Partial Knee Replacement

Many are familiar with the term knee replacement, also known as arthroplasty. It is a common operation that involves replacement of all surfaces of the knee and is usually performed for those suffering from degenerative disease of the knee, of severity great enough to cause significant pain and limitation of daily activities.

The knee is the joint between the femur (thigh bone) and tibia (shin bone). It is consists of 3 sets of surfaces that move against each other, one on the inner part of the knee (medial compartment), one on the outer part (lateral compartment) and one between the knee cap (patella) and the femur. In earlier stages of osteoarthritis, it is often worse in one compartment. However, if the pain was severe enough to require knee replacement, the only option was to operate on both medial and lateral compartments. This is quite extensive and can be very painful. It also removes otherwise healthy surfaces.

Now, with technological advancement and implant development, patients have an option of partial knee replacement.

In partial knee replacement, only the surfaces of the affected compartment are replaced. For many patients, this would be the medial compartment. As only one compartment is operated on, post surgical pain is less, rehabilitation can start earlier and the patients may require shorter hospital stay. 

Other benefits of partial knee replacement is the preservation of healthy joint surface., that would otherwise have been removed during a total knee replacement.

Outcomes of partial knee replacement are encouraging.

Before undergoing partial knee replacement, patients will need to be carefully assessed by trained orthopedic surgeons. The doctor will ask the patients for details of their symptoms and conduct a thorough physical examination. X-rays will be ordered and occasionally other scans as well. The doctor may also ask for blood investigations to identify the cause of the knee pain/problem.

If the careful evaluation reveals that one compartment of the knee is more severely affected and surgery is required,  partial knee replacement will be considered as one of the options. The surgeon will discuss with the patients advantages and disadvantages of partial knee replacement compared with a total knee replacement before coming to a final decision.

For patients with single compartment disease, who are considering knee replacement  but are held back because of worry about pain, partial knee replacement provides an individualised surgical option, and may well be their key to their lifestyle of choice.

Knee Pain: What can be done about it?

The knee is a very important part of the body. As a weight-bearing joint, it plays a crucial role in support, walking and running. Healthy Knees are also required for squatting, sitting and even turning in bed. Knee Pain will affect all these aspects of daily life that many of us take for granted. If left untreated, knee pain can worsen and eventually limit one's lifestyle and independence.

Hence, it is important for Knee Pain to be properly assessed, its cause diagnosed and treated correctly.

Knee pain can occur for many reasons. One of the most common is injury. This can be from an accident during sports, road traffic accidents, or even from repetitive stresses. The injured part of the knee could be the meniscus, ligament, cartilage, or even bone.

Other causes of knee pain include localised Knee Disease, such as infection, tumours, degeneration, or as part of a general disease process, such as autoimmune arthritis, gout. Occasionally, knee pain may be due to disease elsewhere, such as the hip. In this case, the knee pain is known as referred pain.

Evaluation of knee pain requires careful review by a doctor. This will involve finding out from the patient the details of his problem and thorough physical examination. Often, imaging with x-rays or MRI scans will be required to make an accurate diagnosis of the cause of the knee pain Sometimes, blood investigations will be needed.

The treatment would be dictated by the cause of the Knee Pain. Oral painkillers can offer relief from mild-moderate knee pain. However, the underlying cause will still need to be treated. Many will benefit from physiotherapy and exercises to strengthen muscles and activity modification. Weight loss will also reduce the stress on the knee and associated knee pain.  However, certain injuries will require surgery to ensure optimal outcome. For example, meniscal tears should be treated with repair, to reduce the chance of worsening knee pain and development of degenerative arthritis in the future.

Other causes may require specific medication, such as antibiotics for infection.

If left untreated, many conditions will continue to affect the knee and the knee pain is likely to worsen. Overtime, the cartilage of the knee will breakdown and the patient can develop osteoarthritis. For severe cases, Knee Replacement is the recommended treatment, and is effective in reducing knee pain, allowing a return to an active, independent lifestyle.

If you do suffer from knee pain, do not ignore it. Seek treatment from qualified professionals to ensure early, effective treatment and optimal outcome in the long run.