Benefits of Partial Knee Replacement
Many Northland patients are now discovering that they are candidates for unicompartmental knee replacement instead of total knee replacement surgery.
“A benefit of partial knee replacements is that we can save more of the bone stock,” explains Robert Paul, DO, an orthopedic surgeon in the Northland. “That’s especially important for younger patients since a total knee replacement involves removal of more bone, making future surgery more difficult. But it is also a great choice for the older patient because it’s a less invasive surgery with less pain and a quicker recovery.”
Since 1995 Dr. Paul has practiced with Orthopedic Surgeons Inc. in North Kansas City. (His brother, David Paul, DO, is also an orthopedic surgeon in the same practice, and was featured recently on one of North Kansas City Hospital’s billboards.) Dr. Paul focuses on conducting unicompartmental knee arthroplasty on patients with osteoarthritis or avascular necrosis that is limited to the medial knee compartment, where the disease usually occurs first. He estimates he has performed more than 500 partial knee replacement surgeries, most of them at North Kansas City Hospital.
Age is Not Defining
Age is not a defining factor. “We’ve performed this surgery on many patients in their 30s as well as the elderly,” he says. “Partial knee replacements do serve as a bridge for people in their 30s, 40s and 50s, delaying the necessity for total knee replacement,” Dr. Paul noted. “Hospital stays are often shorter, and recovery can be days instead of weeks.”
“Having this surgery also helps the patient stay healthier,” he says. “Since they have less pain and more natural movement, they tend be more mobile and get more exercise.”
Dr. Paul uses the Biomet® Oxford® meniscal partial knee, leaving up to 75% of the bone intact. “The Oxford replacement knee received FDA approval, but doctors must receive specialized training to use it,” he noted. Two physicians in Oxford, England, developed the Biomet partial knee, and also teach the surgical procedure through training sessions that include a one-day lecture plus a day of hands-on practice in the lab. Dr. Paul completed his training in 2006 in Boston.
Who is a Candidate?
The surgery is done on patients with osteoarthritis, but not on those with rheumatoid, psoriatic arthritis or other autoimmune inflammatory arthritis. “If the X-ray indicates that arthritis is contained only in the medial joint, partial knee replacement is recommended, but if arthritis is in the lateral joint, I would proceed with a full knee replacement,” Dr. Paul says.
“Patients are informed so that they know going into surgery that there’s up to a 98% certainty that partial knee replacement will be done,” he added. “They also know that if we find that the lateral joint has problems, we will have to do a full knee replacement.”
"Many potential candidates for a unicompartmental knee replacement receive a full knee replacement because of a misunderstanding of the risks, which are about the same as for a partial knee replacement,” Dr. Paul says. “Additionally, not every surgeon performs this type of surgery and may not offer it as an option. In his experience, whether patients have a partial or total knee replacement, they have well over a 90% chance of going 15 to 20 years before further surgery is required."
Robert F. Paul, DO
Dr. Paul is board certified in Orthopedic Surgery. He attended medical school and completed his residency at the Kansas City University of Medicine and Biosciences and Park Lane Medical Center/OSI. In 1995, he joined Orthopedic Surgeons Inc. (OSI) in North Kansas City.
To learn more, call 816-459-7500.