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Partial versus Total Knee Replacement

A man holding his painful kneeThe time has come to proceed with replacement surgery on your arthritic knee. The only question now is “Do I do a partial knee replacement (PKR) or a total knee replacement (TKR)?”

The simple answer to this question lies in another question….where is your arthritis located?

The knee joint is comprised of three separate areas where cartilage is rubbing together and cushioning the shocks of activity. There is the “inside” of the knee, or medial side, which is where your knees can touch together. There is also the “outside” of the knee, or lateral side, and the front under the kneecap, or patello-femoral area. Orthopedic surgeons refer to these “areas” as compartments of the knee: the medial compartment, the lateral compartment, and the patellofemoral compartment.

A partial knee replacement is a smaller surgery, but will only replace one of these areas. If your arthritis is confined to a single compartment in your knee and all of your symptoms are located in that area, then you may be a good candidate for a partial knee replacement. A total knee replacement will replace all three compartments, but is certainly a more involved procedure with longer recovery.

The 2 biggest problems with a PKR are:

1. Failure to alleviate all of the pain in the knee.

2. Progression or worsening pain later, which may then require conversion to a TKR.

These situations can occur because you had mild arthritis in other compartments of your knee and they either were unrecognized or not bothersome at the time of your original surgery OR you developed arthritis in the untreated compartments later.

A total knee replacement eliminates the possibility of these problems occurring as it replaces the entire knee. The trade-off is that a TKR is a bigger surgery with a longer recovery.

You should also note that partial knee replacements will not address instability, lack of motion of the knee, or any malalignment, or crookedness, of your leg. These issues are addressed with a TKR.

Both operations can be done successfully in well-chosen patients. If you elect to undergo a partial knee replacement, be sure to understand the risk of conversion to a total knee replacement later. Your surgeon can educate you as to these risks.

Don’t forget to consider our educational Surgication courses on Total Knee Replacement or Partial Knee Replacement!!