Orthopedic surgeon Dr. Brandon Gough on Partial Knee Replacement at Phoenix Spine and Joint

• February 23, 2021

Seniors are no longer taking growing older lying down. More and more people today are aging with the expectation being active. Everywhere you look people are running, hiking, playing tennis, biking and even engaging in team sports well past age fifty five. While the attitudes of older Americans has changed, arthritis has not.
Arthritis results of damage to joints caused by inflammation and often affects the knee. For many people it starts with an accident, triggering post traumatic arthritis. Others have an inflammatory disorder, such as rheumatoid arthritis. But for almost of a third of American over 55 the cause of their osteoarthritis is not known. The knee is one of the joints most commonly affected by osteoarthritis. Knee pain due to severe osteoarthritis is now a common cause of total knee replacement.
Orthopedic surgeons point out that hat we commonly call the knee is actually made up of three compartments: inside, outside, and under the knee cap. Knee osteoarthritis may affect any one, two, or all three of these compartments. In a total knee replacement your orthopedic surgeon replaces all three compartments of the knee. But there is another option. In a partial knee replacement only one or two of the compartments is replaced. Partial knee replacement are much less common than total knee replacement, making up only 2.7% of patients who’ve had a joint replacement in the American Joint Replacement Registry. But surgeons note increasing interest in partial knee replacement.
“One of the most common questions we get is whether or not I’m a candidate for partial knee replacement” said Dr. Brandon Gough, MD. Dr. Gough is an orthopedic surgeon who specializes in minimally invasive muscle and soft tissue sparing robotic joint replacement surgery at Phoenix Spine and Joint in Scottsdale, AZ. There are several reasons why patients are asking about partial joint replacement, and the first one is patient satisfaction.
People who had partial knee replacement are much more likely to be delighted with their surgery than those who had total knee replacement. While individual studies vary, about one in four people who’ve had total knee replacement are not highly satisfied. The reasons people give for being unsatisfied are persistent pain, limited activity, need for prolonged rehabilitation, and limited range of motion after surgery. By contrast, patient satisfaction after partial knee replacement is much more consistent with over 90% of patients being highly or completely satisfied.
So, what’s the difference between partial and total knee replacement? In partial knee replacement only one or sometimes two of the knee compartments are exposed and replaced. While the incision is similar, the amount of surgery that goes on underneath is generally half. Half the surgery, half the recovery. Partial knee replacement has higher satisfaction than total knee replacement because it hurts less and has faster recovery.
At Phoenix Spine and Joint our surgeons use robotic assistance for knee replacement surgery. The Mako, Navio, and Koury robots enable our surgeons to make the bone cuts necessary for surgery with superhuman accuracy. In addition, the robot makes a three dimensional computer model of your knee during surgery, which allows the surgeon to balance your knee, and select the perfectly sized implants. There are actually missions of possible combinations of parts and angles of cuts, more than any human could possibly do in their head, but very possible with computer assistance.
The biggest disadvantage of partial knee replacement is the possible need for revision surgery. As you age the arthritis may progress in the unreplaced compartments of your knee. If the arthritis progresses enough surgery may even be required to replace the compartments left behind by the first surgery. However, the hardware exists to convert your partial knee replacement easily into a total knee replacement. In addition, partial knee replacements have the longest implant survival reported in joint replacement; the FDA now permits Smith and Nephew to advertise their partial knee replacement hardware as having a 35 year lifespan.
With a longer implant life, less pain, and quicker recovery it’s no wonder people like their partial knee replacements more consistently than their totals. With robotic assistance and muscle sparing techniques partial knee replacement is likely to be the best solution for more and more patients as time goes by.