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Partial knee replacement

Definition

A partial knee replacement is surgery to replace only one part of a damaged knee. It can replace either the inside (medial) or outside (lateral) parts of the knee.

Surgery to replace the whole knee joint is called total knee replacement.

Alternative Names

Unicompartmental knee arthroplasty; Knee replacement - partial; Unicondylar knee replacement; Arthroplasty - unicompartmental knee; UKA; Minimally invasive partial knee replacement

Description

Partial knee replacement surgery removes damaged tissue and bone in the knee joint. The damaged areas are replaced with a man-made implant, called a prosthetic.

Before surgery, you will be given anesthesia, which is medicine that blocks pain. You will have one of two types:

  • General anesthesia makes you sleep through the procedure and unable to feel pain.
  • Regional (spinal or epidural) anesthesia numbs you below your waist. You will also receive medicines to make you relax or feel sleepy.

The surgeon will make a cut over your knee. This cut is about 3 to 5 inches long.

  • Next, the doctor examines the entire knee joint. If there is damage to more than one part of your knee, you may need a total knee replacement. Most of the time, however, this is not needed since the tests you had before the procedure would have shown this damage.
  • The damaged bone and tissue is removed.
  • A man-made part made of plastic and metal is placed into the knee.
  • Once the part is in the proper place, it is attached with bone cement.
  • The wound is closed with stitches.

Why the Procedure Is Performed

The most common reason to have a knee joint replaced is to relieve severe arthritis pain.

Your doctor may recommend knee joint replacement if:

  • You can’t sleep through the night because of knee pain.
  • Your knee pain prevents you from doing daily activities.
  • Your knee pain has not gotten better with other treatments.

You will need to understand what surgery and recovery will be like.

Partial knee arthroplasty may be a good choice if you have arthritis on only one side of the knee, and you:

  • Are older, thin, and not very active
  • Do not have very bad arthritis on the other side of the knee or under the kneecap
  • Have only minor deformity of the knee
  • Can move your knee in a good range
  • Have stable ligaments in the knee

However, most people with knee arthritis have a surgery called a total knee arthroplasty (TKA).

Knee replacement is most often done in people age 60 and older.

Risks

Risks for this surgery include:

Before the Procedure

Always tell your doctor or nurse what drugs you are taking, including herbs, supplements, and medicines bought without a prescription.

During the 2 weeks before your surgery:

  • Prepare your home.
  • Ask your doctor which medicines you can still take on the day of your surgery.
  • You may be asked to stop taking medicine that makes it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), blood thinners such as warfarin (Coumadin) and other drugs.
  • You may need to stop taking any medicines that weaken your immune system, including Enbrel and methotrexate.
  • If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see the doctor who treats you for these conditions.
  • Tell your doctor if you have been drinking a lot of alcohol (more than one or two drinks a day).
  • If you smoke, you need to stop. Ask your doctor or nurse for help. Smoking slows healing and recovery.
  • Let your doctor know if you get a cold, flu, fever, herpes breakout, or other illness before your surgery.
  • You may want to visit a physical therapist before surgery to learn exercises that can help you recover.
  • Practice using a cane, walker, crutches, or a wheelchair.

On the day of your surgery:

  • You will usually be asked not to drink or eat anything for 6 - 12 hours before the procedure.
  • Take the drugs your doctor told you to take with a sip of water.
  • Your doctor or nurse will tell you when to arrive at the hospital.

After the Procedure

Most patients go home the day after surgery.

You can put your full weight on your knee right away.

After surgery, you will be encouraged to do as much as you can for yourself. This includes going to the bathroom or taking walks in the hallways with help.

Most people recover quickly and have much less pain than they did before surgery. People who have a partial knee replacement recover faster than those who have a total knee replacement.

Outlook (Prognosis)

Many patients are able to walk without a cane or walker within 3 to 4 weeks after surgery. You will need physical therapy for 4 to 6 months.

Most forms of exercise are OK after surgery, including walking, swimming, and biking. However, you should avoid high-impact activities such as jogging.

References

Mihalko WM. Arthroplasty of the knee. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 7.

Berger RA, Meneghini RM, Jacobs JJ, et al. Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg Am. 2005;87(5):999-1006.

Patil S, Colwell CW Jr, Ezzet KA, et al. Can normal knee kinematics be restored with unicompartmental knee replacement? J Bone Joint Surg Am. 2005;87(2):332-338.

Richmond J, Hunter D, Irrgang J, et al. American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee (nonarthroplasty). J Am Acad Orthop Surg. 2009;17:591-600.


Review Date: 8/12/2013
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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