Guide to Knee Surgery: Partial vs Total Joint Replacement

Knee pain and mobility issues due to arthritis or wear are common reasons for considering knee surgery. The two primary types of knee surgery are partial knee replacement and total knee replacement. This guide provides answers to frequently asked questions to help you understand these procedures and make informed decisions.

Partial vs. Total Knee Replacement

Question: What is knee replacement surgery?

Answer: Knee replacement surgery, also known as knee arthroplasty, involves removing damaged cartilage and bone from the knee joint and replacing it with artificial components. This can help relieve pain and restore function in patients with severe arthritis or injury.

Question: What is the difference between partial and total knee replacement?

Answer: In partial knee replacement, only the damaged part of the knee joint is replaced, while in total knee replacement, the entire knee joint is replaced. Partial knee replacement is typically suitable for patients with damage confined to a specific area of the knee, whereas total knee replacement is for those with extensive damage across the entire joint.

Candidates for Surgery

Question: Who is a good candidate for partial knee replacement?

Answer: Candidates for partial knee replacement usually have:

• Osteoarthritis limited to one compartment of the knee, based on X-rays or scans.
• A relatively stable knee with intact ligaments.
• Adequate range of motion and alignment.

Question: Who should consider total knee replacement?

Answer: Total knee replacement is recommended for patients who have:

• Severe arthritis affecting the entire knee.
• Significant pain and stiffness.
• Poor function and mobility.
• Tried non-surgical treatments without success.

Benefits and Risks

Question: What are the benefits of partial knee replacement?

Answer: Benefits include:

• Shorter hospital stay and recovery time.
• Smaller skin incision and less pain post-surgery.
• Lower risk of infection and blood clots.
• Preservation of healthy bone and tissue.
• More natural knee movement.

Question: What are the downsides of partial knee replacement?

Answer: The disadvantage of partial knee replacement compared with total knee replacement is the potential need for more surgery. For example, a total knee replacement may be necessary in the future if arthritis develops in the parts of the knee that have not been replaced. The need for additional surgery is slightly higher for partial knee replacement than for total knee replacement, over the longer term.

Question: What are the benefits of total knee replacement?

Answer: Benefits include:

• Comprehensive relief from pain.
• Improved function and mobility.
• Longer-lasting results.

Question: What are the risks associated with knee replacement surgery?

Answer: Risks can include:

• Infection.
• Blood clots.
• Implant loosening or wear.
• Nerve or blood vessel damage.
• Continued pain or stiffness.

Question: What type of anaesthesia is given for knee surgery?

Answer: Before your procedure, the anaesthetist will discuss anaesthesia choices with you. 

Anaesthesia options include:

• General anaesthesia, in which you are put to sleep.
• Spinal injection in back, in which you are awake, but your body is numb from the waist down.

Procedure and Recovery

Question: How is partial knee replacement performed?

Answer: Partial knee replacement involves a smaller incision than total knee replacement. The surgeon removes the damaged bone and cartilage and replaces it with an implant, leaving the healthy parts of the knee intact. This typically results in less trauma to the knee.

Question: How is total knee replacement performed?

Answer: In total knee replacement, the surgeon makes a larger incision, removes the damaged cartilage and bone from the entire knee joint, and replaces it with metal and plastic components. This completely reconstructs the joint.

Question: What is the recovery process like for partial knee replacement?

Answer: Recovery from partial knee replacement is generally quicker. Patients walk with assistance on the day of surgery and return to normal activities within a couple of months. Physiotherapy is essential to regain strength and mobility.

Question: What is the recovery process like for total knee replacement?

Answer: Recovery from total knee replacement can take several months. Patients may start walking with assistance within a day or two after surgery, but full recovery, including physiotherapy, can take three to six months.

Longevity and Outcomes

Question: How long do partial knee replacements last?

Answer: Partial knee replacements can last 10 to 15 years, depending on factors such as patient activity level and weight. Advances in surgical techniques and materials continue to improve the longevity of implants.

Question: How long do total knee replacements last?

Answer: Total knee replacements typically last 15 to 20 years. Many patients experience significant improvements in pain relief and joint function that allow them to maintain an active lifestyle.

Making the Decision

Question: How do I decide between partial and total knee replacement?

Answer: The decision depends on the extent of knee damage, your overall health, activity level, and personal preferences. Consult with an orthopaedic surgeon who can evaluate your condition, discuss the benefits and risks, and recommend the most appropriate surgery.

Question: What questions should I ask my surgeon before deciding?

Answer: Consider asking the following.

• • Am I a candidate for partial or total knee replacement?
  • What are the potential benefits and risks of each option?
  • What is the expected recovery time and process?
  • How long will the implant last?
  • What can I do to improve my chances of a successful outcome?

Conclusion

Your doctor will discuss with you the options that will best relieve your individual symptoms as there are a range of treatments for knee osteoarthritis.

Knee replacement surgery, whether partial or total, can significantly improve the quality of life for those suffering from severe knee pain and dysfunction. Understanding the differences, benefits, risks, and recovery processes of partial and total knee replacements can help you make an informed decision about your treatment. The final decision is a personal one, and best discussed with a knee replacement specialist who frequently performs both procedures. Always consult with a qualified orthopaedic surgeon to determine the best approach for your specific needs.

Article produced by:

Mr Kasetti Ravikumar FRCS, FRCS Orth, MS, Mch

Consultant Orthopaedic Surgeon

KIMS Hospital & Sevenoaks Medical Centre

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