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Recent NICE guidance on partial knee joint replacement

Paul Haslam Knee Specialist Coriel Orthopaedic Group

As a knee surgeon I am particularly pleased that NICE have recommended patients should be offered a partial knee replacement where appropriate. It is estimated that up to 50% of knee replacements could be partial and yet only 10 % are actually performed. This means a large number of patients are having a bigger operation than necessary and never know they could have had a partial knee. The evidence suggests that the functional outcomes of Partial Knee replacement are superior to that of a Total Knee replacement. In addition to this Partial knee replacement is a less invasive procedure leading to a lower chance of developing serious medical complications post operatively. As there is less surgical insult the post-operative recovery is quicker leading to a reduced hospital stay and less pain after the operation. The operation only involves removing the damaged part of the knee and not the ligaments which are retained. This means your knee, following a successful partial replacement, feels almost normal unlike a Total Knee replacement which always feels a bit artificial. This procedure is ideal for patients who want to continue to remain active and play sports such as golf, tennis or skiing. If your pain is mainly located to one part of the joint and x-rays confirm arthritis in one part of the knee only then you may be suitable for a partial knee replacement. Your surgeon should discuss the option of a partial knee replacement with you. If you surgeon doesn’t wish to discuss partial knee replacement it may be worth asking for a second opinion.

Case example Partial knee replacement.

Mrs A presented with a 3 year history of pain in both knees. She had already had tried all non-operative treatment such as physio, painkillers and steroid injections. Mrs A gave a history of severe pain interfering with all aspects of her life with a recent deterioration leading to night pain and lack of sleep. X-rays showed severe medial compartment osteoarthritis (wear and tear in the inside part of the knee only). Following a thorough examination and discussion of the risks and benefits it was decided to proceed to surgery in the form of a medial unicompartmental knee replacement. This procedure only replaces the damaged inside part of the knee.

Mrs A had surgery earlier this year. She was in hospital for only 1 night and recovered quickly. At 2 months she was reviewed and was virtually pain free. As her knee was not keeping her awake at night anymore she was enjoying a good night’s sleep. All her normal activities such as cleaning, walking and shopping were significantly improved after the surgery.


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