The purpose of prosthetic knee surgery is to reduce pain and restore the function of the diseased joint. Although total knee replacement is an excellent choice for patients with knee osteoarthritis, there are other surgical options. Patients with osteoarthritis that is limited to only one part of the knee may be candidates for single- compartment knee replacement (also called partial knee prosthesis).
In the single-compartment knee surgery, only the damaged compartment is replaced with metal and plastic. The cartilage and the healthy bone of the remaining part of the knee are not touched.
Dr. Rakesh Mahajan is the best knee replacement surgeon in Delhi. He has 18 years experience in arthroscopy and joint replacement. At the moment he is associated with BLK Super Speciality Hospital, New Delhi. The cost of partial knee replacement in India begins from USD 4000. This includes a 5 day stay in the hospital.
The advantages of the partial knee prosthesis
Partial knee replacement offers many benefits including –
- conservation of the cruciate ligaments of the knee
- a minimally invasive operation
- a reduced incision in the skin
- less blood loss during surgery
- less postoperative pain
- low risk of infection
- immediate tolerance to loading and exercise
- greater mobility
- less rehab period compared to traditional interventions
- possibility of returning to conventional techniques (possible conversion into total prosthesis in the case of failure).
Knee arthrosis degeneration can occur in any of the three compartments that make up the knee joint. Two of the three compartments of the knee are formed by the lower part of the femur and the upper part of the tibia. Moreover, the third knee compartment (the patellofemoral one) is formed by the patella and the anterior part of the femur called trochlear bone.
The medial compartment is the point of the knee most exposed to arthrosis. Lower, however, are the risk percentages of developing gonarthrosis in the lateral and patellofemoral compartments.
Patient selection is essential in this type of surgery because a wrong indication will inevitably lead to an unsatisfactory result.
The cardinal rule for implanting unicompartmental prosthesis is this: osteoarthritis must be limited to only one of the three compartments of the knee.
If osteoarthritis is in the medial compartment of the knee (medial tibiofemoral knee osteoarthritis), a single-compartment medial prosthesis can be implanted.
In the event that the arthrosis has affected the lateral knee compartment (lateral tibiofemoral knee osteoarthritis) lateral unicompartmental prosthesis can be implanted.
Finally, if osteoarthritis affects the patellofemoral compartment, unicompartmental patellofemoral prosthesis will be implanted.
The cruciate ligaments of the knee must be robust. The absence of the anterior cruciate is a contraindication, as is the absence of the posterior cruciate ligament and the meniscal lesion of one of the compartments not affected by arthrosis.
In young subjects, however (up to 60 years of age) a lesion of the anterior cruciate ligament will not be an absolute contraindication since a combined procedure of unicompartmental prosthesis can be followed with the simultaneous reconstruction of the anterior cruciate ligament.
In particular cases it is also possible to implant two unicompartmental prostheses in the knee at the same time, to replace two of the three compartments of the knee damaged by arthrosis.
After unicompartmental knee replacement, you will usually be kept under observation for at least two hours, while the effect of anesthesia wears off. The knee will be bandaged, and ice can be placed on it.
Already in the first moments after the operation, you will have to try to move your feet and ankles to promote circulation.
You will begin rehabilitation on the day of surgery, after a few hours. Recovery of knee function is usually rapid, and you will feel much less pain than total knee replacement. Physiotherapy is required for at least a month to make the muscles strong and if needed, correct faint varus/valgus (knock knee/bow legs) condition that may develop.