Partial vs. Total Knee Replacement: Understanding Your Options
When knee arthritis or damage becomes severe enough to require surgery, two primary surgical options may be considered: partial knee replacement (also called unicompartmental knee arthroplasty) and total knee replacement. The right choice depends on how much of your knee is affected, your overall health, activity level, and goals for recovery. Understanding the differences between these procedures can help you have a more informed conversation with Dr. Eskildsen about your care.
Partial Knee Replacement (Unicompartmental)
A partial knee replacement resurfaces only the damaged compartment of the knee — most commonly the inner (medial) side — while leaving the healthy bone, cartilage, and ligaments intact. This is an option for patients whose arthritis is confined to one area of the knee joint rather than affecting the entire knee.
Benefits of Partial Knee Replacement
Smaller incision and less tissue disruption: Only the affected compartment is replaced, which means less bone removal, less blood loss, and a smaller surgical wound.
Faster recovery: Patients typically experience a quicker return to daily activities, walking, and driving compared to total knee replacement.
More natural knee feel: Because the healthy ligaments and other compartments are preserved, many patients report that a partial knee replacement feels more like their natural knee.
Less pain after surgery: The reduced extent of the procedure often means less post-operative pain and a lower need for strong pain medications during recovery.
Preservation of bone stock: Because less bone is removed, a partial replacement preserves more of your natural knee structure, which can make future revision surgery easier if needed.
Greater range of motion: Studies show that partial knee replacement patients often achieve a higher degree of knee flexion and a more natural walking pattern compared to total knee replacement.
Risks and Considerations of Partial Knee Replacement
Stricter patient selection: Not all patients are candidates. Partial replacement requires an intact anterior cruciate ligament (ACL), a stable knee, a correctable deformity, and arthritis confined to one compartment.
Higher risk of revision: Arthritis may progress to other compartments over time, potentially requiring conversion to a total knee replacement. Revision rates are somewhat higher than for total knee replacement.
Implant loosening: As with all knee replacements, the implant may loosen or wear over time, particularly in very active patients.
Persistent pain if disease is underestimated: If arthritis in other parts of the knee is more advanced than imaging suggests, some patients may experience ongoing pain after surgery.
Total Knee Replacement (Total Knee Arthroplasty)
A total knee replacement resurfaces all three compartments of the knee — the medial (inner), lateral (outer), and patellofemoral (kneecap) compartments. The damaged cartilage and bone are removed and replaced with metal and plastic implant components. This procedure is recommended when arthritis has spread throughout the knee or when a partial replacement is not appropriate.
Benefits of Total Knee Replacement
Addresses widespread arthritis: Total knee replacement is effective for patients with arthritis affecting multiple compartments, severe deformity, or significant bone loss throughout the knee.
Lower long-term revision rate: Total knee replacement has excellent long-term durability, with studies showing that over 90% of implants still functioning well at 15 to 20 years.
Suitable for a wider range of patients: Total knee replacement can be performed even in patients with ACL deficiency, inflammatory arthritis (such as rheumatoid arthritis), significant deformity, or obesity.
Comprehensive pain relief: By replacing all three knee compartments, total knee replacement eliminates pain from all arthritic areas of the joint at once.
Corrects significant deformity: Total knee replacement can realign the leg and correct bow-legged or knock-kneed deformities that cause pain and abnormal gait.
Risks and Considerations of Total Knee Replacement
Longer recovery: Total knee replacement involves more extensive surgery, and most patients require several weeks of physical therapy and a longer period before returning to full activities.
Less natural feel: Some patients notice that a total knee replacement does not feel quite as natural as their original knee, particularly with activities like kneeling or squatting. However, the majority of patients are satisfied with their outcome.
Greater blood loss and longer surgery: Total knee replacement is a more extensive procedure, which can mean increased blood loss and a slightly higher risk of transfusion compared to partial replacement.
Stiffness: Achieving a full range of motion after total knee replacement requires dedicated physical therapy. Some patients may experience persistent stiffness if rehabilitation goals are not met.
Which Procedure Is Right for You?
Choosing between a partial and total knee replacement is a decision that depends on many individual factors, including the extent of your arthritis, the condition of your ligaments, your age, activity goals, and overall health. Both procedures have excellent track records and can dramatically improve quality of life when performed in the right patient.
Dr. Eskildsen will perform a thorough evaluation — including a physical examination and review of your X-rays and medical history — to determine which option offers you the best outcome. Contact our office to schedule a consultation and take the next step toward a pain-free, active life.