Partial Knee Replacement

[shine]

I am 43 years old. Knee trouble the past two or three years. I had it scoped about two years ago and it has gotten progressively worse sense. Bone on bone, no cartlidge on the inside of my left knee. Arthritis on the lower part of knee as well. Tried the Synvisc and pain relievers, etc. Looking at doing a partial knee replacement. Wanted to know if anyone had any advice or have had a partial replacement and could give me some of their own experiences. Thanks.

 

[calling_all_angels]

Shine,
Hello there nice to met you!
Did your OS say that you could do a partial? I would be sure to talk to my Doctor and see if a partial would be the right thing for you. Sometimes you have to go to a TKR.

 

[shine]

I have had three doctor opinions. All three say TKR later in life. Two of the three doctors say they would do a partial replacement now if I chose to do so. The doctor I am seeing now did my brothers knee surgery. He had a high tibial osteomony to buy some time before a TKR. He advised me not to have this surgery.

 

[Texas]

My Dr's said the same also couldnt promise no pain , long term after surgery. Just make sure hes clear. Hate to see you have to have TKR surgery in a yr or 2...........Good luck though, hope you feel better. Please let us know........

 

[Jamie]

The deal I made with my surgeon was that he would do a partial if possible, but once he got into my knee if he felt a TKR was needed, that's what he'd do. You see, sometimes it is not possible to see everything that is wrong in xrays or MRI's. In my case there was significant arthritis behind the kneecap that didn't show in any imaging in addition to the loss of cartilage on the inside of the joint that did show up.

This is why you need to find a surgeon you trust and go with their recommendation. And unless your brother is an orthopedic surgeon, I'd pretty much discount his recommendation. Sorry to be so blunt, but you need to make the decision based on opinions of medical professionals. Not everyone has the same things going on and what may have worked for him could be the worse thing for you to do.

One other point....don't be afraid of a TKR. In the months leading up to my surgery, I strongly wanted to avoid having the whole joint replaced. But as two doctors pointed out, a partial sometimes has to be replaced in a couple of years, putting you back into a major surgery situation in a relatively short amount of time.

In the end, my doctor was absolutely correct and I couldn't be happier with my new knee. So do your research (as you have), get multiple opinions (as you have), pick one surgeon and go with the recommendations. You won't regret it.

 

[Josephine]

Darn, Jamie! You made me redundant again!

Yes, she got it right on there, shine. But the bottom line is that a partial is not always a good choice. The specs for a partial is that the arthritis is confined to one area of the joint only, otherwise you will still be left with pain. My sil had a partial 2 years ago and has been extolling the virtues of it ever since but whilst looking after me after my TKR, she interestingly asked me if I had any residual pain in the joint and when I asked her if she had, she went very quiet!! :skp:

Short answer here is that if you are prepared to risk a) residual pain and/or b) another major op in 2/3 years time, then by all means go for it. You never know, you might be lucky and get away with it! There are plenty of PTKRs walking around out there who've had them for a number of years and have no problems. But generally speaking, it is a short-term solution.

Another thought, having a partial does not make the operation any less major. But it's your knee and your shout. Choose wisely!

 

[shine]

I understand PKR may be a short term solution. That is really what I want to get from this thread. I want those people who have had PKR done to post their experiences. What is to gain from a PKR? disadvantages?

 

[Texas]

OK, were just trying to help...Thats all............Hope you get your answers soon........and get this taken care of one way or another...

 

[Jamie]

Shine, there are some folks who have had PKR's on the forum, but I don't think they are active right now. Hopefully, one or more will see your post and provide their experiences. As I recall, all were successful surgeries with recovery periods and experiences pretty much like a TKR.

 

[loggon]

Shine
you might want to look at the prior post on partial knee replacements on here. I just read a few and seems to me those folks would have been better off with a tkr. Not much use in having an operation that may (and it appears more often than not) leave you in pain. Also to know that you have to have a TKR down the road... Why go through recovery twice. ("it ain't a piece of cake)
I had my rtkr done in March and the doctor said my left knee will be needing work later. He said he could do a PKR but would need a TKR in a few years. I will skip the PKR and do the TKR as I don't like the recovery. Since the recovery is the same for both it just seems a waste to do it twice.

But good luck in what ever you choose.

 

[Judles]

Jo and Jamie,,,,,surely there must be some research to support how how many partials go on to have TKR's.... IMO, I wouldn't want to even think of having another surgery after going through such a major surgery.....ugh!

 

[cheryl50]

Hi Shine had BPKR on 2/2/09 and am doing great. I am 51 and have been athletic all my life. My OA was medial and so I only needed the medial compartments replaced. I agree with the others that the surgery is BIG and recovery is hard, but I am feeling pretty good at 4 months. All my OA pain is gone and I can play golf and doubles tennis and bike. I did not make the decision myself. My surgeon made the call. I trusted him completely and believe it was the right thing for me. Time will tell if I will ever need TKR. I hope this helps you. Good luck! It was totally worth it for me.
Cheryl

 

[shine]

Did you have any fluid on your knee? Cysts? What surgery if any or how many did you have before making the decision to have the PKR? BPKR? What does the B stand for?:skp:

 

[Jamie]

The "B" means bilateral....meaning both knees were done.

 

[Josephine]

Usually at the same time!

 

[Brian]

The cartilage wear in both my knees was/is on the inside. I did ask the surgeon about PKR but got the impression that they have gone out of favour in the UK because the life span, even with older people, is around 5 years before a TKR is needed. This was confirmed by a couple of people I met at hospital who were there to have PKRs replaced by TKRs.

I think they are known as the Oxford knee in the UK, from the city where they were developed. Maybe they are of benefit for younger, more active patients as some of the movement of the original knee is retained?

 

[Josephine]

The Oxford is one type, Brian. There are lots of others. Actually the Oxford range is HUGE, including both partial and totals and lots of other types and goes way back to the late 70s. They are the standard for all knees now in use.

There is a place for partials but the case selection is all. Surgeons have to be very careful when they make such decisions.

 

[shine]

The Oxford is the one my doctor uses. Is there one better than the other?

 

[Gringo]

I know PKRs are still being done in the US. I was wondering why bother, if you have to open the knee up, why not just fix it all so that you can control the tolerances, etc.

My OS was saying he might be able to get away with a PKR on my second knee, but that was while we were still focused on my really bad one. Afterwards, he said that if he finds that the ACL is as bad as he thinks it is, he will do a total on the second one as well.

I have to wonder about PKRs. If the problem is OA, that doesn't really stop it, does it.

And what about half the weight being on artificial surfaces and the other half on biological surfaces. Will the bone ones wear faster?

What is the advantage of a PKR over a TKR? Isn't the recovery the same?

 

[Texas]

Thats what I wanted. The knee was to far gone though. I was told that you could have a PKR but in the long run would prob end up doing a TKR anyway. You might get some time out of it but I would only want to do it one time only ya know...........