Total Joint Replacement Educational Series Part 2: Unicompartmental vs. Total Knee Replacement - What is the Better Option for Arthritic Knees?
Background Information
As you may have seen on the news or in magazines, orthopaedic implant companies have been marketing unicompartmental knee replacements, or what they are calling "minimally invasive" knee replacements. The unicompartmental replacement basically removes the one area of your knee that has the damaged cartilage and bone, theoretically permitting a smaller incision and faster recovery, compared to a total knee replacement. BUT YOUR ARTHRITIS MUST BE LIMITED TO ONLY ONE SMALL PART OF YOUR KNEE for this approach to be successful!
One estimate is that only 5% of patients with knee arthritis may even be a candidate for a "uni". For example, if you have arthritis that has spread to the knee cap, then you are not even a candidate for the "uni." If you would have the "uni" you could still be left with pain from your knee cap arthritis and therefore would be best treated with a total knee replacement. Remember, even a "total" knee replacement is really just a resurfacing procedure. The areas damaged with arthritis are "resurfaced" and the missing cartilage is replaced with the artificial cartilage, leaving your healthy bone intact.
Uni Replacement Total Replacement
As you may have seen on the news or in magazines, orthopaedic implant companies have been marketing unicompartmental knee replacements, or what they are calling "minimally invasive" knee replacements. The unicompartmental replacement basically removes the one area of your knee that has the damaged cartilage and bone, theoretically permitting a smaller incision and faster recovery, compared to a total knee replacement. BUT YOUR ARTHRITIS MUST BE LIMITED TO ONLY ONE SMALL PART OF YOUR KNEE for this approach to be successful!
One estimate is that only 5% of patients with knee arthritis may even be a candidate for a "uni". For example, if you have arthritis that has spread to the knee cap, then you are not even a candidate for the "uni." If you would have the "uni" you could still be left with pain from your knee cap arthritis and therefore would be best treated with a total knee replacement. Remember, even a "total" knee replacement is really just a resurfacing procedure. The areas damaged with arthritis are "resurfaced" and the missing cartilage is replaced with the artificial cartilage, leaving your healthy bone intact.
Uni Replacement Total Replacement
X-ray of a unicompartmental knee replacement and a total knee replacement.
SO WHAT IS FACT FROM FICTION?
POTENTIAL BENEFITS:
WHAT ARE THE POTENTIAL PROBLEMS:
*AS ALWAYS, CONSULT YOUR ORTHOPAEDIC SURGEON ON THE PROS AND CONS OF THIS INTERVENTION.
SO WHAT IS FACT FROM FICTION?
POTENTIAL BENEFITS:
- Smaller incision and less bone and muscle work
- Less blood loss
- Usually a shorter recovery and hospital stay
- Usually a shorter rehabilitation
- The uni replacement may be used as a bridge to a total knee replacement for some younger patients
WHAT ARE THE POTENTIAL PROBLEMS:
- To be a candidate, you must meet specific requirements or the surgery will not likely be a success. These include but are not limited to:
- ARTHRITIS ISOLATED to just one of the three knee compartments and NO knee cap arthritis
- An intact anterior cruciate ligament
- Adequate range of motion, and at least being able to bend your knee 90-100 degrees
- You cannot have significant "bowlegged" or "knock-knee" deformities
- No history of inflammatory arthritis like rheumatoid arthritis
- There are the same restrictions after a partial knee replacement as for a total knee replacement, which is avoiding high impact activities, such as jogging
- If you have arthritis in other parts of the knee that is being replaced, such as the knee cap, you will likely still have pain after surgery, and a total knee replacement would be a better option
- Most importantly, as a guideline, only about 5% of patients that have knee arthritis are candidates for a unicompartmental knee replacement rather than a total knee replacement
*AS ALWAYS, CONSULT YOUR ORTHOPAEDIC SURGEON ON THE PROS AND CONS OF THIS INTERVENTION.
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