Human knee is made up of 3 compartments – medial, lateral and patellofemoral. Unicondylar Knee Replacement is resurfacing of the damaged medial compartment of the Knee.
In most of the cases, arthritis of the Knee begins with the loss of cartilage of the medial compartment and then progresses to lateral and patellofemoral compartment. Replacement of just the medial compartment at the proper time will stop the further progress of arthritis.
In UKR, no ligament of the knee is sacrificed whereas at least one ligament is sacrificed in TKR. UKR saves 75% of healthy bone of the Knee joint. The incision is half than in TKR and no tendon or muscle is cut. The hospital stay is 3 days.
Partial knee replacement is appropriate for patients with arthritis that is confined to a single medial (inner) compartment of the knee. The surgery is contraindicated in patients with inflammatory-type arthritis like Rheumatoid arthritis and gout.
The things which are ‘LESS’ in UKR are : Less bone loss Less pain Less Hospital and home stay No Physiotherapy The things which are more in UKR are: More natural feeling More satisfaction More flexibility More movements
UKR is appropriate for patients over 40 years old who meet other eligibility criteria.
There are two types of implants available: Fixed bearing – in which the poly is fixed to the tibial base plate. Mobile bearing – in which the poly is mobile. We use Mobile bearing joints in all our UKRs
Knee prostheses or implants are made of metal and plastic. These surfaces are designed to glide smoothly against one another just as cartilage does in a healthy knee.
Most of the patients are able to resume biking, tennis and swimming. But contact sports should be avoided. One can even sit crosslegged and climb stairs.
As with any joint replacement surgery, complications may include infection and deep vein thrombosis. Generally, complications occur less frequently after UKR than they do following total knee replacement.
We take utmost care to see that the patients have a pain free postoperative period. We have a team of Anaesthetists who are well experienced in post-op analgesia techniques. Walking is started on the evening of surgery. Toilet training starts on the 1st post-op day. By the 2nd post-op day the patient is made to climb the stairs and is discharged on the 3rd day.
It’s a misconception that UKR is a stop gap surgery. A well-done partial knee replacement in an appropriately selected patient can have a survival rate that is comparable to that achieved with a total knee replacement. Published long-term clinical results on the Oxford Partial Knee demonstrated a 92.4% survivorship at 10 years,94.0% at 15 years and 91% at 20 years.
THE MOST IMPORTANT POINT ABOUT UKR is that the patient has to come in time. The surgery should be done in the hands of the surgeon who is especially trained in UKR. And right selection of patient is of utmost importance.
Implants are mechanical devices and they are subject to conditions that can lead to mechanical failure. The most common being implant loosening or implant wear that leads to loosening. Failed implants can be revised successfully; revision is a Primary Total Knee Replacement.