Knee resurfacing and partial knee replacement
Unicompartmental Knee ReplacementKnee replacement surgery mainly aim to decrease pain and restore function of the knee. total knee replacement which is known as arthroplasty is a very good option for patients knee osteoporosis, arthritis other surgical options are also there. Patients with knee osteoporosis or arthritis which is limited to just one part of the knee. So unicompartmental knee replacement also called a "partial" knee replacement or Knee Resurfacing or Partial Knee Resurfacing, retains the healthy compartments of the knee joint and only removes or replaces the damaged surfaces. Resurfacing is an option for patients whose arthritic deterioration of the knee is limited to only one or two of the compartments of the knee.
The knee has three major compartments:
The inside part of the knee known as the medial compartment.
The outside part of the knee known as the lateral compartment where the thighbone (femur) and the shinbone (the tibia) meet.
The front of the knee between the kneecap (patella) and thighbone (femur) known as the patellofemoral compartment.
Only the damaged compartment is replaced with metal and plastic in a unicompartmental knee replacement. The healthy cartilage and bone in the rest of the knee is not disturbed.
Is partial knee replacement correct option for you?To be a candidate of partial knee replacement surgery your doctor will review to check
The osteoarthritis deterioration must be limited to one or two compartments of the knee. Patients with significant knee stiffness, inflammatory arthritis, or ligament damage is not considered to be ideal candidates. Arthritis can occur in any one, or all three compartments of the knee joint. Most frequently the medial compartment is affected by osteoarthritis of the knee while lateral compartment less frequently effected by this disease. Arthritis that occurs only in the patellofemoral compartment of the knee is very rare.
Your surgeon will help you understand whether this procedure is suited for you. If you are a right candidate then you must know that modern unicompartmental knee replacements have demonstrated excellent results in both both younger and older patients.
Partial Knee Replacement SurgeryPatients will be admitted to the hospital on the day of surgery.
Before the surgery a doctor from anesthesia department will evaluate the patient's medical history and based on that he or she will decide and discuss anesthesia choices for the patient. Discussion based on anesthesia choices with the surgeon mainly is done during preoperative clinic visits. Either general anesthesia in which the patient is put to sleep or spinal in which the patient awake but the body is numb from the waist down is given. Before surgery the surgeon will mark sign on the knee to verify the surgical site.
Partial knee replacement surgery lasts between 1 and 2 hours.
An incision will be made by the surgeon at the front of the patient's knee. To verify that the cartilage damage is limited to one compartment and that the ligaments are intact the surgeon will explore the three compartments of the patient's knee. If he or she feels that the knee is not suitable for a partial knee replacement, then he or she will discuss and suggest for a total knee replacement surgery.
When patient's knee is suitable for a partial knee replacement surgery. If the bone disease is only in the medial compartment, then the surgeon can only reshape those damaged surfaces of the knee. A combination of metal and plastic bearings will then partially cover the repaired surfaces on that side. Conforming precisely to the anatomy of the knee a cobalt chrome implant will be resurfaced. The tibia component is mostly made of polyethylene and only require least bone removal to secure the implant. All healthy cartilage, ligament and bone in the patient's knee will be retained, so the for this procedure to be successful other compartments must have healthy cartilage.
Implants for a partial knee replacement is much smaller than a total knee replacement implant for this reason the healthy tissues of the knee is not disturbed. In some cases surgeons use a surgeon-interactive robotic arm system, which enables the surgeon to pre-operatively determine the affected and damaged area of the bone to be removed and then to plan the precise alignment and placement of the resurfacing implant specific to the anatomy.
By selecting the affected portion of the knee that has become damaged by osteoarthritis, the surgeon can isolate and resurface only the arthritic affected portion of the patient's knee without disturbing the healthy bone and tissue surrounding it. The joint may bend better and function more naturally by retaining undamaged parts of the knee.
Complications of the surgeryRisks involved with partial knee replacement are very low. The surgeons must discuss each of the risks with the patient and must take specific safety measures to avoid complications.
The most common risks are:
- Blood clots. One of the most common complications are blood clots in the
leg veins of knee replacement surgery. In the deep veins of the legs or pelvis
blood clots can form after surgery. Blood thinners like warfarin (Coumadin),
aspirin, low-molecular-weight heparin, or some other drugs can prevent this
- Infection. Antibiotics will be given before starting the surgery and will
be continued for about 24 hours afterward to prevent infection.
- Injury to nerves or vessels. Often during the surgical procedure nerves or
blood vessels may be injured.
- Continuation of pain.
- Implant loosening.
- Risks from anesthesia.
Longevity of Partial Knee ReplacementsGenerally, depending upon age, weight, and activity level of the patient knee resurfacing patients can expect to use their unicompartmental knee replacement for 10-12 years. Based on the orthopedic surgeons report from all around the world the success rate is about 92% at 10 years. This indicates that many patients have enjoyment of their partial knee replacement for long term.
Recovery after surgeryIn partial knee replacement hospitalization is shorter, rehabilitation and faster returning to normal activities.
Patients mostly have less postoperative pain, less swelling, and have easier rehabilitation than patients who undergo for total knee replacement. Generally in most cases, 1 to 3 days after the operation patients go home.
Patients can put weight on the knee immediately after surgery. Initially they might need a walker, cane, or crutches for the first several days or weeks until they become comfortable enough to walk without support.
The patient will be given exercises to help maintain their range of motion and restore your strength by the physical therapist. Patients must continue to see their orthopaedic surgeon for follow-up visits at regular intervals.
Patients mostly resume their regular activities of daily living by 6 weeks after surgery.
Advantages of Partial Knee Replacement SurgeryThe advantages of partial knee replacement when compared to total knee replacement are:
- Quicker recovery
- Less pain post-surgery
- Much less blood loss
Disadvantages of Partial Knee ReplacementThe disadvantages of unicompartmental knee replacement over total knee replacement are.
- Sometimes less predictable pain relief.
- Potential need for more surgery.
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