Why is a Partial Knee Replacement Better Than a Total Knee Replacement?

Dr. Dan Albright, an orthopedic surgeon, discusses the difference between a partial knee replacement and a total knee replacement and when he would use a partial knee replacement over a total knee replacement.

Transcript of video:


Why is a partial knee replace better than a total knee replacement? That's a question I'd like to address in this segment.

I'm Dan Albright, MD. I'm an orthopedic surgeon in Raleigh, North Carolina.

So why are partial knees is better than total knees? There's some debate and controversy there, but I'll give you my opinion.

There are many times - yesterday, in fact, I operated on a woman's knee and only the inner part of the knee was worn out and so I only replaced the inner part of the knee. And I think that's better than a total knee.

I have several patients where I have done a total knee replacement, which you have to do some times. And then on that same patient I've done a partial knee replacement in a different year. Without exception they always like their partial knee
replacements better.

Partial knee replacements move more. They flex more and they feel more natural. That sounds like, perhaps, a cliché, but when you replace only part of the knee, the inner part that's worn out and you preserve the outer part and you preserve the kneecap it feels more natural. Patients tell me that and there's literature to support that.

I'll show you some anatomy here just to demonstrate. On the model here are several knees. The first one is a knee with no arthritis. The blue is the cartilage on the femur and that's crucial there is also cartilage on the tibia. Tibia is the leg bone right here. Anyway, when the cartilage wears out is when you need a knee replacement. On the very end here that brownish discoloration - that patient needs a total knee. The whole knee's shot. Total knees are great in the right situation.

Where there are many patients where arthritis just starts on the inner part, right there where the brown is, but the rest is pretty good. So I almost feel guilty when I replace somebody's knee, like a total knee like some patients just want a total knee, no partial, but they're only worn out on the inside. So I'm taking out pristine cartilage on the outside and taking out a pristine kneecap cartilage and it's overkill. To do a total knee, a lot of people don't need a total knee. A lot of people just need the inner part replaced - that's all that's worn out and the benefit is, I believe, better motion, it feels more like your normal knee because you have one third of it replaced - the rest is good. And it is untouched by surgery.

This is an example, two examples, one the total knee. Here's an example of a knee that's wearing out, just another example where you see the cartilage is being lost there on the end of the bone. And it's like walking on sandpaper. There's no cushion there. So I'm a big believer in total knees. I do a lot of them when the whole knee is worn out. This is a total knee. Its got a femur, and you have a tibia, and then you also have a kneecap - a plastic button glued on the kneecap.

The partial is much smaller. Here is a partial. I use the Oxford knee which I think is better - we'll go into the reasons in a minute, but it's just the inner part of the femur's replaced, a glued on piece of metal. You have a glued on piece of metal on the tibia. Then the magic of the oxford is you have this mobile piece of plastic - it moves around in between. There are good twenty years success rates on this specific type of partial knee replacement.

So, yes, I do a lot of total knee replacements, but I try to do a partial
whenever I can if only the inner part of the knee is worn out. The patients love it. It's a smaller surgery, it's a safer surgery, it has less risks than a total knee, and it works really nicely.

So if you having knee pain, knee arthritis, I'm happy to go into all this with you.

My website is danalbrightmd.com.

Our appointment line is not 919-863-6808.

Thanks.