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Partial Knee Replacement

Knee replacement surgery has become a common knee surgery to reduce pain, inflammation, and discomfort in the knee. Partial knee replacement, also known as unicompartmental knee replacement, is a type of knee replacement surgery that only replaces sections of the damaged joint. Partial knee replacement surgery is a less invasive knee surgery. For younger patients, partial knee replacement is beneficial because it removes less bone. As younger patients often need to undergo another knee replacement surgery later in life to correct the wear and tear on the artificial joint, having more bone in the knee can make a future revision knee replacement easier to perform.

What are the parts of the knee?

The knee joint is where the thigh bone (femur) meets with the shin bone (tibia). Articular cartilage provides cushioning between these bones to reduce friction and grinding when the leg moves. Articular cartilage is smooth because it is continually lubricated by the joint lining. This lubricating fluid is kept within the joint capsule. The movable front bone of the knee that is commonly referred to as the kneecap is known as the patella. The patella is encased within a tendon that attaches the thigh muscles to the tibia. The back of the kneecap also has a layer of articular cartilage over it so that it can smoothly move over the front of the thigh bone. Your knee has 2 femoral condyles, which are bony protrusions that extend from the bottom of the thigh bone. These are known as the medial femoral condyle and the lateral femoral condyle. Multiple muscles and ligaments of the leg begin or are inserted into the femoral condyles.

What can Dr. Rozbruch achieve with partial knee replacement surgery?

Dr. Rozbruch can replace an arthritic knee joint with partial knee replacement in order to reduce the grinding of the thigh and shin bones. When these bones come into contact in an arthritic knee, they can cause inflammation, pain, and reduced knee mobility. By replacing part of the knee, Dr. Rozbruch can place a new surface over the joint. This surface, similar to articular cartilage, will cushion the knee and reduce any painful grinding of the tibia and femur. Partial knee replacement surgery can help restore knee mobility and functionality.

What should I expect before partial knee replacement?

A physical examination with your family physician may be needed before partial knee arthroplasty. A physical exam can ensure you are in good health and are a proper candidate to undergo partial knee replacement surgery. Dr. Rozbruch may also suggest spending time with your physical therapist prior to your knee surgery. Meeting with the physical therapist who will be working with you after surgery can help you become accustomed to post-operative exercises. Your physical therapist may take note of your current level of knee mobility to use as a comparison after knee surgery. During these pre-operative physical therapy sessions, you may practice using crutches or a walker, which will be used as you walk during recovery from knee surgery.

What should I expect during partial knee replacement?

There are 2 techniques used during partial knee replacement surgery, including a cemented knee prosthetic and an uncemented knee prosthetic. A combination of both uncemented and cemented techniques may be used in some partial knee replacements. Dr. Rozbruch can help you decide which technique may be best for you during your unicompartmental knee replacement.

The artificial knee joint is made up of 2 parts, which are referred to as the tibial component and femoral component. The tibial component replaces the upper portion of the shin bone, and the femoral component replaces the lower part of the thigh bone. The femoral component is a single piece made out of metal. On the other hand, the tibial component is made of 2 pieces, including a metal tray that will be adhered directly to the bone and a spacer made out of plastic that will function like articular cartilage. During a cemented partial knee replacement, the artificial knee joint is secured using medical-grade cement. A mesh material that promotes bone growth will be used during an uncemented partial knee replacement.

To begin partial knee replacement surgery, Dr. Rozbruch will place an incision at the front of the knee. Incisions for partial knee replacement surgery are generally smaller than those used in traditional knee arthroplasty, as only a portion of the knee joint is being removed and replaced. For some patients, partial knee replacement may be less invasive than traditional knee replacement. Once the knee has been opened, a surgical guide is placed at the end of the thigh bone. This guide enables Dr. Rozbruch to cut the bone at the proper angle to match the leg’s natural alignment. Multiple segments of the lower thigh bone will be removed at this point during partial knee replacement.

Dr. Rozbruch will prepare the shin bone and use another surgical guide to properly make aligned cuts into the bone. The femoral component will then be situated on the thigh bone. If you are undergoing an uncemented partial knee replacement, the mesh material will be held between the thigh bone and femoral component. Medical-grade cement will be applied to the femoral component prior to placement if you are undergoing a cemented partial knee replacement. The metal tray that will hold the plastic spacer will then be attached to the top of the shin bone. The metal tray may be cemented into place or secured with screws. Dr. Rozbruch will then place the plastic spacer on the metal tray. Once the placement of the knee prosthetics are satisfactory, Dr. Rozbruch will close the incisions with sutures or metal staples.

What should I expect after partial knee replacement?

Following partial knee replacement, you may use a continuous passive motion device. This machine is used to passively move the leg and knee to help reduce the possibility of blood clots forming. Continuous passive motion devices can move the knee without straining the healing muscles or bones. Physical therapy sessions will begin 1-2 times daily while you stay at the hospital. It is important to start moving the leg and knee shortly after partial knee replacement surgery. Physical therapy exercises will help you regain a proper range of motion in the knee as you heal. Ankle and foot exercises may also help blood circulation and reduce the risk of blood clots. Shortly after partial knee surgery, your physical therapist may suggest a light walk as long as your knee can support part of your body weight. The majority of patients recovering from partial knee arthroplasty are able to return home 1-2 days after knee surgery. After you are released from the hospital, routine check-ups with Dr. Rozbruch are required to ensure that you are healing properly from partial knee arthroplasty.

How long does it take to recover from partial knee replacement surgery?

The majority of patients are able to walk unassisted approximately 1 month after partial knee replacement, but physical therapy sessions and full recovery may take 5-6 months. Initial physical therapy sessions will be most concerned with treating any pain or swelling you have from partial knee arthroplasty. Patients should use a walker or crutches as suggested by Dr. Rozbruch and your physical therapist. It is important not to place full weight on your leg until the knee has healed properly and can support this weight. As you progress through physical therapy, strength exercises will be added to help tone the muscles of the hip, thigh, buttock, and calf. Endurance exercises such as cycling may be added later during physical therapy. As physical therapy ends, you will begin exercises that mimic your daily activities, helping you adjust to returning to everyday life. Your physical therapist will provide you with a list of exercises to do at home once your therapy sessions have ended.

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