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Partial or Full - Getting conflicting Info

Discussion in 'Knee Replacement Pre-Op Area' started by Scott11, Feb 12, 2019.

  1. Scott11

    Scott11 new member
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    I've gone to one surgeon that thought a bilateral partial knee replacement would be best. This is on the medial side of both knees.

    I have varus deformity (bow-legs). While this surgeon is first rate with 200+ knee replacements a year, I wanted to alleviate any questions in my mind about partial/full.

    I just went to a second surgeon and he is also highly rated doing 200+ knee replacements a year. He said that he would NOT do a partial. His reason is that there is too much varus deformity and OA in the patella area. He thought the deformity was close to 20% but he never measured it. So I'm not sure how to resolve this conflict.

    The second surgeon also said I had OA in the patella region also. My preference is the PKR due to only removing the bad and keeping the good. Also the hope that the PKR knee will feel more natural. Both surgeons use MAKO robotics and Stryker prosthetic.

    The first surgeon was looking at a 6 month old xray. The second surgeon looked at xrays done that day.

    Another point is both will have a cat scan (because of the robotics). Will varus angulation and other issues (OA in another compartment) show up on the cat scan that will change the recommended solution from PKR to TKR?
     
  2. kneeper

    kneeper FORUM ADVISOR Forum Advisor

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    I'm sure Josephine will weigh in and she knows more than I do, but I can say that if you have issues in more than one compartment most people would say your best bet is probably tkr.

    Also, most of us with TKR would say our new knees feel pretty darn natural. You may not feel that way right away (though I did) but once you're healed you're off and running, so to speak. :)
     
  3. Celle

    Celle FORUM ADVISOR Forum Advisor

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    I agree with kneeper.
    Since you have OA in more than one compartment of your knees, a TKR is more appropriate.

    Also, the second surgeon was looking at recent X-Rays, not ones that are 6 months old. He was using up-to-date information.

    Did you know that one of the main reasons why a PKR has to be revised to a TKR is because the OA has spread to other knee compartments?

    I've had both a PKR and two TKRs and I can honestly say that my knees feel just as natural with the TKRs as the first one did with a PKR - and that PKR did have to be revised to a TKR later.
     
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  4. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Good surgeons don't need to measure. They ca just eyeball it.
    That's a jolly good reason for NOT having a partial. You could find yourself having to have another major surgery within a few months and who wants that!
    That's a false economy. as I said previously, you could end up having to have it all done again!
    Another old wive's tale! I hear this opinion touted about in various places but it's so untrue. Total knees feel perfectly normal. I have two and they're fine!
    It will show everything! And varus (or occasionally valgus) deformities are almost inevitable in arthritic knees. It's part of the arthritic process that the bone wears down and part of the objective of doing a knee replacement is to correct that deformity.

    varus-valgus.JPG
     
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  5. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    About “feeling more natural,” I too can attest that TKRs can feel completely natural. I had bilateral TKRs and my knees felt stable and good right away. Feeling natural came a little later in recovery, but my knees feel that way now.

    Partials can be good for many patients. When they fail it’s most often due to arthritis in other knee compartments. If that’s the case with your knees, a TKR is your best bet.
     
  6. julie1968

    julie1968 member

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    One Dr had told me a partial would work after xrays and new Dr she said that would be a waste if OA is significant. My opinion I would do TKR.
     
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  7. Scott11

    Scott11 new member
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    Thank you all for the replies. I've given the new x-rays to the 1st doc along with my questions. We'll see what I get back from him or his PA
     
  8. maryo52

    maryo52 FORUM ADVISOR Forum Advisor

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    If you have two doctors who say two different things, then consider a third opinion ("break the tie"). I wanted a partial as well, for the same reasons as you. But the surgeon who was going to do it said he wouldn't know for sure what he would do until the surgery. I actually held out for two more years and got a TKR.
     
  9. NavyGunns

    NavyGunns FORUM ADVISOR Forum Advisor

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    @Scott11, the ultimate decision is yours and yours only. It’s smart to seek out as much information and insight as you can. Based on what you’ve shared, my own personal experience, and what I’ve learned from others on this forum, my guess is that you would ultimately be happier with a full TKR. During my own discussions with my OS, he stressed the only reason he was recommending a PKR for me was because there was no signs of OA or damage in the other two compartments. He did reserve the option of going with a TKR if he found issues once he got my knee opened up. So far, at 10 months, I’m very happy with my decision. However, if I was in your place, I believe I would have opted for a TKR and I believe my OS woukd have agreed.
     
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  10. Rick951

    Rick951 junior member

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    @Scott11 I also had a PKR on October 3rd. I am very happy with the results! Before my operation my OS also said, if the rest of my knee did not look great, he would do a TKR. I did not know the result until I woke up in recovery. I also asked my OS regarding TKR vs. PKR. He is very conservative less than 20% of the knees he does are PKRs. He said there are a lot of PKRs that should have been TKRs. I am glad I found my OS!!!
    Now my operative leg is my better leg. After less than 6 months I don't even think about the replacement! It feels totally normal, and the BEST part,, NO PAIN!!!!!!
    Best of luck on your decision and operation!!!!
     
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  11. Scott11

    Scott11 new member
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    Thanks Navygunns and Rick951. I like to hear from folks that have had the partial. The first Surgeon (PKR) reviewed the new X-Ray and still didn't see anything to change his mind. He did say that he would move up the CAT Scan and that will give him a better view of everything. At that point, I'll get his opinion and make a decision.
     
  12. NavyGunns

    NavyGunns FORUM ADVISOR Forum Advisor

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    @Scott11, I believe an important factor will be which compartment is of concern. The few members here that I know who have not been happy with their PKR mainly had a patella-femoral PKR. Mine involved the lateral compartment.
     
  13. bill 3/20

    bill 3/20 junior member

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    I had pkr - medial. I am pretty satisfied. The flexion in my fake knee is as good as the flexion in the real knee. The downsides almost 2 years out is that the replaced knee is stiffer in the morning, there are some areas of reduced sensation, and there continues to be some soreness after exercise. Still all things considered it's pretty good. I am going to have to have surgery on my 2nd knee in the next 6 months or so. I will go with a pkr again.
     

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