Partial or Total, how do you tell/know?

[NewToMe]

Hey smarties!

I've had a full Left knee replacement and doing well, but now the right is being cranky. I went to a new (to me) surgeon because we retired in a different state, saw a PA had new films...right is medial bone on bone and has been since before the LTKA.

The PA talked about a partial, but I recall my previous surgeon doing a test to see if I had issues behind the knee cap, I don't remember what the test was!

Suggestions?

Also, as long as I don't try to pivot on the right, no pain to speak of, but it stalls when it's kept straight for a long time.

Thanks!
Kathy

 

[Jockette]

I am not a fan of my partial, it did not go well. But, sometimes totals don’t go well. My best advice is, if you opt for a partial, make sure the surgeon you choose does a lot of them. My lack of experience and knowledge of any joint replacement, before surgery, led me to a local surgeon and I agreed to a partial. Learning much more after my surgery, I suspect my surgeon has done very few Patellofemoral PKRs. The surgeons experience is the key to a good outcome.

 

[mendogal]

My own opinion is that when there's anything uneven in the knee - whether from arthritis, injury, foot or hip problems - wear and tear will create new problems.

So while we have had many members do very well with partials (seems like a lot of those are the athletic youngsters?) I figure eventually the unoperated side is going to go kaput so you may as well get the whole shebang.

Honestly I wasn't given a choice - I already had issues on both medial and lateral.

I totally agree that finding a surgeon who specifically does lots of partials and who can give you realistic expectations is key.

 

[EalingGran]

My surgeon is an expert on partials and had done a lot of the research. He thinks they can be a good choice for a fair number of people. He thinks they give a better range of movement and a more natural feeling knee. There is a higher revision rate but he thinks that because they are easier to revise, surgeons are more willing to do so if the patient is not fully satisfied. There is a research paper that shows that where patients have had one partial and one TKR, they prefer their partial knee. Although of course there could be some bias here- as the knee that had the partial was probably less damaged pre-op.
I agree with @Jockette that it is important to get a surgeon who does lots of partials.
Remember there are there are three types of partials medial, lateral and patellofemoral. Medials are by far the most common and straightforward. I would reinforce the advice about getting an expert if you are having one of the rarer partials. They are more complex surgery from what I have read.
I had one of the rarer lateral PKRs.
I have great ROM ( 150+, almost as good as my other side) and a very natural feeling knee. I do still have some arthritis in the unoperated patellofemoral compartment ( some crepitus and the odd twinge) but it doesn't bother me and doesn't seem to be changing.
Ultimately it does depend on how much arthritis you have in the other compartments. I was very knock kneed/ valgus deformity and the hope is that now my leg is straight my other compartments ( medial/ patellofemoral) won't get worse.
I think medial partials can work well for people with the opposite problem to me ( bow legs/ varus deformity) where the arthritis is uneven and mainly on the medial side.

 

[lrj]

I had patella femural PKR in both knees. So far, it's been great. MRI showed I had more cartilage damage than the X-ray indicated. I know they chose partial for me because of my age (37) and the other compartments just show early signs of arthritis. My surgeon told me I will likely need TKR in about 20 years based on the current conditions. I also had an osteotomy to fix alignment issues. Without that, I'd be looking at TKR much sooner.
Partials can be great, but it depends on what else is going on. Talk with your surgeon. Discuss the benefits of each.

 

[NeedaThneed]

I thought I might get a partial medial but since I had pain on the lateral side of kneecap, surgeon said “no way, I can only do a total”.

 

[Cyclegal]

I had a partial and am totally delighted with it---however I had damage in the medial compartment only, due to a very bad torn / extruded meniscus. I think as long as your arthritis is limited to one compartment the partial is the way to go. Seek out the doc who does a lot of partials, my understanding is they are technically more challenging (for the surgeon) and so not many ortho surgeons are fans.

the recovery is no picnic and I think just as brutal as a total.

Liz