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Author Topic: Partial Knee Replacement vs Osteotomy?  (Read 10876 times)

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Offline RedRider

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Partial Knee Replacement vs Osteotomy?
« on: June 15, 2011, 05:26:10 PM »
Hi all,

I have a full thickness cartilage tear (approx 1cm) on the lateral side of my knee.  It's painful, but somewhat tolerable.  I've had problems with this knee since I was 14 when I had a meniscal repair.   16 years and 2 more surgeries later I have no more lateral meniscus and a good amount of arthritis in that compartment.  I'm an active 30 year old and I understand Osteotomy is a better option for younger, more active people, but at this point my days of high impact activity are over. Can someone please convince me why a PKR would not be advantageous over a osteotomy?  It sound like my knee would be more stable, balanced have a better outcome with a PKR.  What am I missing here?

Thank you in advance!


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Re: Partial Knee Replacement vs Osteotomy?
« Reply #1 on: June 15, 2011, 05:56:40 PM »
I'm in a similar position to you except I'm 53 years old.
I lead a very active lifestyle and was given the option of a HTO or PKR.
I spent alot of time reading articles on various web sites and ended up using this one because your 'talking' to people who have been there!
If you look in the Arthritis section, there's a blog for Osteotomies etc..
You will find a number of people have asked the same question as you, including myself.
I also looked at peoples post-op diaries to give myself a better understanding of what the recovery was like.

For me there was only one choice, a HTO, as I was told that I could eventually return to high impact sports such as skiing and soccer.
There were too many disadvantages with a PKR. Your losing your own bones and after that there's no going back.
If your young and active, the PKR will wear out quickly and then your left with a TKR.
What happens when the TKR wears out???
I'm based in the UK and my OS would not recommend a PKR to anyone under 60.

My HTO is booked in for 2nd August and I intend to keep a post-op diary.

Good luck in your choice.


Offline RedRider

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Re: Partial Knee Replacement vs Osteotomy?
« Reply #2 on: June 15, 2011, 07:49:49 PM »
Thanks for the reply Mike, its nice to see i'm not alone in my precidacment.  I've been browsing this forum lately and its been answering a lot of questions for me.  I look forward to reading about your recovery.

Offline npw171264

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Re: Partial Knee Replacement vs Osteotomy?
« Reply #3 on: July 19, 2011, 04:46:39 PM »
Hi Guys, I have similar issues, had 5 ops on left knee since 15, microfracture last year failed. I was told couldnt have PKR due to damaged ligaments, and would need full knee replacement. 

However recently changed surgeons and he has told me i can have a high tibia closed wedge osteotomy.

I am confused here because would ligament damage not be a problem with this operation.

Offline RedRider

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Re: Partial Knee Replacement vs Osteotomy?
« Reply #4 on: December 17, 2013, 08:09:23 PM »
A long awaited update......

Went into the doctor last week and informed him of the considerable pain in the lateral region of my right knee.  Basically, he said that osteotomies are a thing of the past, and joint replacement technology has advanced enough so that it can provide significantly better outcomes.  He said my cartilage is dwindling down to nothing and my best option would be a bicompartmental knee replacement.  He uses DJO global hardware for the lateral side and Arthrosurface for the patellar resurfacing so I'd love to get feedback from anyone with experience with that particular hardware.

I'll keep posted of my progress, I'm currently fishing around for a second opinion.

Offline FMRCathelete

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Re: Partial Knee Replacement vs Osteotomy?
« Reply #5 on: December 17, 2013, 11:05:28 PM »
RedRider -Are you in the US or UK?  Just asking as I was recently made aware of a newer less invasive procedure that I wish I had known about before I had PKR at 37.  Here is a link to video -it is actually being perfromed an an OS!

Good luck.
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Offline dm

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Re: Partial Knee Replacement vs Osteotomy?
« Reply #6 on: December 20, 2013, 04:53:03 AM »
there's another thread going on with several people having issues with arthrosurface parts, FYI.

I'm just shy of 42, have bicompartmental damage, that's grade 3/4, and the beginnings of lateral issues, just had first lateral partial meniscus removal in 2010. As a result of having 2 compartments trashed, I'm told PKR is out, that HTO not advisable for patients who have patellofemoral compartment issues - like kneecap tracking already screwed up - and with me also now having the beginnings of issues to the other side... the recommendation for me is TKR when I can't live with this anymore.

Felt like something broke loose in the knee last week, so gonna pursue a new mri after the first of the year once deductibles on insurance reset... and see what it says broke, since I have a new lump and painful spot, plus having issues straightening my knee now as well as weight bearing. SUCKS! :( If they gotta go back in cuz something broke, they might as well be prepared to do the TKR, no point in doing another MFX, for the same recovery time, might as well spend it getting back on my feet instead of sitting on my rump!
multiple arthroscopies 2/00,3/01,6/01,1/03, 12/07,10/10. chondromalacia, severe medial joint space narrowing following 3 partial menisectomies, chronic pain problems, kneecap problems, OCD lesion, failed mfx.