Choosing between partial and total knee replacement

Knee replacement surgery has become increasingly common, offering relief to millions of people suffering from severe knee pain and limited mobility. However, when considering knee replacement, patients are often faced with a crucial decision: partial or total knee replacement. Both procedures aim to alleviate pain and restore function, but they differ in scope and approach. In his latest online article, Mr Tarique Parwez delves into the nuances of partial and total knee replacement, comparing their benefits, drawbacks, and suitability for different individuals.

Partial knee replacement:

Partial knee replacement, also known as unicompartmental knee replacement, targets only the damaged portion of the knee joint. It is typically recommended for patients whose arthritis is confined to one compartment of the knee, usually the medial (inner) or lateral (outer) compartment. This procedure involves replacing only the damaged cartilage and bone with prosthetic components, leaving the healthy parts of the knee intact.

Advantages of partial knee replacement:

1. Preservation of healthy tissue: By selectively replacing only the damaged part of the knee, partial knee replacement preserves the healthy ligaments, cartilage, and bone. This can result in a more natural feel and better range of motion compared to total knee replacement.

2. Faster recovery: Because partial knee replacement is a less invasive procedure, patients often experience quicker recovery times and shorter hospital stays.

3. Improved range of motion: Retaining healthy knee structures can lead to better postoperative range of motion and overall function, particularly in activities that require bending and flexing of the knee.

Drawbacks of partial knee replacement:

1. Limited suitability: Partial knee replacement is only suitable for a subset of patients with unicompartmental knee arthritis. Individuals with widespread knee damage or significant deformity may not be candidates for this procedure.

2. Risk of progression: In some cases, arthritis may progress to affect other compartments of the knee joint after partial knee replacement, necessitating additional surgery.

Total knee replacement:

Total knee replacement involves resurfacing both the femoral (thigh bone) and tibial (shin bone) surfaces of the knee joint with artificial components. This comprehensive approach is typically recommended for patients with advanced arthritis affecting multiple compartments of the knee or those with significant deformity.

Advantages of total knee replacement:

1. Comprehensive correction: Total knee replacement addresses arthritis in all compartments of the knee joint, providing comprehensive pain relief and functional improvement.

2. Predictable outcomes: Total knee replacement has been extensively studied and refined over several decades, resulting in predictable outcomes and long-term success rates.

3. Reliable pain relief: Patients who undergo total knee replacement often experience significant and lasting pain relief, allowing them to resume activities of daily living with greater ease.

Drawbacks of total knee replacement:

1. Longer recovery: Total knee replacement typically involves a longer recovery period compared to partial knee replacement, with a gradual return to activities over several weeks or months.

2. Potential for complications: As with any major surgery, total knee replacement carries risks such as infection, blood clots, and implant loosening. However, these risks are generally low when performed by experienced surgeons in appropriate candidates.

Choosing the right option:

The decision between partial and total knee replacement should be made in consultation with a qualified orthopaedic surgeon, who can evaluate the extent of knee damage, overall health, and individual goals. Factors such as age, activity level, and the presence of other medical conditions will also influence the recommendation.

Mr Tarique Parwez is an esteemed orthopaedic surgeon. You can schedule an appointment with Mr Parwez on his Top Doctors profile.