Ask the Sports Doc: Needing a new knee
Published 9:06 pm Friday, July 31, 2009
A question from a patient WG: What is a knee resurfacing? I have heard that on the radio and wanted to know if that is any different than a knee replacement. How do I know if I am a candidate for a partial knee replacement versus a total knee replacement?
Dr. Patel: Let me begin by saying a knee resurfacing is the same as joint arthroplasty, which is in essence joint replacement surgery. Lately, I have heard more marketing about a knee replacement which replaces two of the three joints in the knee (Bicompartmental).
I am not a fan of this bicompartmental knee replacement. First, there are no long term results on how the durability and revision rates on it. Also, my philosophy is if you are replacing two of the three, why not replace all three?
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With newer materials in the total knee, patients can expect at least 15-20 years longevity of a total knee replacement. A bicompartmental knee does not have a track record for that long. I think a partial knee (unicompartmental) replacement does have merit, but patient selection is critical for success.
There are several factors which can make a total or a partial knee last a long time. Obesity can increase the wear rate on a total knee. The type of components used can also vary; this can also vary how long the implants last.
I use a rotating platform knee. This type of knee bends and rotates, allowing for less contact stress in the implants.
Surgeon technique can also vary, affecting rehab and longevity of the total knee. All my patients have a muscle sparing approach incision; this exposure allows the majority of my patients to be weaned off of any assistive devices within two weeks after surgery.