Unicompartmental Knee Replacement

The purpose of knee replacement surgery is to restore function, increase mobility, and decrease pain. Many times a total knee replacement is the best option for patients who have severe knee arthritis. However, patients with osteoarthritis that is limited to one particular area of the knee may be candidates for a partial knee replacement (also called a unicompartmental knee replacement).

What are the advantages of a partial knee replacement?

There are many research studies available that support how a modern partial knee replacement performs superbly for a vast majority of patients. There are many advantages to having a partial replacement versus a total replacement of the knee. These include a quicker recovery time, less blood loss during the procedure, and less pain after surgery.

Many report that a partial knee replacement feels more “natural” than a total replacement and the range of motion is often reported as “better”.

Who is a candidate for a partial knee replacement?

The orthopedic specialist may recommend this procedure if you have severe osteoarthritis of the knee and have tried and failed with nonsurgical treatment measures. A partial knee replacement is only considered if your knee problems affect your quality of life and interfere with your daily routine.

Also, your arthritis should be limited to one compartment of the knee, not the entire knee as seen with inflammatory arthritis. Those patients with significant knee stiffness or ligament damage are not ideal candidates.

What should I expect before the surgery?

Your orthopedic specialist, working closely with your family doctor, will determine which type of procedure you need. He may test your range of motion, the ligament quality, and assess your activity status. Patients who have pain located entirely on either the inside portion or outside portion of the knee are good candidates for a partial knee replacement.

Those who have pain throughout the entire knee or in the front aspect are usually better qualified for a total knee replacement. You may have additional imaging tests on your knee to determine which surgery suits you best.

Before your operation, a member of the anesthesia team will evaluate you. Anesthesia will either be spinal (you are awake but numb from the waist down) or general (you are completely asleep). The choice will depend on your surgeon’s preference and your health needs.

What happens during the surgery?

A partial knee replacement generally lasts 1 or 2 hours. The orthopedic specialist makes an incision at the front of your knee in order to explore the three compartments of the joint space. He uses a special saw to remove the damaged cartilage and knee components and caps the ends of the femur (thighbone) and tibia (lower leg bone) with metal coverings.

These metal pieces are connected to the bone with a special type of cement. To create a smooth gliding surface, the doctor places a plastic insert between these two metal components.

What happens after surgery?

After your procedure, you will be taken to a recovery room and closely monitored. Expect to have an IV for around 24 hours to receive medicines for pain control and antibiotics. Once you are awake, you will notice a bandage on your knee and a small drain that collects fluid from the joint space.

Some patients may be candidates to have this procedure on an outpatient basis, but most will need to be admitted to the hospital. You can expect to go home 1 to 3 days following a partial knee replacement.

A fracture is a broken bone and when a bone is fractured, it is broken. A bone may be completely fractured or partially fractured in many different ways. It could break cross-wise, length-wise, or in the middle.

What causes a fracture?

Fractures happen from a variety of things and in many ways. The three most common causes of fractures include:

Trauma – Injury from trauma accounts for most fractures. This involves a fall, a motor vehicle accident, or an injury during a sporting event.

Osteoporosis – This condition can contribute to fractures. Osteoporosis is a bone disease that results in thinning of the bone. Bones that are affected by osteoporosis become fragile and break easily.

Overuse – This sometimes results in stress fractures, breaks that are common among athletes.

How are fractures diagnosed? … read more

The upper portion of your arm bone is shaped like a ball. Muscles and ligaments hold this ball against the cup-shaped part of the shoulder bone. Orthopedic specialists perform a shoulder replacement when this area is damaged from arthritis or trauma.

Before the Procedure

During surgery the anesthesiologist will use general anesthesia which means you will be unconscious. Occasionally, your orthopedic specialist prefers to use regional anesthesia, meaning you won’t be able to feel the area he is working on and you will be sleepy but awake during the surgery.

The choice of which kind of anesthesia will depend on your overall health status, what you prefer, and what your anesthesiologist chooses. Also, you will be given antibiotics during and after your surgery to reduce the risk of infection. Many times our orthopedic surgeons want you to get your dental work completed before you have shoulder replacement surgery.

During the Procedure

A total shoulder replacement is done to replace the ends of bones in a damaged shoulder joint. This procedure creates new joint surfaces. During surgery, the orthopedic specialist will replace the ends of the damaged upper arm bone (called the humerus) and the socket (called the glenoid). The surgeon will cap these areas with artificial surfaces made plastic and metal. Shoulder joint components that are placed into the joint must be held in place with cement or they may be made out of a special material that allows new bone to grow into the joint components over time and hold them in position.

Basically, for shoulder joint replacement, your orthopedic specialist will make an incision over the front of your shoulder joint to open up the area he will be working on. Then he will remove the top of your upper arm bone, cement the new prosthetic head and stem in place, and smooth or replace the surface of the old socket. He will then close the incision with staples or sutures and place a bandage over your wound. This surgery usually takes anywhere from one to two hours to complete.

After the Procedure

Right after surgery you will have an intravenous (IV) and antibiotics going through this for one or two days. You will also receive medications that will prevent blood clots and relieve pain. Keep in mind that you will not feel yourself for a few days after surgery due to the effects of anesthesia. You may be constipated, have an upset stomach, and feel groggy or tired.

When you wake up from the procedure you will have a bandage on your shoulder and possibly a drain to collect fluid and prevent it from building up in the joint area. A physical therapist will begin to work with you to perform gentle exercises on your shoulder on the day of surgery or the day after. The sooner you work your shoulder, the better.