Partial Knee Replacement in Doha

What is a partial knee replacement?

The knee has three compartments: the inner (medial), the outer (lateral) and the joint behind the kneecap (patellofemoral). Arthritis often starts in just one of them, most commonly the inner side. A partial knee replacement, also called a unicompartmental or uni knee replacement, replaces the damaged surfaces of that one compartment with metal and a plastic bearing, leaving the rest of the knee untouched.

Because the cruciate ligaments and the healthy compartments are preserved, the knee keeps more of its natural movement and feel. A patellofemoral replacement, for arthritis limited to the kneecap joint, is a less common type of partial replacement.

Who is suitable?

• Arthritis confined to one compartment, confirmed on X-ray and examination
• Pain located mainly on that side of the knee
• A functioning ACL in most designs
• Good range of movement and a deformity that corrects easily
• No inflammatory arthritis such as rheumatoid arthritis

Age alone is not a barrier, and partial replacement suits both active patients in their fifties and older patients who benefit from a smaller operation. Patients with arthritis in more than one compartment, significant stiffness or ligament damage are usually better served by a total knee replacement or, in younger patients with good cartilage elsewhere, an osteotomy.

Assessment

Assessment includes a careful examination, weight-bearing X-rays and often stress X-rays, which show whether the other compartments are preserved. An MRI may be used in borderline cases. It is important that symptoms match the worn compartment: pain spread across the whole knee or behind the kneecap may point to a problem a partial replacement would not address.

The operation

The operation is performed through a smaller incision than a total replacement, under spinal or general anaesthesia. The damaged cartilage and a thin layer of bone are removed from the worn compartment, and the implant components are fitted precisely. Many patients walk on the day of surgery or the next day, and hospital stays are often short, in some cases one or two nights. Blood loss and early pain are usually less than with a total replacement.

Recovery

• Walking with a frame or crutches from the first day, progressing to a stick within a few weeks
• Physiotherapy to restore bending, straightening and strength
• Driving often after about four to six weeks, once you can control the leg safely
• Desk work at around four to six weeks; more physical work later
• Most patients feel steady progress over three months, with continued improvement up to a year

Low-impact activities such as walking, swimming, cycling and golf are generally encouraged. Many patients find kneeling and floor sitting easier than after a total replacement, although this varies and kneeling may remain uncomfortable for some.

Benefits and risks

Compared with a total replacement, partial replacement in suitable patients often means a quicker recovery, better bending and a more natural feeling knee. The trade-off is a higher chance of needing further surgery later, mainly because arthritis can progress in the other compartments or the implant can loosen. If that happens, conversion to a total knee replacement is usually possible.

Other risks are those of any joint replacement: infection, blood clots, stiffness, persistent pain, and rarely nerve or vessel injury. Careful patient selection is the most important factor in a good result.

Choosing the right operation in Doha

Not everyone with arthritis on one side is a candidate, and not every knee replacement needs to be a total one. Dr. Gelber assesses each compartment at Aman Hospital in Doha and explains whether non-surgical treatment, osteotomy, partial replacement or total replacement fits your knee. Cost depends on the procedure, implant and hospital stay, and coverage varies by policy, so check with Aman Hospital and your insurer.