The main difference between total and partial knee replacement is how much of the knee joint is replaced. Partial knee replacement may be considered if osteoarthritis is limited to only a suitable section of the knee and other structures are preserved. Total knee replacement may be more appropriate if osteoarthritis affects multiple sections, if there is widespread deformity, or if there are different joint problems. The decision should be based on examination and imaging findings, not solely on age or the patient’s desire for “less surgery.”
How many episodes are there in the series?
When evaluating the knee joint, three main compartments are mentioned:
- Internal section: medial compartment
- External section: lateral compartment
- The section between the kneecap and the thigh bone: patellofemoral compartment
Osteoarthritis may be evident in only one of these sections, or it may spread to multiple sections of the knee over time.
What is a partial knee replacement?
In partial knee replacement, only the affected section is replaced. The goal is to preserve as much of the healthy bone, ligaments, and joint surfaces as possible.
Who might be a suitable candidate for a partial knee replacement?
The following factors, when considered together, may lead to the consideration of a partial prosthesis:
- Calcification occurring in a limited compartment.
- The knee ligaments must be functional.
- The other joint sections are adequately preserved.
- The deformity and range of motion should be within appropriate limits.
- The pain is consistent with the calcified area.
Definitive suitability is determined by X-ray, additional imaging if necessary, and a detailed physical examination.
What is Total Knee Replacement?
In total knee replacement, the worn joint surfaces of the knee are prepared more thoroughly, and prosthetic components are placed on the femoral and tibial sides. If necessary, the joint surface of the kneecap is also evaluated according to the surgeon’s preference and the patient’s condition.
Total osteoarthritis is considered especially when osteoarthritis affects multiple compartments or when there is widespread structural damage in the knee.
The Most Important Differences Between Total and Partial Knee Replacement
Scope of Surgery
Partial replacement focuses only on the damaged portion of the knee. Total replacement involves a more extensive articular surface replacement.
Amount of Tissue Preserved
Partial replacement surgery allows for the preservation of more natural bone and connective tissue. Therefore, in suitable patients, it may be possible for the knee to feel more natural.
Appropriate Number of Patients
Not all cases of knee osteoarthritis are suitable for partial replacement. If the osteoarthritis is widespread, replacing only the painful section may not be sufficient.
Improvement
AAHKS states that partial knee replacement, being a more limited surgical procedure, may be associated with easier and faster early recovery in some patients. However, this advantage applies only to carefully selected patients.
Long-Term Durability
Total knee replacements have very strong data regarding long-term durability. In contrast, with partial replacements, osteoarthritis may develop in other parts of the knee or a need for revision may arise in later years.
This doesn’t mean partial prosthetics are a bad method; it means there’s a different balance of advantages and disadvantages in the right patient.
Which is better?
There is no single right answer to the question of “is total or partial surgery better?”. The best method is the one that is appropriate for the extent of the disease in the patient’s knee.
In a suitable individual with disease affecting only one compartment, a total prosthesis may be overly extensive. Conversely, performing a partial prosthesis on a patient with widespread osteoarthritis may lead to persistent symptoms or the need for further surgery in the future.
What are the advantages of partial knee replacement?
In suitable patients:
- More natural bone can be preserved.
- A significant portion of the vineyards can be preserved.
- The surgical field may be more limited.
- Recovery may be faster in the early stages.
- The knee may feel more natural.
None of these benefits are guaranteed for every patient.
What are the disadvantages of partial knee replacement?
- Not every patient is suitable.
- Osteoarthritis in the knee can spread to other parts of the body over time.
- Some patients may require a conversion to a complete prosthesis in later years.
- Pain may persist if the wrong patient is selected.
What are the advantages of total knee replacement?
- It can treat widespread knee osteoarthritis.
- Extensive clinical data are available regarding long-term outcomes.
- It offers a more comprehensive solution for diseases affecting multiple compartments.
- It may be a more suitable option for some patients with significant deformities.
How is Robotic Surgery Used in Total and Partial Prosthetics?
The Mako robotic system can be used in the planning of both total knee replacement and, in suitable patients, partial knee replacement.
Personalized Planning with 3D Tomography
A three-dimensional bone model is created from the patient’s computed tomography (CT) scans. The surgeon can then evaluate the size and placement of the prosthesis on this model before surgery.
Haptic Technology
The surgeon controls the robotic arm himself. The haptic system helps to work within the planned bone preparation limits.
The robot does not make the decision of “partial or total” surgery on its own. This decision is made by the surgeon after evaluating the patient’s joint structure.
What is Makoplast?
Makoplasty is a term used to describe partial knee replacement surgeries performed with the support of Mako robotic technology. The aim is to replace only the damaged section with a prosthesis, preserving as much healthy joint tissue as possible in suitable patients with limited osteoarthritis.
For more detailed information, please see the Makoplasti: Robotic Partial Knee Replacement page.
Which tests are used when making a decision?
X-ray
Standing knee X-rays provide important information about the extent of osteoarthritis, joint space, and leg alignment.
Physical Examination
The condition of the ligaments, the range of motion (flexion and extension) of the knee, whether the deformity has corrected, and the location of the pain are all assessed.
Advanced Imaging if needed.
Some patients may require additional bone or soft tissue evaluation. Appropriate protocols for robotic mako planning utilize CT data.
Does age determine the choice between partial or total dentures?
Age is only one of the important factors. Nowadays, decisions are not made simply based on rules like “partial disability under 60, total disability above 60”.
The location of the disease, the condition of the ligaments, activity level, deformity, bone quality, and the patient’s expectations should all be evaluated together.
Total and Partial Knee Replacement Evaluation in Adana
Dr. Muhsin Dursun, at Adana Ortadoğu Private Hospital, assesses the need for knee replacement and the appropriate type of prosthesis on a case-by-case basis for patients with knee osteoarthritis.
Depending on the extent of osteoarthritis , robotic knee replacement or, in suitable patients, macroplastics ( knee replacement surgery) options may be considered.
Frequently Asked Questions
Is a partial knee replacement better?
It can offer significant advantages in carefully selected patients; however, it is not suitable for patients with widespread osteoarthritis. The fact that it’s a “smaller operation” doesn’t automatically mean it’s better.
When is a total knee replacement necessary?
When osteoarthritis affects multiple sections of the knee, when pain and loss of function are advanced, and when non-surgical treatments are insufficient, total knee replacement may be considered.
Can a partial denture be converted to a full denture later on?
Yes, partial knee replacement can be revised to total knee replacement if necessary. However, this is a second surgical procedure and is planned individually for each patient.
Can Mako be used in both total and partial knee replacement?
Yes. The Mako platform offers both total and partial knee replacement applications.
How do I know which prosthesis is right for me?
The examination, standing X-rays, and further imaging if necessary, are used to assess the location of the osteoarthritis and the condition of the ligaments, thus making a decision.
Important Medical Information
This content is for general informational purposes only. The timelines and recommendations presented here are not the same for every patient; the type of surgery, the surgical approach used, comorbidities, preoperative muscle strength, and the physician’s rehabilitation protocol may all alter the process. Personal diagnosis, treatment, medication use, or postoperative activity decisions should be based on the recommendations of the orthopedic and traumatology specialist who is monitoring the patient.
