A 37-year-old member asked:
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when does an orthopedic surgeon come to a conclusion that a partial knee replacement is the only option?

10 doctor answers
Dr. Joel McClurg
Specializes in Orthopedic Surgery
You decide: The knee has three compartments. The medial or inside, the lateral or outside, and the knee cap or patellofemoral joint. Partial replacements can replace 1 or occasionally two of these. Whether we replace 1, 2 or all three parts depends on the x-rays, the patients complaints, and physical examination. Surgery is reserved for patients in which all conservative treat has failed.
Answered on Mar 18, 2014
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Dr. Thomas Deberardino
32 years experience Orthopedic Surgery
One other option for medial compartment arthritis is a high tibial osteotomy. We make a bone cut almost all the way across the top part of the tibia and use the lateral portion of the remaining intact bone to hinge the bone open a predetermined amount to redirect the compressive forces away from arthritic part of knee to the normal part. A plastic implant (iBalance) is holds the bone in place.
Nov 18, 2011
Dr. Scott Hacker
24 years experience Orthopedic Surgery
Up to you !: Replacements are done for severe pain associated with knee arthritis. Arthritis is like losing the tread on your car tire. Many treatments short of replacement include medications, therapy, injections and arthroscopy. When these don't work, the next, and only option, is replacement. Partial replacement is only for specific arthritic conditions, and not the most common option. Ask your surgeon!
Answered on Nov 6, 2014
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Dr. Frederick Buechel, jr. md
26 years experience Orthopedic Surgery
My patient range for partial knee replacement has been from 40 to 94. If you have isolated unicompartmental disease and it hurts in the compartment that is diseased on xray, and does not hurt in the other compartments, than you are a candidate. Inflammatory arthritis meaning rheumatoid arthritis or other immune mediated arthritis conditions are not good for partial knee replacement because those conditions have a systemic cause and the whole joint by definition is involved. Younger patients have the advantage of keeping all the parts of the knee that are not arthritic and preserving the more natural kinematics of the knee with a partial knee and usually getting much better motion with a knee that feels like their own. The plastic Bearings can be changed out in the future if they begin to wear down and you may not ever need to convert to a total knee if bearing changes are sufficient. Robotic Arm assisted partial knee replacement is a predictably better reconstruction for younger people especially since an HTO (high tibial osteotomy generally has a poor 10 year survivorship and leads to a difficult future total knee reconstruction. For older patients my outpatient robotic arm assisted partial knee replacement its an easier operation to recover from and they can easily get back to golf ad tennis in 4-8 weeks and get back to daily walks unassisted in 2-3 weeks and they are much happier not having to sacrifice a significant part of their life recovering from a total knee. Well done partial knees have just as good long term followup as total knees but the installation is key. Therefore, if I was the patient and had the option of a partial knee replacement done with high precision I would choose this every time. If the surgeon does not do many partial knee replacements or does not use a high precision system like the Makoplasty system then i would choose the total knee from that surgeon. But the orthopaedic surgeon rarely will say that the partial knee is the "only option", it is "an" option.
Aug 15, 2012
Dr. Bruce Prager
42 years experience Sports Medicine
Unicompartmental knee (partial) knee replacements are usually for the under 50 patient (+ or - 5 yrs) who has arthritis on one side of the knee joint.
Feb 4, 2012
Dr. Ralph Salvagno
39 years experience Orthopedic Surgery
Failure of previous: Orthopaedic surgeons will try to presevre cartilage if possible. Cartilage grafting may be an option if there is a localized well defined defect in the cartilage. Age is also a consideration as our ability to regenerate cartilage is unfortunately age dependent!
Answered on Mar 4, 2012
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2 thanks
Dr. Amir Khan
Dr. Amir Khan answered
27 years experience Sports Medicine
Partial arthritis: Replacements are performed after conservative options have failed including: meds, injections, therapy, and other surgeries such as arthroscopy. The knee is considered to have 3 compartments: front (patello-femoral), inside (medial) and outside (lateral). If there is severe arthritis in one compartment then a partial replacement or osteotomy for that compartment can be considered. Ask your doctor.
Answered on Jan 15, 2012
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1 thank
Dr. Amir Khan
Dr. Amir Khan answered
27 years experience Sports Medicine
Cartilage restore: In select cases cartilage resoration with or without an unloading osteotomy procedure may be an option. These options need to be carefully considered with your orthopedic surgeon. Once you have a partial knee replacement there is no going back.
Answered on Mar 18, 2014
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3 thanks
Dr. Frederick Buechel, jr. md
26 years experience Orthopedic Surgery
After full review: The answer to the question is an orthopaedic surgeon may come to a conclusion that a partial knee replacement is the only option after all other options have been discussed with, or tried on the patient, and both the doctor and the patient have decided together for a variety of reasons that this is the only option at that time in the patients life.
Answered on Aug 15, 2012
Dr. Michael Patney
33 years experience Orthopedic Surgery
After failing other : Only after failing conservative treatment with antiinflammatories, therapy, bracing and injections. Surgery should not be the first recommended treatment.
Answered on Aug 29, 2013
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Dr. Kevin Watson
19 years experience Orthopedic Surgery
Partial knee: If the patient has advanced wear of the joint only on one side of the joint, then a partial knee replacement is an option. If arthritis is on other sides of the joint as well, then total knee replacement is the better solution.
Answered on Sep 28, 2016
Dr. Abdul Ahmed
41 years experience Orthopedic Surgery
Partial Knee : Partial knee replacement is performed only if one of the three knee compartments are severely affected by osteoarthritis or traumatic arthritis it can be medial , lateral or patellofemoral compartment of the knee. It is considered in young age patients with minimal varus , valgus or fixed flexion deformity. Partial knee can be later converted to a total knee replacement.
Answered on Jun 13, 2016
Dr. Peter Ihle
54 years experience Orthopedic Surgery
Usually after the-: /workup, only certain patients R selected 4 these based on the surgeons familiarities with them. & the patient must fit the criteria 4 them.
Answered on Aug 17, 2016

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