Sunday, February 25, 2007

Partial Knee Replacements

Usually, osteoarthritis of the Knee involves the entire joint, and a Total Knee Replacement is the treatment of choice. Perhaps one in ten people with knee osteoarthritis with severe enough involvement of the joint to consider surgery are fortunate enough to have the arthritis limited to only one compartment of the knee. In this case partial knee replacement is the best surgical choice. The knee has 3 compartments (think of the knee as a 3 room home). When just one compartment has all the articular cartilage or joint surface damaged (one bad room, two good room) partial knee replacement is done. This is also known as unicompartmental knee replacement (uni) if the medial or lateral compartment between the femur and tibia (thigh and shin bone) is replaced or patellofemoral replacement if the joint between the femur and patella (thigh and knee cap bone) is replaced.

Unicompartmental knee replacements function better than total knee replacements because less of the normal anatomy is disturbed ( no knee ligaments removed, less bone removed) and the uni knee bends, straightens and rotates more naturally. Recover after unicompartmental knee replacement is quicker and the postoperative pain is less compared to total knee replacement.

Longevity of a unicompartmental knee is very good, with nine in ten uni's working well at 10 years after surgery and many functioning well 20 years after surgery. The most common cause of failure after uni knee replacement is advancing arthritis in one or both of the previously uninvolved compartments of the knee.

Here is an excerpt of an article in the Arizona Republic about one of my patients in whom I performed partial knee replacement in one knee, then 3 months later the other knee. This is an example of how well partial knee replacements function. Outcomes like this is why I wanted to practice medicine. The link to the full article is at the bottom of this post.

"After suffering for years with knee damage that limited her mobility, Sarah Panepinto does not take dancing with her husband or playing tag with her kids for granted.

Last year, the 41-year-old Gilbert mother of five children had partial knee-replacement surgery on both of her knees. Since then, Panepinto said her recovery has been a miracle.

I can dance. I'm speed-walking. And I can even play Dance, Dance, Revolution with my kids," Panepinto said.

The more active lifestyle is a blessing for Panepinto who needs the energy to keep up with the home-schooling of her two teens and two elementary school-age kids.

I'm off anti-depressants . . . I feel like I have my life back," said Panepinto who has suffered from knee problems since she was 12."

Read the full article

9 comments:

Dr Dork said...

G'day and welcome to blogland. Nice to see an orthopod - don't seem to be many of you guys around on the net.

Best wishes
Dork

Anonymous said...

Any chance of some pictures for us lay people?

The Angry Medic said...

Why didn't I find you sooner? Your knee analogy would've helped a brain-damaged med student like me tremendously with anatomy exams last year.

Like Dr Dork said, welcome to the blogosphere! It's a nice place really. Despite the nasties out there.

Sid Schwab said...

Off to a good start: people seem to like learning about things medical in blogs, especially when told in terms of specific patients.

Meanwhile, as someone who also grew up in Portland and who had a friend named Don Tarlow whose dad was in the furniture business, I'm wondering if you're in that family somehow? (I'm a ways older than you!)

Stefan D. Tarlow MD said...

Pictures are an excellent suggestion. I will compile a few appropriate visuals and post in the near future.

valerie said...

How nice to see an orthopod and a Golden owner on blogger! Mostly I lurk and you're getting kudos from some of my favorite docs-that's an honr, so keep it up. I have worked for an orthopedic surgeon for 21 years both in clinic and as first assistant, so I'm finding your site quite interesting. We arerevising a uni to a full total in the morning, wil be interesting to see if the lateral compartment is eburnated. Keep it up, I like your blog!

valerie said...

How nice to see an orthopod and a Golden owner on blogger! Mostly I lurk and you're getting kudos from some of my favorite docs-that's an honr, so keep it up. I have worked for an orthopedic surgeon for 21 years both in clinic and as first assistant, so I'm finding your site quite interesting. We arerevising a uni to a full total in the morning, wil be interesting to see if the lateral compartment is eburnated. Keep it up, I like your blog!

bob said...

hi my husband already had a knee revision, but now had the stainless steel rod in his knee revision cracked. doctor has no clue as to what he is going to do.. any suggestions. a third revision??? what next? email me with any suggestions flhbob83@aol.com thanks

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