KNEE ARTHRITIS - Unicompartmental knee replacement :
partial knee replacement - - Posted by c.heifner (c.heifner), 11 November 2002
My Dr. has advised me that I am a good candidate for a partial knee replacement. Has anyone had this procedure done? When? What kind of results?
Thanks,
Carol
Posted by burbn8r (Audrey), 12 November 2002
Carol,
The knee is made up of 3 compartments, the medial compartment, the lateral compartment, and the patellofemoral compartment. You did not specify which compartment of your knee your doctor intends to replace. I have had a patellofemoral joint replacement. If this is the procedure that you are seeking information on let me know.
Audrey
Posted by c.heifner (c.heifner), 12 November 2002
It is the medial compartment of the knee so probably not related but thanks anyway.
Carol
Posted by burbn8r (Audrey), 12 November 2002
Carol,
What you need done is referred to as a unicompartmental knee rplc. Try doing a google search with that as your subject, there is a lot of information out there about it.
Audrey
Posted by c.heifner (c.heifner), 12 November 2002
Thanks for the suggestion, Audrey. I have already done that & did find a lot of info. Just wanted to talk to a "live" patient but that isn't always a good way to go either since everyone is so different.
I have already had an HTO on the right knee which I have had good results with. Just don't want to go that route again.
I do not handle being laid up well as I am so active so that's why I like the idea of a partial.
Good luck with your paetella.... partial. Hope you are healing well.
Carol
Posted by allens (allens), 17 November 2002
hi,
I had a unicompartmental done on1-6-02, I would recomend it to anyone. I spent 1 day and night in hospital, very painless. Went home on the 7th. stopped using my crutches on sunday , I went back to work [driving myself ] for half days last week!. the swelling is minamal, not much pain or aggrivation. today I worked in the yard minamal. I have 110 degrees in motion already. Also I am walking great not much limping, I'm real happy!!!! Considering that I had a failed Unispacer done on August 29 and removed and replaced with the unicompartmental.
Posted by c.heifner (c.heifner), 18 November 2002
Hey, that is great news! Your message said you had it done 1-6-02. Did you mean 11-6-02? I will see Dr. in Denver this Thurs (11-21-02) to get the (hopefully) final okay.
May I ask how old you are? What did your Dr. tell you to expect as far as longevity of this partial replacement? Any restrictions?
I am so happy for you. Sounds like you have a great attitude too. Really helps!
Posted by Irene (Irene), 8 January 2003
Dear Carol I had Bil. oxf. knees done on dec. 2/02. I'm doing well. ROM is 125 degrees , still some stiffness in both knees. Ambulating well- one cane when I'm outdoors. Still not driving .My OS told me 6 weeks . Coming up soon. P.T. very important . Exercise at home also vital. It's hard work . So far I feel it's been worth it. Irene.
Posted by c.heifner (c.heifner), 8 January 2003
Irene,
Thanks for your comments. I did have a partial knee replacement done on 12/5/02. It is a little over 4 weeks now & I am doing super. ROM 125, no pain meds, & no cane. I quit using a crutch at 3weeks. Starting to try & build up my strength now.
I did not understand exactly what you had done but it sounds like you are doing great. Good luck.
Carol
Posted by Irene (Irene), 9 January 2003
Dear Carol I had a partial knee replacement in both my Knees at the same time. You had surgery 2 days after me. Pain free - I'm waiting for that . Does your knee feel stiff on getting up from a chair? Thank you for your speedy reply. Irene.
Posted by c.heifner (c.heifner), 10 January 2003
Irene,
I can't say I am totally pain free. Tonight it is pretty sore but about 3 days ago I was using a "rubber band" & pushing down on it for strengthening & for some reason it really irritated it. Not too worried about it. Anyway the point is that if I do occassionally need pain med I just take some Tylenol. But it definetly isn't totally pain free so don't feel you're not doing as well. I still feel like I have a very slight limp.
Hope that helps make it clearer.
Carol
Posted by Ann (Ann), 12 January 2003
Just discovered this thread and have more questions for
those of you with some actual experience with uni replacement.
I am an avid tennis player. Is it realistic to think that you
could play competitive sports with a uni? Are any of you
involved in athletics? Was the topic of post op sport ever
discussed with your respective drs.?
I have very little pain in the real world. My problem is that
I can't run, push off, do anything ballistic on the tennis court.
The medial arthritis has put my quads to sleep despite
deligent rehab (post meniscectomy) for months and months.
Sport has always been a huge part of my life. I no longer jog but I want to hang on to tennis. To non-athletes I'm sure it may sound foolish to risk surgery when I have a functioning
civilian knee.
I welcome any perspective.
Posted by burbn8r (Audrey), 12 January 2003
Ann,
You are right. It does sound foolish that you would risk surgery when as you said you have very little pain in the real world. To be honest if you are only limitations are that you can no longer participate in extremely demanding physical activity I do not know if a surgeon would even consider you a surgical candidate. In all likelihood I think non-surgical options such as PT, bracing, and perhaps injections would be tried first.
Return to sport following any surgery largely depends on the condition of you knee going in. In the majority of cases a partial knee rplc is done as a salvage procedure to buy younger patients time before a total rplc becomes necessary. The components utilized in a PKR are not meant to last as long as those used in a TKR. Knee replacements in general were/are not made for younger active people. You will find that older patients fare better with any sort of joint replacement because they are less active and therefore there is less stress in their new joint.
I realize sports is a big part of your life but I think you need to look at the bigger picture. You need to ask yourself if you would rather have 5 more years on the tennis court or 10 or more years of walking relatively painfree. Nothing comes with a guarantee, with any surgery there are risks. I have been through 3 surgeries in the last 2 years, that last being a partial knee rplc. Mine was not the unispacer but a patellofemoral joint rplc, better explained as 80% of a total knee rplc. Each surgery I had was supposed to improve my mobility. I still need a cane or crutches to walk short distances and a wheelchair for long ones. I am 37.
I guess what I am trying to say is that before you consider surgery you need to look more at what you have to lose rather than what you have to gain.
Audrey
Posted by Ann (Ann), 12 January 2003
Audrey,
Thanks for such a thoughtful answer. You are, of course,
right. The risk/reward ratio is exactly as you described.
By the way, I am not a young person; I'm close to 60
but have continued to play competive sports all of my life.
I am, however, aware that the longevity of the PKR is
about 10 years.
I appreciate the wisdom of your answer.
Posted by Irene (Irene), 12 January 2003
Dear Ann. I am 62 and I certainly not as athletic as you are. From what I understand you should only do low impact activities such as walking, cycling, swimming, and aquatics. One should avoid twisting your knee, jumping, and forced movements. It is best that you contact our O.S. I had my surgery because of pain on walking, climbing stairs, and night time discomfort. I was told that with care and exercise this surgery should last a lifetime- here's hoping. Irene.
Posted by c.heifner (c.heifner), 13 January 2003
HI Ann, Irene, & Audrey,
I am 60 & although I don't play any sports such as tennis due to the pain factor before my PKR 5 weeks ago my Dr. told me that I will be able to play doubles tennis. keep in mind that the more hard wear you put on your knee the more quickly the replament material will wear out .
I am thrilled that I will be able to hike, ride bikes & garden. I don't think I will try doubles just b/c I want to get as much use as I can from this knee. Being an "A" type personality I tend to overdo anyway.
Carol
Posted by burbn8r (Audrey), 14 January 2003
Carol,
I too was advised that I could play doubles tennis post-op. That statement is based on post-op protocol rather than on an individual case basis. My surgeon told me his goal was to keep me walking prior to my surgery so I am sure when he read what I would and wouldn't be able to do following surgery he didn't really believe that I would be playing tennis. As it is I am still barely walking. So much for wishful thinking.
Audrey
Posted by c.heifner (c.heifner), 15 January 2003
Audrey,
I feel badly as I am coming up on 6 weeks post op& am walking normally with little pain now. I have lost some rehab time due to flu/bronchitis episode. One thing in my favor is I do not have a weight problem (5'4" 125lbs) & remember I only had 1 knee done. it sounds like you are doing everything right. Give it time & try to measure the small accomplishments.
Carol
Posted by burbn8r (Audrey), 15 January 2003
Carol,
I take it personally that you seem to imply that I must have a weight problem since my surgery was not a success. A successful surgical outcome is more dependent on the condition of your knee going in, something I did not have in my favor. I have had 4 open surgeries on my right knee, the first being when I was only 18. My left knee is in bad shape as well but unfortunately my right knee will never be strong enough for me to even consider surgical options.
Do not feel badly that you are doing so well, consider yourself lucky. A friend of mine had her surgeon tell her that a successful surgical outcome comes from 2% surgical skill and the rest plain luck. Add to it a knee that is basically beyond repair pre-op and you wind up in my shoes.
Audrey
Posted by Ann (Ann), 15 January 2003
Audrey,
Your last post really got to me; I sense your utter
frustration. You have educated yourself about
knee issues and the advice you gave to me was
extremely helpful. Nevertheless, it is clear that
having a bad knee makes unwelcomed and drastic
changes in our lives.
I wish I had some meaningful words to return to
you and to lift your spirits. I don't think any of
us can escape the periods of depression that
we all experience. Feeling lousey most of the time
has a way of using up all of our limited supply of
Good Attitude Bullets. The thing to do is to focus on
all the things we can do rather than all of the things we can't do.
I see people in rehab that make me ashamed of feeling sorry for myself.
So, hang in there. You aren't alone.
Posted by burbn8r (Audrey), 15 January 2003
Ann,
You are right, I am frustrated. I think one of the things that frustrates me most is peoples attitudes towards me. Everyone seems to think they are an amatuer OS. People assume that I must have caused my knee problems or that I did not work hard enough in rehab. I actually asked my OS if there was something I did wrong or if there was anything else I could have done to make my surgery work and he assured me I did everything I could, that my knee has just been through too much. I am constantly informed that someones mom, grandmother, aunt, etc had a total knee rplc and they recovered quickly and are doing great. I have even had someone suggest I see a chiropractor, if you can believe that.
I am currently seeing a pain management specialist in the hopes of getting the pain to a manageable level. I have 2 small children so regardless of the pain I am in I have to keep going. While I do as much as I can with them there is so much I will never be able to do and that it mentally tough. I know there are people worse off than I am but you know, there are a lot of people that are better off that take what they have for granted.
The number of people that illegally use the handicapped parking spaces because they are too lazy to walk appalls me. People are actually envious of the fact I have handicapped parking priveledges are that makes me sick. I would give anything to be able to park far away and enjoy a nice walk.
I will try to hang in there but some days that is easier said than done.
Audrey
Posted by Irene (Irene), 15 January 2003
Dear Carol, Ann and Audrey. My heart goes out to you all. Knee problems are no fun. I think we all understand how each of us feels about our disabilities. We must keep plugging along, work hard at exercising and encourage one another. I enjoy chatting to you all.
Please keep in touch. Irene.
Posted by Ann (Ann), 16 January 2003
Audrey,
If you have a hammer in your hand everyone starts
to look like a nail. Don't use up any of your energy
in an attempt to "defend" yourself against any
real or imagined criticism from others. YOU are
not at fault regarding your knee problems.
It is, however, critical that you focus on the
real issues and not let anger take over.
At some point, a sort of informed resignation has
to kick in. No, I don't mean giving up. I mean
acceptance of our knee problems and hanging on
to realistic expectations. We eventually use up all of the options available to resolve these knee issues. When that time comes we need to accpet what is.
Of course, I hate that reality but that is the way it is.
Knee patients can become very selfish. We use up so much energy trying to fight back that there isn't much left for those that we love and those who love us.
Posted by burbn8r (Audrey), 16 January 2003
Ann,
I think perhaps you need to listen to your own advice. You said at some point an "informed resignation" must take place and that I should accept my knee problems and have realistic expectations. You posted here and asked if you would be able to play competive tennis after a PKR. Which one of us has not accepted their knee problem and has unrealistic expections, not me. I did Disney World in a wheelchair, something I never expected to do yet I did not want my children to miss out on the experience.
I have fully accepted the severity and permanence of my condition, as has my family. The house we are building is being modified to be completely wheelchair accessible because in all reality the day will come that I am completely wheelcair bound because of my knees.
My anger towards ignorant people who think they have all the answers has nothing to do with my knee problems. I have had no tolerance for them for a long time. My way of thinking is "unless you have walked in my shoes don't tell me how I should be walking."
Enough said.
Audrey
Posted by Ann (Ann), 16 January 2003
Sorry, Audrey. My message was only intended to
be helpful. Apparently it was not. I wish you
nothing but the best. Please, however, don't
boo your own cheerleaders.
Posted by Lbliny (Cari), 16 January 2003
......I think I might add something to this also....I have not had a pkr or a tkr but I had a TTT 3 years ago that fixed my knee but destroyed my life forever. !!!!!!!!! As a result of the TTT ( and 2 subsequent surgeries ) I have developed an incurable permanent nerve disease called RSD or CRPS. This stand for Reflex Sympathetic Dystrophy or know also known as Chronic Regional Pain Syndrome. It will never go away and can spread all over my body since it is a disease of the sympathetic nervous system. All the so-called cheerleaders do nothing more then patronize those of us with REAL, not imagined problems.
Although my condition is not of a surgical nature any longer, it is still disabling and life altering as others.
Cari
Posted by CTM (CTM), 23 January 2003
Audrey,
I'd like to know more about your partial joint replacement in the patellofemoral compartment. My case is too long to list but the last thing I did was bilateral TTT's 2-2 1/2 years ago.
I had inquired with the Cleveland Clinic once about partial joint replacements and was told they were not done there at all. So I'm very curious about where yours was done and how you are doing now.
Thanks
Tom Myers
Cincinnati, OH
Posted by burbn8r (Audrey), 23 January 2003
Tom,
I had a patellofemoral joint rplc in May 2002 after a failed TTT. I had grade 4 damage to the entire patella and the trochlear groove of the femur. I also have wear on the femoral condyles as well, although not as severe. My OS did the PF rplc in the hopes of buying me 5-10 years before a TKR. Unfortunately due to the number of past surgeries and the condition of my knee going in my surgery was not a success. I have a lot of soft tissue problems, the major one being my patellar tendon is shot. Even if my OS were to go in and convert my PKR to a TKR it would only address the bone damage, not my other problems.
I would be happy to answer any specific questions you may have about the surgery itself or the rehab. It might be easier if you IM me through the boards mail system.
Audrey
Posted by karenk (karenk), 22 May 2003
Allens:Could you tell me why you had your Unispacer replaced with a partial? I have a Unispacer and still am experiencing too much pain and other problems. thanks, Karen 
Posted by Sam (Sam), 19 June 2003
Ann,
I am a 52 yo avid tennis player. I have OA in both lateral compartments. No meniscii and bone on bone. Been this way since '96. I use 2 unloader braces and 4 advils when I play tennis. I look like Forrest Gump on the tennis courts. Mostly doubles, sometimes singles. The braces allow me to play longer and back to back days. They do not help with movement. My OS says there is not anything he can do for me. He is surprised I can play tennis. A unispacer would not help my mobility and I am too young for TKR. Not that it would help. He says to wait for future developments. One thing that looks promising is salucartliage. It is a manmade csrtliage. It is being used in Europe and undergoing FDA testing for USA. Web site is http://www.salumedica.com/ . I would be glad to exchange experiences and news with anybody on this forum.
Sam
Updated Thu Apr 29 2010
