Knee Replacement Options

Total Knee Replacement TKR

This is performed to treat arthritis when it affects more than one compartment. I will aim for kinematic alignment, and resurface the patella as part of this procedure.

Partial Knee Replacement UKR

This is performed to osteoarthritis of a single compartment only. Most commonly this is a medial UKR, but can also be either a patellofemoral joint replacement or lateral UKR.

Knee replacement surgery is used to treat end stage osteoarthritis of the knee joint, when there is 'bone on bone' disease and all other treatment options have failed. The joint is resurfaced to replace the damaged cartilage, with the aim of relieving pain and improving function.

TKR is indicated in cases of end-stage arthritis, where non-operative methods fail to provide adequate symptom control. It is primarily a pain relieving procedure.

The knee is a fascinatingly complex joint that facilitates weight bearing through three separate compartments - medial, lateral, and patello-femoral. Total knee replacement (TKR) surgery is indicated when you have bone on bone arthritis affecting more than one compartment.

TKR is an option when all other treatment options for osteoarthritis have failed. These include non-operative measures such as weight reduction and lifestyle modification, physiotherapy exercises (including Pilates), use of braces/walking aids, analgesia, and injectable agents. It aims to improve your sleep quality, and get you back to performing day to day activities without pain.

Before, and crucially after, your surgery it is vital that you engage with physiotherapy to optimise your outcome. It is important you have good muscle control and work hard to optimise your range of movement.

Total Knee Replacement (TKR)

Surgery is performed under either a general or spinal anaesthetic, combined with local anaesthetic nerve blocks. The procedure is around an hour long and is commonly done as a daycase procedure. Following surgery you will need to use crutches for around 6 weeks, and it takes roughly 6 months to fully recover from the operation.

No knee replacement will ever be as good as a well functioning native knee with intact articular cartilage, meniscus, and ligaments. To try and improve outcomes following TKR I use modern personalised kinematic alignment philosophy. This aims to restore your individual native knee alignment and anatomy, with limited soft tissue releases, to lead to improved kinematics and a more natural knee function.

Personalised Knee Replacement Philosophy

If you have osteoarthritis affecting only one compartment of your knee you may be a suitable candidate for a partial knee replacement. The benefits of a partial knee replacement are that it only resurfaces the damaged bone, leaving intact well functioning cartilage and ligaments. This leads to an operation that is generally shorter, with a quicker recovery time. It has a lower complication profile and is an overall safer procedure than a total knee replacement. The potential downside of the procedure is that you can wear out the remaining parts of the knee that haven't been replaced, so there is a slightly higher revision rate with this operation.

I perform around 40% of my knee replacements as UKR. Most commonly osteoarthritis affects the medial (inside) part of your knee, and this is my most common UKR procedure. I also deal with a large number of patients with anterior knee pain, often due to patellar instability, and regularly perform isolated patellofemoral joint replacements. Less frequently, in the case of isolated lateral compartment disease affecting the outside of your knee, I perform lateral UKR.

UKR is performed for disease confined to a single compartment only. It preserves native ligaments and cartilage to optimise function and recovery following surgery.

Partial Knee Replacement (UKR)

Surgery is performed under either a general or spinal anaesthetic, combined with local anaesthetic nerve blocks. The procedure is around an hour long and is often done as a daycase procedure. Following surgery you will need to use crutches for around 3-4 weeks, and it takes roughly 2-3 months to fully recover from the operation.

With an isolated patellofemoral joint (PFJ) replacement I create a new groove on the end of the femur and replace the undersurface of your patella. It is designed to treated isolated PFJ osteoarthritis. This is commonly seen in patients with a history of patella instability. The implants will hopefully reduce pain and provide sufficient stability, but there may be a need to do a formal ligament reconstruction (MPFL) or move the position of the patella (tibial tubercle osteotomy) in order to optimise patellar tracking and stability of the joint replacement.

Patellofemoral Joint (PFJ) Replacement

info@ahearnknee.co.uk

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