Unicondylar Knee Replacement

Total knee replacement is an excellent surgery. It has evolved over the decades to become one of the most successful procedures in all of medicine. Patients are cured of pain and disability. They regain their ability to walk normally, without a limp or support. They can resume living normal lives again. Without surgery, they are stuck in a rut of suffering and handicap with a lifelong dependency on kidney destroying medicines.

However, total knee replacement comes with a bag of its own problems. It is not without reason that patients fear the surgery. The foremost fear is that the surgery is a major surgical adventure.

Major surgery means more risk! The risk of an adverse event in the peri-operative period is always lurking round the corner.

Major surgery means more pain! Post operative pain is dreaded! Only recently have we truly succeeded in pain control with the use of ultrasound and nerve locator guided nerve blocks and LIA (local infiltration analgesia). 

Major surgery means more weakness! Patients routinely require a walker to walk for a week or two after surgery. 

Major surgery means a longer recovery! Patients take up to 3 months to return to normalcy and actually start experiencing the benefits of the surgery. 

What is a half knee (or partial knee) replacement? The knee is made of 3 different compartments. Two compartments are between the thigh and leg bone and the third compartment is between the knee cap and the thigh bone. In total knee replacement, we replace all three compartments and sacrifice two ligaments (out of 4) and both menisci (natural shock absorbers found in the knee). However, arthritis does not damage all compartments equally. Most of the times, it is only the medial or inner compartment that suffers the brunt of the destruction. In partial knee replacement, only this compartment is replaced with sacrifice of a single meniscus. Two compartments, all 4 ligaments and one meniscus is preserved. Many studies have shown this procedure to be as effective in relieving pain as total knee replacement. The survival of partial knee prosthesis is also as good as total knee prosthesis. 

By doing this selective procedure we gain many advantages. This surgery is done by a minimally invasive technique. It involves less cutting of skin, muscle, tissue and bone. Most of the knee is left untouched as it is healthy. Hence this is not a major surgery.

Risk of an adverse event is less!

Pain is very less! Lesser volume of trauma coupled with modern pain management makes post op pain negligible.  

Less muscle cutting means minimal weakness! Patients can stand and walk without a walker on the same day, a few hours after surgery. All this translates into a faster recovery. No longer do patients have to wait for 3 months to get back to normal.  

Partial knee replacement or unicondylar knee replacement is a natural evolution of a total knee replacement. It retains all the effectiveness of a total knee and brings with it significant advantages! I have pointed out the advantage of less risk and quicker pain-free recovery in this article.....but it doesn't stop here! Stay tuned for the next article.