Partial Knee Replacement

When it comes to arthritis-related knee pain, some adults may benefit from a partial knee replacement (PKR), also known as unicompartmental knee replacement. PKR is less common than the total knee replacement procedure. Many joint replacement surgeons may only do two to five of these surgeries per year. We recently had the pleasure of sitting down with Brian Perkinson, M.D. of the Bone and Joint Institute of Tennessee to discuss this procedure. A high volume, specially trained partial knee replacement surgeon, Dr. Perkinson performs approximately 75 of these surgeries per year.

WS: Who is a good candidate for partial knee replacement? 

Dr. Perkinson: We look at the knee as being three different compartments. A good quality partial knee replacement candidate typically has the majority of their arthritis focused in one compartment. They usually have a functioning normal knee with a good pre-existing range of motion. Of course, patients need to see a doctor for a proper evaluation and recommendation.

WS: What are the benefits of partial knee replacement over total knee replacement?

Dr. Perkinson: The procedure is essentially a resurfacing technique, and the benefits are pretty impressive. It’s a faster recovery. It offers a better kinematic knee (more normal biomechanics) because you’re keeping all of your normal ligaments in the knee. There is lower blood loss, lower rate of infection, higher satisfaction rates, and a higher percentage of people feeling like they have a more normal knee––compared to full knee replacement. Additionally, you have not burned the bridge for getting a total knee replacement. I find it very beneficial to the young patient; we can buy them more time before needing a total knee replacement. The procedure can also be beneficial for an older patient where the partial knee replacement is going to outlast them.

WS: What recent technological advancements in partial knee replacement have changed the quality of care patients receive?

Dr. Perkinson: Partial knee replacement has always been a little bit of a niche surgery. Very few surgeons performed it because it required good patient selection and a high level of skill to provide a quality outcome.  In my practice, about one-third of my arthritic knee patients are actually good candidates for a partial knee replacement. The ability to do partial knee replacements is increasing because of the advancements in technology. The tech that the Bone and Joint Institute and Williamson Medical Center has chosen for the procedure is the MAKO Robot, which was originally used for partial knee replacement.  Robotics allow us to use 3D planning from a CT scan and real-time understanding of where the knee is in space to create a live GPS during surgery. It allows us to position the patients’ components accurately, size them accurately, and balance the knee in relation to its existing ligaments appropriately. So, patients have faster recovery, better biomechanics, a more normal feeling knee and successful long-term outcomes to 15 years.

WS: What questions should patients interested in partial knee replacement ask their surgeon?

Dr. Perkinson: If you’re interested in partial knee replacement, be sure to ask your doctor if they perform this procedure and at what volume. I recommend patients seek out providers who do a high volume of partial knee replacements, as frequency matters. Many doctors only do two to five of these per year. In my practice, I average 75 partial knee replacements per year.

WS: What do you enjoy most about your work?

Dr. Perkinson: I think the most enjoyable thing… the beauty of orthopaedic surgery… is that you change peoples’ lives profoundly in a way that brings them great joy. A lot of medicine is saving lives. That’s not what orthopaedic surgeons do. What we do is save your function and your happiness. We take people who are suffering, who can no longer play on the floor with their grandkids, or go on a hike in the woods, or play tennis, and we get the opportunity to provide them a surgery that allows them to return to the things they love and be with the people they love. When people come back in and say, “You changed my life and I’m so happy I met you. You took care of me.” Well, that’s the best feeling in the world, and I think that’s why we all do it.  Unicompartmental Knee Replacement at Bone and Joint Institute of Tennessee For more information about partial knee replacement, contact Brian Perkinson, M.D. at Bone and Joint Institute of Tennessee. Call (615) 791-2630. You can also schedule an appointment online.