Difference between a partial knee replacement and total knee replacement?

Should you be getting a partial or a total knee replacement surgery? It really depends on how bad the knee arthritis is in your knee joint and the skill of your surgeon. You need to be a good candidate for partial knee replacements. And the surgeon needs to be well trained in doing them because not all surgeons know how to do partial knee replacements or are confident in doing them, if they do know how to do them.

Total knee replacements, where the entire surfaces of both bones are replaced, that’s the most common knee surgery. What they’ll do is they’ll shave off the ends of the thigh bone right here, here’s the thigh bone, here’s the kneecap and the shin bone.

Those make up the knee joints, they’ll shave off the ends of the thigh bone right here. And then they’ll shave off the top ends of the shin bone, and replace both of those surfaces with artificial metal parts.

And then in between the two surfaces will put a big plastic chunk that replaces your meniscus, they usually replace the backside of the kneecap right here, they’ll shave the back of it off and put some plastic part on there that interfaces with the middle parts and the end of the thigh bone. That’s a total knee replacement.

Now of partial knee replacement is when they only replaced one half of the joint. Now there’s three compartments in a knee, there’s what they call the medial compartment, which is on the inside part of the knee, the lateral compartment on the outside part of the knee. And then the where the kneecap touches the thigh bone right here.

 So the patella femoral compartment. And that’s another part of the joints, they can replace all three. But the most common partial knee replacement done like  90%+ is the medial compartment, they call this a unicompartmental knee replacement. So they’ll shave off the end of the bone right here on the thigh bone, this knobby part right here, then they’ll shave off the top part of the shin bone right here, put metal parts on both of those, and then a plastic part that only fits between the two metal parts on one side of the joint.

In order to have this type of surgery to be a good candidate, you have to only have knee arthritis on one side of the joint, and then the other side has to be okay. Now usually the people that have this kind of situation are very bow legged. And they’ll do a surgery to kind of correct the bow leggedness while replacing only the inside part of the knee joint.

Now, let me tell about the benefits of a total knee replacements. The main ones are that most knee surgeons that do read knee replacements, know total knee replacements very well. So you’re going to be more successful in having a good outcome because of the surgeon if you get a total knee replacement, because that’s the main thing that they’ve trained on when it comes to knee replacements.

Also another benefit is that the tools, the tools that are used to do the cutting to do the measuring to do the alignment, all the different components that go into the surgery, there’s much more tools for a total knee replacement than partial knee replacements because those just aren’t as commonly done.

Now some surgeons out there think that if you have any joint arthritis in your knee, it is better to just replace the whole thing because what they tend to see is people eventually get it on the other side. So their mindset is you might as well just have one surgery, because if you have a partial knee replacement, then eventually they think that you’re going to get on the other side. And so you’re going to have to go through another surgery later on.

So their argument is, why not just do one surgery instead of two surgeries ,that revision surgery. However, there’s something you need to know about, I’m going to tell you about muscle imbalances and how you might benefit from only having a partial knee replacement. If you’re aware of these muscle imbalances, this is something that surgeons aren’t aware of. Let me tell you the benefits of a partial knee replacement surgery.

The recovery time tends to be quicker, not always. But because it’s a little bit less invasive, it’s still quite an invasive surgery, they’re replacing your joints, they aren’t cutting off the entire ends of the bone. So you technically have less healing to do, the incision tends to be a little bit smaller as well. And people tend to have better range of motion in their knee afterwards, compared to a total knee replacement surgery.

And then in the event that you do need to have another surgery later on a revision like maybe you need to upgrade to a total knee replacement, you still have a lot of bone leftover for them to be able to do the full the total knee replacement surgery if you have to go back to that. Now a downside to the partial knee replacement like I said, there’s less tools available.

So you have to kind of search and find the right doctor that does these I would look for a doctor that does 20, 30 or more a year partial knee replacements because if they’re doing five or 10, anything in that range.

Then they’re probably not as experienced with doing the partial knee replacements and you’re probably signing up to be a guinea pig of theirs to get so that they can get better at it and if you’re okay with that then that’s you but I don’t know if I was getting a partial replacement I would want it done by an expert so I would go find the guy that does them all the time.

It’s a bit more of an art to do the partial knee replacement because there aren’t tools available. So you need somebody who is experienced in knowing how much to cut off what kind of alignments to do, because the tools just aren’t there compared to a total knee replacement. Let me tell you about muscle imbalances and knee replacements.

Something that surgeons and even physical therapists aren’t trained to identify and treat is a muscle imbalance. The way this works is in your knee, in your leg, you have muscles on the front of your thigh called the quads, muscles in the back of your thigh called a hamstrings, and you have the calf muscles down here and up at the hip you have the glute muscles on the back and the hip flexors in the front.

When you have an imbalance, the most common imbalances that the quad muscles are much too strong relative to the other muscles in the area. And it causes a lot of pressure to build up at the knee joints, the hamstrings can be involved in this and getting too strong as well. And that’ll pull the knee joint together too much and cause a lot of compression.

Even in somebody that has had a knee replacement already, this imbalance can be there, the surgery doesn’t fix it, whether it’s a partial or a total knee replacement, that does not fix the imbalance. So you can still have chronic pain even after having a knee replacement. This is why the revisions are done for people that have partial knee replacements.

But now leading up to a knee replacement, you probably had knee osteoarthritis. And the root problem of knee osteoarthritis is often this imbalance that causes excessive pressure. So it stands to reason that if you never address the muscle imbalance going into a knee replacement surgery, whether it was a partial or a total, you probably still have that muscle imbalance.

And it’s imperative, it’s so important for you to treat that muscle imbalance so that you can have the normal pressures that the knee joint is supposed to have in your knee. Because then you set yourself up to have as little or no pain as possible. Not many healthcare professionals will tell you about muscle imbalances.

They may mention it but not really know how to identify it or treat it. I talk about it at length on this channel here and I’ve linked some playlists and programs that we offer down in the description below on this video.

Go check them out there’s one called the Knee Arthritis Recovery Program and the other one called the Failed Knee Replacement Recovery Program. And then we’ve got playlist of videos that we have on YouTube called the Knee Arthritis Help playlist and the Failed Knee Replacement Help playlist as well go check those out.

And please share this with a friend that you know that suffering with knee problems so they might learn about muscle imbalances. And then also give us a thumbs up and share our videos subscribe to this channel and turn on our notification bell so that you don’t miss out on any of the helpful videos that we post each and every week. Thanks so much for watching. I’ll see you in the next video. Bye bye!