Partial vs.Total Knee Replacement

For someone with a knee problem, knowing how to deal with it effectively can be a challenge. Your knee surgeon may have mentioned either a total or a partial knee replacement. Each type comes with its own set of risks and rewards, so how do you know which would be best for you?

Risks

For a Total Knee Replacement (TKR), the knee surgeon performs major surgery. This is a very invasive procedure during which all three knee compartments (inside, outside, and front) have any bad surfaces removed and the parts replaced by metal and plastic. The ligaments may be also be altered during this process.

As with any major surgery, there are significant risks involved:

  • Deep Vein Thrombosis (DVT) can be a deadly issue related to blood clots in the leg
  • Stiffness and pain
  • Scarring can be extensive as the incision is large (10-14 inches long)
  • The need for future surgeries due to implant or prosthetic failures, limited life span of parts, or the need for scar revision
  • Fluid accumulation in the joint
  • Nerves and blood vessels may be compromised
  • Risk of infection is high

Partial Knee Replacement (PKR) comes with similar surgical risks, but generally to a lesser degree since the surgery is less invasive. Patients who undergo PKR may eventually need additional surgeries as the knee surgeon must correct the rest of the knee as it deteriorates.

Advantages

After a TKR, patients often have more trust in the knee joint than with a partial. The knee feels strong and stable and the patient is comfortable being active on the new joint.

In the case of a PKR, this is a much less invasive surgery. The natural parts of the knee are not as damaged and less may need to be replaced. A smaller incision is needed to achieve the goal of improving the knee. Other advantages of PKR include:

  • Less scarring due to smaller incision (3-4 inches long)
  • Ligaments are spared
  • Less nerve interruption and therefore better patient satisfaction with regard to pain
  • Quicker recovery
  • Reduced risk of complications

For the majority of patients, a partial replacement is much preferred since it is less risky and invasive, yet still provides substantial pain relief. Your knee surgeon can help you decide which surgery is right for you and your lifestyle.

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