top of page
UKR Final_edited.jpg

PARTIAL KNEE REPLACEMENT

Overview

Unlike total knee replacement surgery, which involves removal of all the surfaces of the knee joint, partial knee replacement (also known as unicompartmental knee replacement) surgery replaces only the damaged part of the knee joint. The success of this operation depends on the fact that osteoarthritis almost always starts in the inner region (medial compartment) of the knee, whereas the outer region (lateral compartment) and ligaments (soft tissue) remain healthy for a long time.

 

This procedure is less invasive than a total knee replacement (TKR) and offers the following additional benefits:

  • Smaller incision (and scar)

  • Less bone removal

  • Less complications

  • Faster recovery (up to three times faster than a TKR)

  • Better function.

 

The main downside to a partial versus total knee replacement is that there is a higher risk of revision for a partial knee replacement.  Any revision procedure has a higher chance of complications and worsening of function afterwards. This risk is balanced against the benefits of a partial knee replacement (highlighted above).

A brief description of partial knee replacement

Risks of Surgery

As with all procedures, a partial knee replacement carries some risks and complications.  

 

The common risks (2-5%) of the procedure include Pain, Bleeding, Blood clots, Stiffness, Prosthesis wear/loosening, Conversion to a total knee replacement.

 

The less common risk (1-2%) of the procedure is Infection.  If infected, the joint will likely require one or more additional operations and prolonged antibiotics, with a risk of increased disability and dissatisfaction.

 

The rare risks (<1%) of the procedure include Pulmonary embolism, Altered wound healing, Nerve damage, Fracture, Blood vessel damage, Progression of OA, Dislocation of the bearing, Death.

 

All complications can lead to a temporary or permanent deficit which can affect your ability to carry out activities of daily living or specific tasks related to your occupation, hobbies, or interests.

The Operation

Upon arrival on the day of your surgery, you will be evaluated by a member of the Anaesthesia team. The most common types of anaesthesia are spinal anaesthesia (you are awake but your body is numb from the waist down) or general anaesthesia (you are asleep). Either option may be combined with a nerve block for added pain control during and after the operation. The anaesthesia team will make a joint decision with you to determine which type of anaesthesia is best.

 

The procedure usually takes 45-60 minutes.

 

The basic steps of a partial knee replacement procedure are as follows:

 

  1. Inspection of the joint. An incision will be made allowing inspection of all aspects of the knee joint. If Mr. White feels that your knee is unsuitable for a partial knee replacement, then he will convert your operation to a total knee replacement instead. Mr. White will have discussed this contingency plan with you before your operation to make sure that you agree with this strategy.

  2. Bone preparation. The damaged cartilage surfaces at the ends of the femur and tibia are removed along with a small amount of bone.

  3. Implantation of the metal prostheses. The removed portions are replaced with metal components that recreate the surface of the joint.

  4. Insertion of a spacer. A polyethylene spacer is inserted between the metal components to create a smooth gliding surface.

After the Operation

  •  Pain relief – Making sure that you are comfortable, and your pain is acceptable after surgery is one of the main tasks of the team of people who will be looking after you.

 

Pain management begins whilst you are in the theatre suite and continues according to your individual requirements throughout your admission.

 

The anaesthetic used is focused on minimising pain after your operation, but pain is a normal part of the recovery process.  The aim of pain relief after your operation is to make the pain bearable and to allow you to get up and start using your new joint.  It is not possible to eliminate pain altogether and a certain level of pain should be expected. 

 

Early mobility is very important in helping to prevent post-operative complications and can speed up your general recovery.  You should be able to take a deep breath and move with the minimum of discomfort.

 

  • Hospital stay is usually 0 (day case) to 1 day.

 

  • Physical therapy – Your rehabilitation and its effect on your outcome is down to you. You will start to put weight on the knee with support from a frame or crutches from the day of your surgery. You should expect to be able to walk independently by 6 weeks following your surgery.

 

It is important to do your exercises regularly and increase your activity day-by-day. This not only improves your rehabilitation and functional outcome, but it also helps prevent complications like a blood clot. Movement also helps to unlock the pain cycle.

  • Wound care - Your wound will be covered with a special dressing in theatre.  We do not disturb the dressing unless it is heavily soiled, this allows healing to take place and reduces the risk of infection.  The dressing will be reviewed daily by the nursing team whilst you are in hospital.

 

Your skin closure will be performed with dissolvable sutures or staples. It will take approximately 10-14 days to heal. If staples are used then they will be removed after this time. A waterproof dressing will be used to cover the wound and showers are permitted, but it is recommended that you do not immerse the dressing in a bath or expose the wound to water until it has healed.

 

Mr. White and/or your physiotherapist are more than happy to discuss in more detail issues surrounding:

  • Returning to work

  • Using your knee following your operation

  • Driving

  • Anticipated length of rehabilitation.

 

Please notify us if undergoing any other operations, hospital tests, dental work, or if you develop any infections or soft tissue wounds before your scheduled operation. Your operation may have to be deferred to reduce the risk of developing a deep infection of your partial knee replacement. If you are unsure, then please discuss this with Mr. White and the team.

Avoiding Problems after Surgery

Recognising the Signs of a Blood Clot

 

Please follow the advice and instructions from the hospital to reduce the risk of blood clots developing during your recovery. You will be discharged with blood thinning medication for the first two weeks following your knee replacement. Notify your GP and/or seek immediate medical attention if your develop any of the following warning signs:

 

Warning signs of a blood clot in the leg (deep vein thrombosis; DVT):

  • Increased pain in your calf and leg that is unrelated to your incision

  • Tenderness or redness above or below your knee

  • New or increasing swelling in your calf, ankle, and foot

Warning signs of a blood clot in the lung (pulmonary embolism; PE):

  • Sudden shortness of breath

  • Sudden onset of chest pain

  • Localised chest pain with coughing

 

Preventing Infection

 

A common cause of infection after a knee replacement is from bacteria that enters your bloodstream during dental procedures, urinary tract infections, and/or skin infections. Theses bacteria can lodge in your knee replacement and cause a deep infection.

 

After a knee replacement, patients with certain risk factors may need to take antibiotics prior to dental work and before any surgical procedure that could allow bacteria to enter the bloodstream.

 

Warning signs of infection. Notify Mr. White, your GP, and/or seek immediate medical attention if you develop any of the following signs of a possible knee replacement infection:

  • Persistent fever

  • Chills

  • Increasing redness, tenderness, or swelling around the knee wound

  • Drainage from the knee wound

  • Increasing knee pain with both activity and rest.

FITZWILLIAM HOSPITAL

Milton Way

Peterborough

PE3 9AQ

Secretary: Julie Bell

Email: enquiries@mrjonathanwhite.co.uk

Telephone: 01733 842309

Website: www.fitzwilliamhospital.co.uk

Contact Us

Thank you for your enquiry. We will respond to your message as soon as possible.

North West Anglia NHS Foundation Trust (NWAFT)
I Want Great Care Reviews for Mr Jonathan White
Fitzwilliam Hospital, Peterborough
Medbelle - simpler, smarter, more personal healthcare for everybody
bottom of page