Unicompartmental Knee Arthroplasty: A Patient's Guide to Partial Knee Replacement using Minimally-Invasive Surgery (MIS) Techniques.
Edited By: Seth S. Leopold, M.D.
Last updated Wednesday, December 29, 2004
About the procedureWhat are the technical details of partial knee replacement surgery for arthritis of the knee? What is actually done? Minimally-invasive partial knee replacement surgery begins by
performing a sterile preparation of the skin over the knee to prevent
infection, followed by inflation of a tourniquet to prevent blood loss
during the operation.
Next, a well-positioned small incision--approximately 3” in
length--is made alongside the kneecap, and the knee joint is inspected.
It is important at this time to confirm that the arthritis is
principally confined to one side of the knee. If there is significant
cartilage damage to the undersurface of the kneecap, or on the opposite
side of the knee, a partial knee replacement is unlikely to provide
durable pain relief. In those cases, a longer incision is then made,
and a traditional total knee replacement is performed; this change in
plans occurs in about 10 percent of patients we consider for partial
knee replacement.
This decision to convert from a mini knee to a total knee
replacement calls for good judgment and a high level of clinical
experience on the part of the surgeon. Proper patient selection is
essential for good outcomes in all types of knee surgery, but this is
especially true for the mini knee.
Next, specialized alignment rods and cutting jigs are used to remove
enough bone from the end of the femur (thigh bone) and the top of the
tibia (shin bone) to allow placement of the joint replacement implants.
Proper sizing and alignment of the implants are critical for normal
post-operative function and good pain relief. Again, these steps are
critical, and considerable experience in minimally-invasive partial
knee replacement is required in order to make sure they are done
reliably, case after case. Provisional implant components are placed,
without bone cement, to make sure they fit well against the bones and
are well aligned; at this time, good function--including full flexion
(bend), extension (straightening), and ligament balance--is verified.
Finally, the bone is cleaned using saline solution and the joint
replacement components are cemented into place using
polymethylmethacrylate bone cement. The surgical incision is closed
using stitches and staples. What is the typical anesthetic used for partial knee replacement surgery for arthritis of the knee? The mini knee may be performed under epidural, spinal, or general
anesthesia. We usually prefer epidural anesthesia, since a good
epidural can provide up to 48 hours of post-operative pain relief, and
allow faster, more comfortable progress in physical therapy.How long does partial knee replacement surgery for arthritis of the knee usually take? No two knee replacements are alike, and there is some variability in
operative times, but the average mini knee takes about 75 minutes to
perform.Surgery for arthritis of the knee at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call the Bone & Joint Surgery Center at 206-598-3354 or Eastside Specialty Clinic at 425-646-7777 to make an appointment.
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