Knee Replacement Options | Total vs Partial

In a healthy knee, the ends of your thigh and shin bones are covered with hard cartilage that allows the bones to move easily against each other. But arthritis can damage the cartilage, causing it to become thin and wear out over time.

A knee replacement surgery isn’t necessary if you experience mild to moderate knee pain because there are other alternatives to a knee replacement surgery such as medications and treatments. However, when your knee doesn’t respond to these treatments, a knee replacement surgery is usually an option.

Knee Replacement Surgery Types

Total Knee Replacement

Known as knee arthroplasty, this surgery is the traditional method for repairing a damaged knee. Noted as among the safest and most effective of all standard orthopaedic surgeries, the procedure for a total knee replacement generally involves removing the surface of the bones that have been damaged by osteoarthritis or other causes and replacing the knee with an artificial implant.

The surgeon will use special surgical instruments to remove the arthritic bone accurately and shape the healthy bone underneath to fit precisely into the implant components. Essentially, a total knee replacement surgery is a multiple-step process that’s recommended for people with severe knee pain.

Most people who have undergone a total knee replacement surgery experience a dramatic reduction in knee pain and benefit from improved mobility and movement. However, as with any surgical procedure, there are risks associated with total knee replacement surgery.

Among them are an infection that can result in additional surgery, blood clots that can lead to stroke or death, and continued knee pain and instability. This surgical procedure also requires an extended rehabilitation programme and proper home planning to accommodate the recovery period.

Implant loosening or failures can also occur, especially if there’s a misalignment between the implant and bone during or after surgery. These failures may be uncommon but would usually require another surgery to redo the procedure.

Partial Knee Replacement

A partial knee replacement surgery is the less common option when it comes to knee surgery. As the name suggests, only one part of the knee is replaced to preserve as much original healthy bone and soft tissue as possible. Generally recommended for patients who have osteoarthritis in one compartment of the knee, this surgery differs from the previous whereby all three compartments of the knee are replaced.

Hence, this surgery can take place in any one of the three anatomical compartments of the knee – the medial compartment (the inside aspect of the knee), the lateral compartment (outside of the knee), or the patellofemoral component (in front of the knee).

For this surgery, the surgeon removes the arthritic portion of the knee, including bone and cartilage, and replaces the compartment with metal and plastic components. But there’s less assurance that a total vs partial knee replacement will reduce or eliminate the underlying pain. The preserved bone may also be susceptible to arthritis which may require more surgeries in the future.

That said, this type of surgery is suitable for younger patients who have plenty of healthy bone. It’s also more suitable for those who lead an active lifestyle and may require a follow-up surgery later in their life or after the first implant wears out.

Unlike a total knee replacement surgery, a partial knee surgery offers several benefits such as shorter hospital stay and rehabilitation period, faster recovery, less pain after surgery, and less trauma and blood loss.

Alternatives to knee replacement surgery

Depending on the severity of the damage caused by arthritis, some doctors may recommend these alternatives before considering knee replacement surgery:

• Arthroscopic surgery –knee arthroscopy in Singapore is a minimally invasive knee surgery that’s performed with a camera inserted through small incisions. This type of surgery can be used to repair cartilage or meniscus tears inside the knee or to remove bone or cartilage fragments.
• Osteotomy – This is a type of surgical procedure where the surgeon makes a cut in the shin or thigh bone to shift the load away from the arthritic area of the knee. Typically recommended for younger patients with deformity or damage in one side of the knee.

While these generally don’t provide good results, they may allow a delay in getting a knee replacement surgery. In some cases, doctors may also suggest non-surgical treatments such as:

• Physical therapy – Knee arthritis typically causes mild to severe knee pain and stiffness. Consulting a physiotherapist to plan an exercise programme can help improve muscle strength to reduce pain. The use of hot and cold therapy may also be included to increase blood flow.
• Medications – While doctors try to limit the number of medications prescribed, several medications can help reduce knee pain, swelling, and stiffness. The two most common supplements for knee arthritis are glucosamine sulphate and hyaluronic acid.
• Injections – If the previous two alternatives fail to reduce knee pain, an injection may help. The process typically begins with a corticosteroid injection to reduce inflammation, pain and swelling. Oftentimes, it’s effective and can be long-lasting, but if it doesn’t provide lasting relief, hyaluronic acid injections may be suggested to improve mobility and relieve pain.

Cost-effectiveness of Partial Knee Replacement vs Total Knee Replacement

Both types of knee replacement surgeries are effective in treating knee arthritis, offer similar clinical outcomes, and result in a similar incidence of re-operations and complications.
However, total vs partial knee replacement surgery offers better benefits for patients who have osteoarthritis in one compartment of the knee. It’s also suitable for younger patients who still have plenty of healthy bone, especially those leading an active lifestyle.

Meanwhile, total vs partial knee replacement is generally recommended for patients who have osteoarthritis in all three compartments of the knee.

Unfortunately, some people may not have knee replacement surgery even if their arthritis is bad. This may be due to having weak thigh muscles (quadriceps) to support the new knee joint or the presence of deep or long-lasting open sores in the skin below the knee, increasing the risk of infection.

Therefore, when it comes to choosing the best option for a knee replacement, it’s important that you consult orthopaedic surgeons to understand the condition of your knee.

At Spire Orthopaedic Centre, everyone should be cared for and healed holistically in comfort without having to travel to different locations to seek medical and surgical help and rehabilitation support.

With a combined facility for collaboration between physicians, physiotherapists, and surgeons, you will experience a seamless service from diagnosis to treatment and rehabilitation that’s tailored just for you at our clinic.