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

Knee Pain and Bicycling

Many of my patients turn to the Internet before and after their visit to the clinic to research their symptoms, find medical advice, and learn exercise that may provide relief. This didn't happen 20 years ago when I started my practice.

Occasionally, I am asked to recommend Internet resources. Today I came across the Gatorade Sports Science Library. This site features articles and rountable discussions by physical therapist and sport medicine physicians. It's worth a visit.

In my sports medicine practice, I see a couple patients per week who experience knee pain when cycling. As a mountain biker and cyclist myself, I found this article about knee pain after cycling rides informative. The article makes the point that simple seat adjustments, altering your biking stroke, and strengthening exercises can provide considerable relief for some people.

Knee Osteoarthritis and Exercise Walking

People who do about 6 to 9 miles a week of recreational walking don't appear to be at greater risk for osteoarthritis of the knee than their more sedentary peers, according to a study appearing in the February issue of Arthritis Care & Research. This article appeared in the Los Angeles Times on February 5, 2007. Based on the results, researchers concluded that even overweight participants — who have an increased risk of developing osteoarthritis — are not more likely to develop the disease as a result of exercise.

The findings should ease concerns among those considering taking up an exercise program.

It is Dr. Tarlow's opinion that the development of knee osteoarthritis is multifactorial. Genetics and family history play an important role. Another strong risk factor for developing osteoarthritis of the knee is a previous serious knee injury such as tearing an ACL ( anterior cruciate ligament) or tearing of the medial meniscus.