Total or Partial Knee Replacement?

I would get another opinion. Pray for guidance 🙏.
I had a partial in 2021 and did very well.
I had a full on other knee in November 2024 and it was rough.

I had a PTR in 2021 that failed the first time they got me up after the surgery. My knee dislocated with leg looking like a zig zag and very painful. Nurses saw nothing wrong with me screaming in pain because the knee was dislocated. Every time I extended the leg the knee would dislocate again and it was painful, not to say the nerve damage that was occurring.

Doc kept telling me it would get in place with scar tissue, which never happened. Three months after the PTK failure he did a TKR - he waited the three months because Medicare would have considered the botched PTK something that should be fixed by him, and not pay for it. This I found out later.

Doc made a BIG point of showing me the knee x-ray was correct after 2nd operation, like I would know. Three months later I still couldn't sleep because of the damaged nerves and was having problems with balancing even though the therapist said I had gotten my range back. All this surgeon wanted to do was the other knee. It was the first thing he would ask at my follow up visits, "so, when do you want the other knee done." I could barely walk 8 months later and asked for more therapy to help me as I felt the leg was weak and strange tingly, pins, needles feeling. Jerk told me he would hold off on any additional therapy UNTIL after the other knee was done!

That was it. Went to a doc, well recommended, who told me PTK's have a high failure rate. That no one should tell me when to have surgery on the other knee. And, importantly, though the first guy got the TKR in right, there were several things that should have been done differently regarding the bone grafting.

And all that pain, not feeling my leg from the knee down, how it would hurt so bad I couldn't touch it or put it down to sleep? That was because so much nerve damage was done in the two operations the nerves never healed, and never will.

So, if I were you I would get a second opinion and probably go with the TKR.

A third doctor opinion may be warranted. Age could also be a factor. For a younger, strongly muscled person a partial may work well. For an older, more sedentary person - your cartilage and bone will continue to deteriorate due to age and arthritis, do you really want to go through a partial, only to have to do the full TKR a year or two later?

Ever since I had bilateral cartilage removal my knees were going downhill. That was 10 years ago. I went to an excellent knee surgeon and he said yes, soon, I will need TKR. I went to Mayo for a second opinion. They told me yes your knees are shot but you are a good candidate for a PKR since only the medial side was shot on both knees. My ligaments were good and the arthritis was mostly confined to the medial side. I went ahead with the PKR spaced 2 years apart. Result? Better than I expected. My left knee is 95% of what it used to be and my right knee which was only done 6 months ago is 90% and still improving. Day 3 to 5 after surgery was "hell" but then it slowly got better. Today I can barely tell that knee #1 was even operated upon because it feels like the original, and knee #2 is rapidly improving as well, it has only been about 6 months. Bottom line: it comes down to whether you are a candidate or not for the PKR. I "was" a candidate but I would not have known that if I did not seek out the 2nd opinion from Mayo. Partial knee replacement is a difficult surgery (as is a TKR) but under certain circumstances it can be a viable alternative to TKR, IMO.

It's really heartening to hear of good results, sounds like you had good advice and the best of surgeons! Thanks for the detailed and very interesting comments. It's good to hear about other options for surgery.

Everyone's situation is a bit unique, so if a person is not comfortable with a quick answer, it's best to seek additional opinions. The sad thing is that not everyone has the means to travel to be seen at the best facilities, so that leaves them with researching local surgeons as best they can, not always easy in rural and smaller towns.

I had a partial knee replacement on the inside of my left knee on 03/21/2025. I haven't made my final decision about whether it worked or not. My gait is fairly even and I am out of PT. The joint still hurts significantly when I get up from a chair or go up stairs. My left leg was always weaker than my right and this hasn't changed. I have had a arthritis flare in both hips and the other knee. This is new; I didn't have it before the operation. I think my alignment is off but I don't know where to go to address that issue.

Sue is going to sing her same song 😉Go to Physical Therapy - not just post-surgery "do this exercise" therapy. Find a Rehabilitation PT clinic. Your orthopedic surgeon may know of one, or is you have a hospital that does a lot of trauma or orthopedic surgeries, they will know.

First, arthritis or other inflammatory flares are not uncommon as our bodies heal after the trauma of a surgery.
Second, a Rehab PT can evaluate your gait, posture, leg lengths, and a host of other issues and get you headed towards proper alignment. They can also work on strengthening both legs to correct imbalances. After my last hip revision (many years ago now) I felt just as you describe. The PT designed a routine of home/clinic/pool exercises to correct my gait (I had limped for over 10 years), my posture and my tendency to turn my right foot inward. This relieved hip, back and knee pain.
Is this something you can try? Even just a few visits can make a big difference. Be prepared to watch yourself walking in a mirror.

Depending on age, health, weight and life interests- factors to discuss thoroughly with DRs. Most TKR lasts at least 10+years, and a second is possible but TKR usually performed near 60s. Partial is OK but often followed with TKR in around 5 yrs. I have had both in my 2 knees. However whatever your choice, the less weight you carry is your best chance with a combination of regular exercise for best recovery and joint longevity. Also recommend wearing proper fitting shoes. Best wishes.

I had two PKR, left and then right, spaced 2 years apart. Mine worked well and I am glad I went that route, but then again I had all the criteria for the partials. After my most recent partial, I noticed that I was having pain in my shin, about halfway down my lower leg on the surgical leg. My PT explained how, in all likelihood, this is from my leg needing to adapt to the new alignment. The stress points have now changed as I was quite bow-legged from the medial side arthritis over the past 10 years. Sure enough, that shin pain has now waned and I am doing quite well. The only pain I really have now is muscular as I lift weights every other day. It bothers me that you say however, that your pain is coming from the joint. I wish you the best of luck and I would listen closely to both your PT and your surgeon. It does take a while for these newly repaired joints to "wear-in" at least it did for me, and I am 68 and active but probably should lose 30 pounds to help my body heal.

I had similar experience. After patella surgery and one year later full replacement. After three and half years I am in more pain and less range of motion. Surgeons ignore my problem and X-ray does not show any problem. Surgeons are in business to make money and cover themselves instead of treating patients Very disappointed with surgeons unethical practice.