The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Unicompartmental knee replacement => Topic started by: Ann on January 12, 2003, 12:12:53 AM

Title: unicompartmental replacement
Post by: Ann on January 12, 2003, 12:12:53 AM
I am looking for information re unicompartmental knee
replacement.  I have medial compartment arthritis
and am very active in athletics.  The OS is suggesting
this "mini" or half knee replacement.  

I had a partial meniscectomy last July (2002) and
have not been able to rebuild my quad muscles despite
hours and hours of rehab.  

The Dr. believes that I have quad inhibition, probably
caused by the arthritis in the medial compartment.

I am not enthusiastic about more surgery since the outcome of the first was a disappointment.  And, I notice on these boards that people have multiple surgeries and things don't seem to resolve.  

Any insight would be most appreciated.  I'm too down about
my diagnosis to be thinking clearly.  Sports are a huge
part of my life and I want to hang on as long as I can.

Title: Re: unicompartmental replacement
Post by: Ann on January 12, 2003, 04:07:51 PM
Thanks for taking the time to respond to my questions.
I read your reply with great care and your conclusions
certainly make sense.  You and Audrey are on the same
page and I need to get to the reality zone.  You both
have far more serious problems than I do and that
has given you the wisdom that I am lacking.

In my defense I can only say that my thinking is probably
distorted by the thought of having to abandon acitivities
that have always been such a big part of my life.  
People who are involved in athletics will understand a perspective that likely seems just plain foolish to others.

Nevertheless, I clearly understand what you and Audrey are telling me.  I also have made note of the multiple procedures you both have had.  THAT really scares me.  Throughout the forum I see that so many people have had surgery after surgery without the intended outcome.  

I absolutely have been in denial about this thing.  I want someone to say that the uni will give me back my active
life.  I probably need more time to accept the reality of my
situation.  You and Audrey have really helped in that regard.
Thank you.
Title: Re: unicompartmental replacement
Post by: jathib on January 12, 2003, 07:26:27 PM
I am missing the lateral meniscus in my knee but my medial meniscus is intact. My OS is recommending an osteotomy rather than a partial knee replacement. What he told me, and what I have read about since then is that a partial knee replacement has the same drawbacks as a total knee replacement. They are mainly recommended for older and more sedentary people. He says I am not a good candidate because I am "only" 45 and active. Partial knee replacements, like total replacements will fail in time and need revising. The more revisions you get the worse they are.

An osteotomy realigns your leg and shifts the weight to the good side of your leg. Of course if both sides of your knee are shot then you won't be a candidate. My doc told me I would be able to resume activities afterwards and could hold off a total knee replacement for another 10 years. He also said to hold off for as long as possible before going for it. I'd like to hold it off until I need a TKR but I'm not sure that will be possible.
Title: Re: unicompartmental replacement
Post by: SueLB on January 13, 2003, 08:41:59 PM
 ???I also have medial compartment arthritis. My OS gave me four options 1. Live with it, 2. Unicompartmental Replacement, 3. Osteotomy, or 4. Unispacer Procedure. Number one doesn't seem like an option any more. Osteotomy is recommended for more active lifestyle. But the procedure involves cutting of the bone. long, painful recovery time. UKR is for a more sedentary activity, no-low impact sport. The procedure requires alot of skills on the part of the OS. You may want to look into a unispacer procedure. It appears to be a less radical surgery than osteotomy or UKR. But, it is very new. It is marketed for the younger, more active individual. But, I also noticed that impact activities such as running are not advised. There is not alot of long term information on it. I haven't decided what to do yet. Anyway, good luck.
Title: Re: unicompartmental replacement
Post by: Mike on July 02, 2003, 07:56:43 AM
I have stage 4 lateral compartmental OA in both knees.  The medial compartment is intact.  However the lateral has been described as the condition of a 70 year old man.  I had rt knee scoped two weeks ago.  And condition was confirmed.  I am 41 years old and have serious concerns about Osteotomy.  Uni compartmental is another option, but I suspect I will burn thru it in less than five years.  Any comments and recommendations are appreciated.
Title: Re: unicompartmental replacement
Post by: rstand on August 20, 2003, 01:36:15 AM
I had a uni done on April 1st. I had explored all options for over 10 years. The Doctors I saw (and there were several) did not want to do a total replacement.
I started walking without pain for the first time in over 20 years in June and like Forrest Gump I havn't stopped since.
I do three miles every day at about 14 minutes per mile with noooo pain! Lost about 20 pounds and feel better than I have for 20 years. Am I a Uni believer? I sure am. Just hope it lasts a long time. If you have any questions, I will check this site from time to time and get back to you.
Title: Re: unicompartmental replacement
Post by: karenk on September 22, 2003, 11:03:07 PM
Always 2 sides to every story, sometimes 3. I had my Unispacer pulled after 11 months of pain. My body just flat rejected it. I now have a 3 wk old partial knee and it is wonderful compared to the Unispacer. I can walk and get out of a chair without pain. I have heard there is a 50% failure rate with Unispacers. Had I known that I would have skipped it and gone to the partial first. These are just tough decisions to make - make one and hope for the best - then revise it! Good luck, Karen
Title: Re: unicompartmental replacement
Post by: rstand on September 23, 2003, 03:49:31 AM
The Uni I refer to is the unicompartment not the unispacer. I explored the unispacer, but the doctor I saw at the time was very conservative an felt I was not a good candidate. The Uni (unicompartment), I had done in early April has been a success so far. Walking without pain is a blessing. The post-op and re-hab were without a problem. As I said in my prior post, I just hope it doesn't wear out from overuse, as I try to make up for lost time from several years of limited mobility.
I hope your results are as good or better than mine!!
Title: Re: unicompartmental replacement
Post by: judith on September 25, 2003, 03:14:40 PM
I have only just discovered this site but read your details with great interest as I have o.a. in both knees ...the left  being the real baddy.I have had cortisone injections which left me feeling quite comfortable but still have a feeling of instability and occasionally great pain when walking.My g.p. and consultant appear not to have heard of unicompartmental or spacer procedures and say it is something not performed in this country !!You and several others know better:I wonder if you could give me a rough idea of the area where you live or even the name of your surgeon ...I live in the Preston/Blackpool area.   regards  Judith
Title: Re: unicompartmental replacement
Post by: rstand on September 25, 2003, 09:59:45 PM
I assume from your note, you are from the UK. I am from the Boston area in the US. The company that developed my procedure only lists US doctors. There are several other companies that developed UNI devices. To read a little more about the procedure try Good luck.
Title: Re: unicompartmental replacement
Post by: Unidoc on October 03, 2003, 07:04:53 PM
Unicompartmental knee replacement (UKR or UKA) is a good option for a small subset of people with knee arthritis. The problem need to be confined to one compartment (medial or lateral - not much data on the patellofemoral joint), the knee need to be stable with functioning ligaments, and it doesn't work for inflammatory arthritis (Rheumatoid, Lupus, Psoriasis, etc). If the procedure is done properly in the right patients, it will last as long as a total knee replacement would, meaning roughly 90% last 10 years, 80% 20 years etc.
Title: Re: unicompartmental replacement
Post by: flossy72 on March 14, 2004, 11:56:55 PM
I have had 3 ACL Re-constructions in my left knee over the last 15 years and have been told that there is nothing more which can be done for this injury. But as a result i now have significant arthritis and unicompartmental knee replacement has been mentioned as a possibility to help alleviate my pain. I am only 32. I also have hyper-extension in my joints. I am unsure of the risks and also what this op entails. Can anyone advise???
Title: Re: unicompartmental replacement
Post by: rstand on March 15, 2004, 03:03:11 AM
The procedure is far less invasive than total knee replacement. In my case it meant one day in the hospital and a few weeks of recovery and physical therapy at home. I am nearly twice your age, but can say without hesitation, that if you are a candidate, the procedure works. Mine was done last April and starting in June I began a walking regimen and have been walking over three miles a day outside ever since. There has been no pain, swelling or any of the other effects you learn to live with when you have a bad knee. I wish you luck with your decision and if you have any specific questions, please post them.
Title: Re: unicompartmental replacement
Post by: mayme on March 15, 2004, 07:10:10 PM
Hello Ann,

I'm new to the website and read your post for the first time today. I believe it was written quite some time ago but I'm wondering how you are. I sure hope you've been able to have pain relief this past year and still do some activities. Are you in U.S or the U.K.? If you're in the U.S., I hope you've heard about some of the information that came out of last week's annual ortho convention. Best of luck to you.

Title: Re: unicompartmental/UniSpacer
Post by: davedoc911 on September 05, 2004, 08:59:57 AM
At our Center for Sports Orthopaedics, SC, we have had significant experience/sucesses with numerous UniSpacer's. To our knowledge, we have performed the greatest number of UniSpacer procedures in the Midwest. The UniSpacer is minimally invasive as oppossed to a partial or complete knee replacement. We have refined the procedure (and include extensive thermal synovial ablation) and believe our results speak for themselves. The indication for the procedure is really not age-related, it's knee anatomy- related. For the appropriate patients, the UniSpacer remains a very good option with regard to more invasive total (or partial) knee procedures. (The so-called overall failure rate, to the best of our knowledge is reportedly less than 5% in the hands of trained and experienced surgeons. It appears to represent a dramatic success story with less invasiveness than 2-part metal on poly total or partial (unicompartmental) replacements.
David H Trotter, MD, President and Founder
Hoffman Estates, IL
[email protected]