- Gout (crystalized uric acid in a joint)
- Excessive pressure on the joints
For the vast majority of patients, surgery is not necessary. In fact, conservative treatments, proper body mechanics, and lifestyle changes can help many people manage their pain and prevent future reoccurrences. Knee surgery is often reserved for individuals who:
- Have joint damage that is significant and irreversible.
- Have chronic, debilitating joint pain that limits or completely impairs their ability to perform everyday activities. This pain may also prevent individuals from sleeping through the night.
- Have attempted conservative methods of treatment and did not achieve relief.
- Have a normal or low risk of other health complications.
If the above points accurately describes your condition, you should talk to your physician about treatment options including surgery. Depending on the severity of your symptoms and your own individual health factors, your physician may recommend a total knee replacement or partial knee replacement.
The Difference between Total Knee Replacement and Partial Knee Replacement
Total Knee Replacement
A total knee replacement, also called an “arthroplasty,” is a technical surgical procedure in which an orthopedic surgeon carefully removes damaged tissue from the patient’s joint and replaces portions of the bone with a prosthetic made from a mix of metal and plastic. During the procedure, the surgeon will customize the artificial joint one component at a time. This form of surgery is necessary when the damage is widespread and has affected most of the joint.
Advantages of a Total Knee Replacement
Pain relief: First and foremost, the replacement of diseased tissue with a prosthetic not only restore the structural integrity of your joint but also give it a way to absorb the shock of movement.
Better mobility: While pain relief is the most predictable benefit, many patients can expect improved mobility and a better range of motion.
Partial Knee Replacement
A partial knee replacement, which is sometimes called a “unicompartmental” or “unicondylar” replacement, also includes the removal of damaged cartilage from the patient’s joint; however, the amount that is removed is significantly less. Moreover, the removed portions of the joint are also replaced with a prosthetic implant.
This form of surgery is more appropriate when the affected area is localized. A partial replacement is also more accommodating of those who do not engage in sports or exercise frequently. Because these individuals use their knee less, there is less wear on the implanted joint.
Advantages of a Partial Knee Replacement
Similar to a total replacement, a partial replacement will relieve pain and improve mobility. It also provides two additional benefits.
A smaller incision: Because the surgeon is removing less bone tissue and cartilage, as well as the fact that these materials are in a more concentrated area, the surgeon can make a smaller incision.
Faster recovery: Alongside a smaller incision and less tissue trauma, it’s easier for the body to heal. In most cases, you can return home on the same day. With about 2-3 weeks of physical therapy, most patients can return to their daily activities.
In the past, patients who receive knee implants were recommended to avoid high-impact sports such as baseball, basketball, or jogging. Today, there is a growing body of research that suggests that high-impact activities don’t contribute to early failure of implants. In fact, patients who exercise and take proper care of their knee can preserve their prosthetic for many years. In the majority of cases, prosthetic failure is due to the weakening of the bone. Resistance exercise can both build bone and also strengthen the muscles that support it.
Discuss Your Surgery Options with Dr. Chaudhary
According to the American Academy of Orthopedic Surgeons, 90% of patients who undergo a form of knee replacement experience less pain, better mobility, and an overall improved quality of life. It’s important to keep in mind, however, that the expertise of your physician and your own individual health factors will play the most significant roles in your outcomes. Moreover, like all forms of surgery, there are some risks that you will need to consider. Working with a skilled and experienced surgeon is the best way to minimize your risks and ensure the best possible outcomes.
Dr. Chaudhary is an accomplished total joint specialist with significant experience in knee surgeries and hip surgeries. With years of experience in performing these operations, he is fully qualified to answer your questions about whether or not surgery is the right option for you and what outcomes you can expect.
Learn more about Dr. Chaudhary or schedule an appointment. For your convenience, he is available at Beacon East, Summit Woods, and Beacon West in Ohio or at Beacon’s Northern Kentucky location.