Q: Am I a candidate for Unicompartmental Knee Replacement ?
You are a candidate for Unicompartmental Knee Replacement
if you have severe pain in your knee in a localized area. This would refer to either the medial (inner) or lateral (outer) aspect of the knee. Additionally, patients who are candidates for this procedure have either normal or very early abnormalities in the other parts of the knee. Patients with severe deformities of the knee are not good candidates for this procedure due to the limited ability to correct such deformities with UKA. Most patients go through a relatively extensive course of nonsurgical treatment such as anti-inflammatory medications, Chondroitin Sulfate and Glucosamine, physical therapy, exercise, injections, and occasionally bracing prior to being considered for UKA.
Q: What are the results of Unicompartmental Knee Replacement?
Unicompartmental Knee Replacement has acheived very good results in many patients. The keys to success are appropriate patient selection and proper surgical technique. The procedure is contraindicated in patients with disease in multiple knee compartments, severe deformities, and ligamentous instability.
Q: How long will I be in the hospital?
Most patients who have a first time knee replacement spend around 2 days in the hospital. The goals of the hospital stay are to work on achieving independence and good pain control with oral medications.
Q: Will I need further surgery in the future?
In the younger patient with arthritis involving just one compartment, there may be microscopic and biological changes in the cartilage in the other parts of the knee. These may not be clinically significant at the time of presentation. However, in the future, in spite of an appropriate partial knee replacement, the other parts of the knee can wear out. This would require a conversion of the partial knee replacement to a total knee replacement. Modern UKA procedures focus on minimizing how much bone is removed during the initial operation to allow relatively straightforward conversion to total knee replacement.
Q: What other options do I have?
The main alternative to UKA for the treatment of Unicompartmental Knee
Arthritis is some form of bony realignment. This would consist of a high tibial osteotomy for medial arthritis and a distal femoral osteotomy for lateral arthritis. In comparative trials, there have been more complications with osteotomies that with UKA procedures. However, in the very young patient, osteotomy may be a better option. Additionally, osteotomy can be combined with fresh osteochondral allografting if there is severe cartilage damage.
Q: When can I drive?
Most patients can drive after about 2-3 weeks. It is extremely important to be aware of one's limitations in this area. You must have full voluntary control of your legs in order to be safe. Most of our patients who are getting back to driving practice in an empty parking lot prior to actually driving on the street.
Q: When can I go back to work?
This depends to a great degree on how physically demanding your work is. Most patients can do office type work within 2 weeks. Patients who are heavy laborers should remain out of work for a minimum of 8 weeks.
Q: How long will I have to be on Walking aid?
You may require a walking aid for not more than 15 days. Generally most patients undergoing Partial Knee Replacement get rid of the walking aid by 5 to 6 days.
Q: Will I be able to climb stairs?
The majority of patients are able to climb stairs after unicompartmental knee replacement. Certain factors such as profound muscle weakness, post-surgical stiffness, and morbid obesity may limit this ability.
Q: Will I be able to kneel on my knee?
Since the kneecap is not replaced, almost all patients can kneel on their knee after Unicompartmental Knee Replacement.
Q: Can I get back into sports?
There is no limitation to sports activities after UKA. Some patients may have some degree of persistent pain in the knee. The higher degree of activity may lead to accelerated wear of the Unicompartmental Knee Replacement implants.