Wednesday, October 21, 2009

Unicompartmental Knee Replacement

What is the point of replacing only half of the knee?

There has been a change in attitude amongst surgeons in the last few decades. The old, aggressive surgical practices of big operations with big incisions has been replaced by minimally invasive techniques and a philosophy of doing the smallest amount possible to achieve a result.

A good example of this is cartilage tears in the knee. The old way was a large incision and complete removal of the meniscus. Today only the torn part is removed and this is done as a day case via key hole surgery.

Knee replacements are the same. Surgeons began to ask: "Why are we replacing the whole knee when only one compartment is worn?"

Due to the angulation that occurs in arthritis - either bow-legged or knock-kneed - all of the weight goes on the worn half of the knee while the other half gets a rest. This means it is often in very good condition.
Half knee replacements are only suitable if there is a good enough surface on the less worn side of the knee.
One of the advantages of unicompartmental knee replacements is that you can still have a full knee replacement later. It is more difficult to perform but not as troublesome as a revision total knee replacement.
There have been some concerns over the lifespan of half knee replacements. It has been argued that their shorter life is a result of them being used on much younger people who demand more from the implant.
There are many factors to consider, so discuss your personal medical history with your consultant to see if a unicompartmental knee is the right choice for you.

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