Difference between total knee replacement and partial knee replacement

Joints enable our bodies to move in a variety of ways, says Dr. Kaushik Patel, an expert orthopaedic and robotic joint replacement specialist from Surat. Our bodies have 360 joints that connect one bone to another. Joints are the points at which two bones come together. They are responsible for the skeleton's flexibility; without them, movement would be impossible.

Joint replacement surgeries, the most common being knee joint replacement surgery, is typically required when the knee joint is worn or damaged, limiting mobility and causing pain even while resting. Following are the conditions which affect the knee joint and where knee replacement surgery is needed:-

  • Osteoarthritis (most common)
  • Rheumatoid arthritis
  • Gout
  • Disorders that cause unusual bone growth around knee joint
  • Death of bone in the knee joint due obstruction in blood vessels
  • Knee injuries
  • Knee deformity

Types of Knee Replacement Surgeries:-

Total Knee Replacement (TKR)

Advancements in medical technology have led to precise and highly functional artificial knee implants that nearly replicate the way of the knee movements — and are custom fit to the body. 

A TKR is one of the safest and the most effective orthopedic surgical procedures. During a total knee replacement surgery, a surgeon removes the surface of the bones that have been damaged by osteoarthritis or other causes and replaces the knee with an artificial implant that is selected to fit anatomy. Special surgical instruments are used to cut away the arthritic bone precisely and then shape the healthy bone underneath to fit accurately into the implant components. In big cities like Surat, expert joint replacement surgeons are available who can properly guide you about the procedure.

The TKR surgery is a four-step process:

  1. Preparing the bone by removing the damaged cartilage surfaces at the ends of the thigh bone (femur) and shinbone (tibia)
  2. During the next phase, positioning of the metal tibial and femoral implants is done or press-fits them.
  3. The next step is to place a plastic button underneath the kneecap.
  4. At the end, the surgeon implants a medical grade plastic spacer between the tibial and femoral metal components so that it creates a smooth surface.

Partial Knee Replacement

Partial knee replacement (PKR) also called as unicompartmental knee replacement, is an option for a small percentage of patients. Few PKRs are performed than TKRs. As the name implies, only a part of the knee is replaced in order to preserve as much original healthy bone as possible. Patients for this type of surgery generally have osteoarthritis in only one compartment of their knee. So surgery takes place in any of three compartments of the knee where damaged bone presents the most pain: the lateral compartment on the outside of the knee, the medial compartment located on the inside of the knee or the patella femoral compartment that’s positioned on the front of the knee between the thigh bone and kneecap. During a PKR surgery, an orthopedic surgeon removes the arthritic portion of the knee and replaces that compartment with metal and plastic components.

A PKR surgery offers advantages like:

  • a shorter hospital stay
  • faster recovery and rehabilitation period
  • less pain following surgery
  • less trauma and blood loss

What Should You Choose?

Being an expert joint replacement surgeon in Surat, Dr. Kaushik Patel suggests that your orthopaedic surgeon is the best one to guide you whether you need a total or a partial knee replacement. PKRs is usually performed on younger patients (under age 65) who have damage in only one knee compartment with plenty of healthy bone remaining. If two or more knee compartments are damaged, TKR is a better option.

The patients who receive a PKR often report that their knee bends better and feels more natural as compared with those who receive a TKR. However, there’s less assurance that a PKR will eliminate the underlying pain. And because the preserved bone is still prone to arthritis, there’s also a greater chance that follow-up TKR surgery may be required at some point in the future. PKRs are most suitable for those patients who lead an active lifestyle and might require a follow-up procedure — perhaps a TKR — in 20 years or so, after the first implant wears out. However, it’s also used for some older individuals who live relatively desk-bound lifestyles. In many patients, a PKR recipient is able to move around without the help of crutches in about four to six weeks, which is half the time for a TKR. About 85 to 90 percent of patients continue to work well 15 to 20 years after the TKR operation.

If a person is having severe knee pain and medications or therapy do not help, consider knee replacement as the answer. In Surat, top orthopedic surgeons are present who perform total and partial knee replacement surgery. This effective procedure reduces pain and enables one to get back to a healthy lifestyle.

Frequently Asked Questions:

1 - Is partial knee replacement better than total knee replacement?

Yes, partial knee replacement is better than total knee replacement if you have damage limited to one knee compartment, as it offers advantages like a shorter hospital stay, faster recovery and rehabilitation period, less pain following surgery and less trauma and blood loss.

2 - How long does the total knee replacement last?

Total knee replacements can be expected to last more than 15-20 years. Three to six weeks after surgery, patients can resume most daily activities like shopping and light housekeeping etc.

3 - Can you climb stairs after a total knee replacement?

Staircase climbing can be done after 48 hours i.e. 2 days after the surgery. For this, proper assistance should be there by the consulting physiotherapist without giving much strain to the joint.

4 - Can you do exercise after partial knee replacement?

Low impact exercise like walking, swimming, yoga can be performed after consulting your specialist. It is better to avoid high-impact activities such as jogging and skipping rope.