Total Knee Replacement

"Hi,

I am Dr. Atul Mishra, Orthopedist. Today I will talk about total knee replacement. Moreover, the emphasis is on partial knee replacement. We all know that total knee replacement is a very gratifying procedure if done in the right patient and at the right place. This surgery is in practice for the last 30 years with a success rate as high as 97%. In this surgery, we put a surface bone above the knee. And there is high-density polyethylene in between. But it has been found that not all the patients are actually a candidate for knee replacement surgery. Particularly in the younger age group that is the age group between 45-65 years, in these patients, many times it has been found that the complete knee is not damaged. Only one compartment of the knee like middle compartment or the which is outside i.e. lateral compartment is gone.

That means the patient which has one compartment of the knee joint damaged does not have to undergo a total knee replacement. The solution for such patients is a partial knee replacement. In this, we do not change or resurface the whole knee. It is only the damaged component which is addressed to. There are some surgeries which are known as joint preserving surgeries where we change the access of the knee joint. and we do not touch the knee joint from inside. That is how we delay the surgery and this is known as joint preserving surgery. Many times, the patient does not agree to this because this has a success rate of around 70-80%. So, if patients want immediate results then the partial knee replacement is the solution. Here, we just open and we make a very small incision and we change the surface of only the compartment which is damaged. We do not touch the other compartment which is normal.

It can be done on the medial compartment, lateral compartment and in the patella femoral portion. The advantages of partial knee replacement are, it is a minimally invasive surgery, cutting of the normal bone is very less and the patient is immediately able to walk and back to the normal routine in 15-20 days. Moreover, there is no limitation of motion. The patient is able to do routine activities. Nowadays, it has also become a computer and robotic navigated. So, this surgery is being in practice for the last 30 years. And such patient who undergoes a partial knee replacement surgery can lead a good and active lifestyle for at least 10-15 years. Thereafter, if they have a problem then this can be converted into total knee replacement.

Thank You!