Partial Knee Replacement: An Early Intervention

"My left knee was hurting me so badly that I could barely walk on it, " remembers Long Island native Robert Fitzgerald. "It was so painful that when I did walk on it, I could only go for short distances at a time, stopping intermittently for the pain to subside."

Robert finally sought the advice of his primary care physician, who referred him to Mark J. Davis, MD a board-certified orthopedic surgeon with extensive and prestigious additional Fellowship training in knee and hip replacement from Anderson Clinic in Arlington, Virginia.
A thorough history and a clinical examination of Robert's knee focused on determining the levels and location of his pain and stiffness.
"Robert's situation was one I encounter on a regular basis," relates Dr. Davis. "He complained that his left knee was extremely painful, and I could see that both of his knees were swollen and starting to change shape, making him bowlegged."
"I looked like I had just gotten off a horse," laments Robert. "I explained to Dr. Davis that during my professional career, I was first a knitting mechanic and then a plumber, both of which required a lot of bending, stooping and being on my knees, which was hard on them.
"Dr. Davis said he would like to take a couple of x-rays."
The doctor explains that x-rays are used to determine if arthritis is apparent only in the inside part of the knee, an important prerequisite in determining the best intervention. In a normal knee, the condyles, two rounded, knob-like protuberances at the bottom of the femur or thigh bone, fit and move in the hollows of the tibia or shin bone, forming the actual knee joint. When one condyle is damaged due to wear, injury or arthritis, the resulting pain and impaired motion of the knee can become incapacitating.
"My x-rays showed that on the inside of my left knee there was bone rubbing bone," says Robert, "which is why I was in so much pain. Dr. Davis explained every thing calmly and precisely."
"For Robert I recommended a UKA, also known as the Repicci Unicompartmental Knee Replacement," explains the doctor. "A UKA relieves the patient's pain and restores both the correct alignment and motion of the knee joint."
UKA Advantages
Performed while the patient is sedated, the UKA procedure involves the re-shaping and re-surfacing of the bones on either side of the knee so that a prosthesis can be implanted.
Fabricated from surgical metals and plastics, one portion fits over the worn condyle while the other is fitted on the hollow at the corresponding end of the tibia.
Designed to stabilize the kneed and permit pain-free motion, including the natural sliding and rolling movements easily performed by healthy knee joints, the prosthesis completely restores the form and function of the natural kneed joint, allowing the smooth movement previously prohibited by worn or absent cartilage.
"We consider partial knee replacement to be a minimally invasive procedure for several reasons," informs Dr. Davis. "First, the skin incision is typically only about three inches long. Secondly, only the damaged portion of the kneed joint is replaced. Basically, we're preserving the natural knee joint and replacing only the portions that are bad, much like a dentist would repair a single bad tooth, rather than pulling all your healthy teeth and giving you dentures.
"Thirdly, unlike with a total knee replacement (TKA), where a patient may remain in the hospital or rehab hospital for up to two weeks after surgery, a partial knee replacement patient typically goes home the day after surgery."
Partial Replacement, Total Success
"Dr. Davis said he was going to help me," recalls Robert, "and that's exactly what he did.
"I drive a school bus for Charlotte County now, and I wanted to be back on my feet as soon as possible, so I had one knee done at a time."
The skilled surgeon notes that, in most cases, the recovery from a partial knee replacement is also fast than that from a total knee replacement: "Typically, patients aren't able to drive until around six weeks after a total knee replacement, but most of my partial kneed replacement patients are able to drive at two weeks following surgery. They become independent again much faster."
"I couldn't believe how fast I was back on my feet," marvels Robert. "I was only sorry that I hadn't had both knees done at the same time, but at least I knew what to expect with the second procedure.
"It worked out just as great as the first one had."
"Partial kneed replacement is an early treatment option," stresses Dr. Davis. "People don't need to suffer for years and years, waiting until they are a candidate for total knee replacement; they can opt for a partial replacement and get back to a pain-free lifestyle much quicker.
"My knees are both feeling just fine," assures Robert. "I have a boat that I love to take out, and I fix my own cars and the neighbors' lawnmowers. I'm always up and down, crawling under machines and doing whatever needs to be done.
"I just can't believe it."
PHCN -Kris Kline
Make a note...
Dr. Davis welcomes your questions about joint replacement and other orthopedic issues. To schedule a consultation, please call (941) 613 - 3800. His office address is 1951-B Tamiami Trail, Port Charlotte, FL 33948

Meet the Expert

Dr. Davis is an expert in UKA (Repicci Unicompartmental Knee Replacement). He hosts one of only a few physician training centers in the entire United States where surgeons can come to study, learn the UKA procedure and then go home to offer it to their own qualified patients. Also, four times a year, Dr. Davis travels to Chicago to teach the surgical technique alongside its developer, Dr. John Repicci of Buffalo, New York.

"It is important to me that my patients know our relationship doesn't stop when their surgery is complete. Many people in our area have no family living nearby, so I also reassure my patients that we have the resources and community connections to make sure that their rehabilitation and well-being are supervised after they leave the hospital."

---Dr. Davis

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