Partial or total knee replacement… Which is the best option for you?
Let us first understand what we are working with. The knee is divided into three compartments. The first compartment is the patellofemoral (the knee cap and the center of the femur). The patella (knee cap) moves over the center of the femur (groove). The lateral compartment is on the outside of the knee. It is where the outside part of the femur and tibia come into contact. The medial compartment is on the inside of the knee. It is where the inside part of the femur and tibia come into contact. A partial knee replacement removes the damaged bone in only one compartment. The bone is then replaced with metal and plastic. A total knee replacement removes damaged bone from all three compartments. The bone is then replaced with metal and plastic.
A partial knee replacement only addresses damage (i.e. arthritis) in one spot, and does not correct problems (i.e. arthritis) that may exist in other parts of the knee. It requires intact ligaments (anterior cruciate ligament, ACL) in order to have a stable knee. In addition, the partial knee replacement can only correct mild deformities. Partial knee replacements have been most successful for medial and lateral compartment arthritis. Patellofemoral partial knee replacements have not been as successful.
The primary advantages of a partial knee replacement are that the knee feels more natural and the recovery is easier. If the arthritis is in other parts of the joint, the ligaments are unstable, or the deformity of the knee is too great, then a total knee replacement is recommended.
In addition, if a partial knee replacement is performed, and arthritis develops in other areas of the knee, the partial knee replacement may need to be removed and a total knee replacement performed.
The decision to proceed with a partial or total knee replacement can only be made after a thorough history, physical examination, and review of x-rays or MRI. Successful partial knee replacements provide long-term relief. Although partial knee replacement is successful, most patients with knee arthritis have it in more than one location. As a result, most patients are not candidates for partial knee replacement.
Computer and robotic assisted surgery have been around for more than 20 years. The goal of using this technology is to improve the positioning of the implants. We used some of the earliest computer assisted machines in 2004. Throughout the years we have continued to follow their development and have implemented computer assisted technology to assist in joint replacement. This is an area in joint replacement that continues to evolve. We believe that in the future all joint replacements will utilize some form of this technology. We would like to be clear that at the current time the use of computer assisted technology and robotics has not clearly shown a clinical advantage over traditional methods. However, although we do not think it is necessary for every patient, we believe there are patients who benefit from the use of this technology. We are happy to discuss the use of computer and robotic assisted surgery at the time of your visit.