Total or Partial Knee Replacement?

That is how I feel about the guy that did my knee surgery. I don't think he leveled with me on how many PTK's he had done because the day of that surgery after they had put me under, a hole was found in the sterilized instruments. They kept me under for an additional hour so the instruments could be reserialized as, get this, it was the ONLY SET they had!!! This the surgeon told H, but only after PTK was done.

He ignored my complaints about the pain and pins and needles, not sleeping exception snatches because if my let touched something I would have excruciating pain.
H. said the same thing. Guy was in it for money. It was during covid times and his surgeries were probably down.

I've had 5 joint replacement and the only one that failed was a partial shoulder replacement at age 52. That put me on total disability. He was not a good surgeon apparently. Another surgeon redid it as a total replacement. After this experience; I woud never have a partial. What are the advantages of a partial vs. total knee replacement other than recovery time? I had a total knee replacement in 1999 and it is still great! Pick the best surgeon and you'll get the best result. Wishing you a great surgery and new knee! ☮️

@wishingwell in my opinion, the advantage of a partial over the total knee is that one can keep their ligaments, if they are good. My ACL and PCL were fine, along with the MCL and therefore they did not need to be replaced. I felt that keeping as much of the original equipment would benefit me, just my analysis.

@shark

But there is a total knee replacement alternative that meets your desire to retain your ligaments. I had a similar desire and my surgeon does bicruciate retaining implants ("BCR") which support and retain the ACL and PCL in a total replacement.

My surgeon did a mini midvastus method, did a right knee BCR using the CORI/Journey II XR procedure, did not (thankfully) use a tourniquet, and did a Functional alignment to repair my severe misalignment. I had zero post surgical pain. My surgeon's recovery protocol is and has been for some time to be a couch potato for the first week, begin some activities around the house in the second week, and then commence PT in the third week. I followed his protocol and in that third week my PT measured my ROM at 122. I was driving after the first week (I felt like I could drive earlier but waited to be cleared by my surgeon's PA). Before my surgery I challenged my surgeon to get me back on the golf course by the end of four weeks. He said that was aggressive but he accepted the challenge. On the 27th day after my surgery I was playing golf. I am, incidentally, an 80 YO male.

I am not saying that one should automatically do a full if a partial is a reasonable alternative. My surgeon does do partials and checked to see if it was an alternative for me and it was not. I just wanted to let you know that there is an alternative in the total knee replacement world that retains your ACL and PCL in the hands of a skilled and experienced surgeon.

My surgeon refers to a patellafemoral replacement as a PKR…I am having this done post patella fracture as my patella does not track properly and arthritis is extreme behind the patella.

What is everyone referring to in this thread when they use PKR as a procedure?

I had a partial knee replacement (Medial component ) on both my knees that gave me relief for about 10 years then had to have a total as the other components became bone on bone - partial was easier recovery - total more extended but I did well - the surgeon who did the total uses a minimally invasive procedure where quadriceps and tender are moved aside instead of cut - scar about 4 " long -

@dig2dye2 PKR = Partial Knee Replacement For the purposes of this discussion there are 3 major compartments of the knee: lateral, medial and patellafemoral. Each compartment can develop problems like arthritis which can lead to erosion of the articulating bone surfaces. Many persons have arthritis in several compartments and a TKR (total) is deemed the best way to fix it. If the problem is limited to mostly one compartment, certain surgeons offer a PKR (partial.) The nice thing about a partial is that less "destruction" of your "old" knee is needed in order to "fix" it. Generally you can keep the bone intact from the unaffected compartments along with the supporting ligaments. PKRs are not really new (like some persons believe) they have been around for decades but so much improvement in technique has come about that, when appropriate, they are MUCH more likely to result in good outcomes, over the years, than before. In your surgical case, it sounds like your surgeon is looking to replace the back side of your patella and the front side of your femur (thighbone) with implants while essentially leaving the medial and lateral sides of your knee intact. In my case, the medial side of my knee was bone on bone while my lateral side and and patellafemoral compartment although somewhat arthritic, were not needing replacement. I am nearly 69 years old and I have returned to sprinting and throwing (track & field.) In the very exciting case of Olympic Champion Lindsey Vonn, her lateral compartment was destroyed and her surgeon replaced that side appropriately (PKR.) Now, only several years after the surgery, Lindsey has RETURNED TO COMPETITION and has qualified for the Olympics again! Although her surgeon was not advocating it, it is what Ms Vonn wanted and she is proving that there is a way. This is uncharted territory but it sure gives hope to folks who want to return to some kind of "action." One of the biggest improvements in PKR is the use of CT scans to computer model the diseased tissue, its removal and replacement with metal and plastic components. What used to be done "freehand" can now be implemented using sophisticated measurements derived from state-of-the-art imaging machinery, all employed by skillful hands of an experienced surgeon. Advancing age & arthritis is not a death sentence. Good luck to you and to all in our efforts to repair our bodies and return to our favorite activities!

@healthtalk
Today the leg is week and I can't depend on it due to all the nerve damage which I have been told they can do nothing about. Even now, almost 5 yrs. later I can feel pins and needles, pain, etc. from my knee down to my ankle and sometimes foot. Even with exercise I can't depend on the leg, the TKR done later may have helped the knee but not the damage the bad surgeon did to me.

Sadly, as my follow up after surgery visits with him I got the STRONG feeling that he didn't care about my pain, not being able to touch the leg, not being able to sleep, etc. He was always wanting to do the other knee.

My other knee needs surgery but it will be a cold day in hades after my last experience because I am scared.

@cboden51

RE my partial knee replacement. I was 75 when he did it and I know understand that at that age it is better to do a whole TKR due to age, future surgery, recovery etc.
The surgeon I had, I found out later, had put a hip replacement in a patient wrong and made him a cripple! Evidently that is why he left that area and bought into the practice down here in a different state.

@sueinmn

Sue - I agree with you about physical surgery. The jerk I had do both surgeries would not approve anything more than the post-surgery physical surgery. In fact, when I was struggling in Jan., at a follow up visit after the TKR in late April and specifically asked for more therapy to help me, he REFUSED saying he would hold off on any more therapy UNTIL he did my other knee!!! No kidding. And, yes, I pushed for it.

THAT was the last time I ever had anything to do with him and his office. This Doc was strange. Earlier, before I even had the first surgery they had me consult this Doctor and I wanted to think about it. I saw the PN for the pain and he gave me a prescription for a pain cream to use on knee - it was about $75.00 after insurance. I had the prescription filled the same day I got it. The next day I got a call from the OFFICE MANAGER, not a nurse, telling me NOT to use the prescription. When I inquired why not, she couldn't give me an answer just that I was not to use it. Of course that lead me to consider the surgery etc. Strange.