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Partial Knee Replacement
Dr. Ambrose Yung
What is Partial Knee Replacement?
A partial knee replacement, also known as a unicompartmental knee replacement, is a surgical procedure that involves replacing only the damaged compartment of the knee with an implant.
This minimally invasive surgery is distinct from a total knee replacement, as it focuses solely on the affected area. It is typically considered when arthritis or other degenerative conditions are confined to a single compartment of the knee.
Indications for Partial Knee Replacement
Partial knee replacement is not suitable for all patients. It may be considered under specific conditions, such as:
Localised Arthritis
The primary indication for partial knee replacement is arthritis confined to a single compartment of the knee. This procedure is not recommended for patients with widespread arthritis.
The most common form of arthritis is osteoarthritis. This causes the breakdown of joint cartilage and adjacent bone in the knees. Rheumatoid arthritis and arthritis resulting from trauma can also necessitate this surgery if they are localised.
Persistent Pain and Impaired Function
When pain and functional limitations due to arthritis cannot be managed effectively by other treatments, such as medication, physical therapy, or lifestyle modifications, partial knee replacement may be considered.
Preparing for Partial Knee Replacement
Effective preparation for a partial knee replacement may include the following steps:
- Medical Evaluation
A thorough assessment by the knee surgeon can help determine if the procedure is needed and if so, which type of knee replacement surgery to conduct. - Medication Review
Discuss current medications with the knee surgeon, as some may need to be adjusted or stopped. - Physical Preparation
Strengthening exercises might be recommended to improve surgical outcomes. - Nutritional Considerations
Dietary adjustments may be made to help support healing. - Arranging for Post-Procedure Support at Home
Plan for post-operative care and assistance at home, to aid in the recovery process.
Partial Knee Replacement Procedure
The procedure for partial knee replacement involves several steps to ensure precision and effectiveness:
- Anaesthesia: The surgery is performed under either spinal or general anaesthesia.
- Incision and Exposure: A smaller incision compared to total knee replacement is made to expose the knee joint.
- Bone Preparation: Damaged portions of the femur bone are cut using specialised jigs, often with computerised navigation assistance. The damaged area of the tibia (shinbone) and cartilage is also cut or shaved to create a smooth surface for the implants.
- Implant Placement: The tibial component is attached to the end of the bone, with or without bone cement.
- Articular Surface Insertion: A plastic piece is placed between the implants to facilitate smooth movement.
- Joint Reconstruction: The femur, tibia and the new components are assembled to form the knee joint, ensuring smooth gliding of the patella over the artificial knee.
- Closure: The joint is irrigated and cleaned, followed by the careful closure of the incision.
Recovery and Rehabilitation
Patients usually stay at the hospital for three days after partial knee replacement, with most patients requiring several more days in an inpatient rehabilitation facility. Following a recovery and rehabilitation plan after this can help lead to optimal outcomes.
The rehabilitation process can include:
- Using Walking Aids to Assist Knee Movements: Patients generally can start moving with the aid of crutches or a walking frame, then start walking normally within 4-6 weeks post-surgery. Partial knee replacement should allow for earlier weight-bearing and return to normal function compared to the total knee replacement.
- Managing Pain and Swelling: It may take 2-3 months for pain and swelling to subside, with leg swelling potentially lasting up to a year. This can be managed by medications or exercise.
- Physical Therapy: Guided exercises can help regain knee strength, flexibility, and mobility.
- Avoidance of Strenuous Activities: Initially, strenuous activities should be avoided. This includes running or jogging, weight training, high-impact sports or aerobics, hiking, and skateboarding or rollerblading. Leisure activities should be resumed gradually.
Benefits of Partial Knee Replacement
Partial knee replacement offers several advantages over total knee replacement.
- Smaller Incision
A less invasive approach means the surgery involves a smaller incision, resulting in less scarring and a reduced risk of infection. - Reduced Blood Loss
The minimised surgical intervention often leads to less blood loss, decreasing the need for blood transfusions and reducing the risk of blood-related complications. - Quicker Recovery
The lesser extent of surgical trauma generally allows for a faster healing process, enabling patients to resume their daily activities more quickly than with total knee replacement. - Less Post-Operative Pain
Due to the reduced invasiveness, patients often experience less pain after surgery, which can lead to a decreased need for pain medications and a more comfortable recovery period. - Better Range of Motion
The preservation of more natural knee structures allows for a greater range of motion post-surgery, which is particularly beneficial for activities that require bending and flexing of the knee. - More Natural Knee Feeling
Since only the damaged part of the knee is replaced, the joint may retain a more natural feel. This is different to the sensation often associated with a total knee replacement, where the entire joint is artificial.
Risks and Complications
Despite its benefits, partial knee replacement, like any surgery, carries certain risks and potential complications:
- Infection: This is a common concern for any surgery.
- Blood Clots: This is another surgical concern. It is most likely to occur in the leg veins.
- Issues with the Knee Implants: This includes the loosening of implants or wear over time.
- Persisting Pain: Some patients may still experience knee pain post-surgery.
- Stiffness in the Knee: Despite surgery, some may feel a persisting stiffness in their knee. This might require additional treatment.
- Complications Necessitating Revision Surgery: Revision surgery is necessary in the case of complications or implant failure.
Our Clinic Locations
Spire Hip & Knee Centre
6 Napier Road #08-04
Singapore 258499
Monday – Friday: 9.00am – 6.00 pm
Saturday: 9.00am – 1.00pm
Sunday & PH: CLOSED
Spire Orthopaedic Physiotherapy & Rehab Centre
101 Irrawaddy Road, #18-03
Singapore 329565
Monday – Friday: 9.00am – 6.00 pm
Saturday: 9.00am – 1.00pm
Sunday & PH: CLOSED
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Frequently Asked Questions (FAQ)
How Painful Is a Partial Knee Replacement Surgery?
While individual experiences may vary, our knee surgeon ensures the procedure is as pain-free as possible. Post-surgery, effective pain management strategies are employed to control discomfort, ensuring a smoother recovery.
How Big Is the Cut for a Partial Knee Replacement?
The incision for this surgery is smaller, thanks to advanced techniques employed by our knee surgeon. This leads to less scarring and a more aesthetically pleasing outcome, while also promoting quicker healing.
How Long Does a Partial Knee Replacement Last?
While longevity varies, modern partial knee replacements can last many years, depending on factors like patient activity levels and overall health.
What Can Help a Partial Knee Replacement Heal Faster?
Adhering to post-operative care plans, including physical therapy, and maintaining a healthy lifestyle can aid in faster healing and recovery.
Can I Run Again After a Partial Knee Replacement?
Resuming running post-partial knee replacement depends on individual recovery. Low-impact activities may initially be recommended, but with the knee surgeon’s guidance and a tailored rehabilitation program, some patients may gradually return to running, focusing on building strength and ensuring the joint’s durability.