A knee joint is composed of three compartments – medial tibiofemoral, lateral tibiofemoral and patellofemoral joint. When end-stage degeneration affects either one of the compartments, the traditional surgical treatment is total knee replacement with a prosthesis which sacrifices the normal cruciate ligaments and also the other normal joint compartments. More than 95% of prosthesis was reported to survive longer than 10 years. However, about 20% of patients were not satisfied and complained about the abnormal feeling of the replaced knee.
Partial knee replacement is minimally invasive with smaller surgical incision, and more importantly, preserves normal bone, normal cruciate ligaments and normal knee function. The speed of recovery and rehabilitation is faster than the total knee counterpart. It’s, however, not suitable when degeneration affects all three compartments or the cruciate ligaments are ruptured. Isolated medial compartment osteoarthritis is the most common indication. Many international studies reported the good outcome of partial knee prosthesis in the medial compartment. In a particular model of prosthesis, Oxford Knee, because of the design of congruent articulation with mobile bearing, it was found to have good result even in over-weight and young patient with high activity level. This could survive up to 90% in 20 years. This disproves the old belief that partial knee replacement is used to buy time for definitive total knee replacement.
When disease only affect lateral or patellofemoral compartment of knee, partial replacement of either of these compartments is also possible, although with less frequent occurrence. It was found the longevity of lateral partial knee replacement is similar to medial counterpart from the international experience. As for the patellofemoral replacement, the implant survivorship is not as good, but it’s expected to improve with better patient selection and better development of prosthesis.
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