Patient question

Only the inside of my knee is worn. Do I really need a full replacement?

Dr. Pablo GelberOrthopaedic Knee Surgeon

Quick answer

Not always. When arthritis is limited to the inner compartment, the ligaments are intact and the knee still bends well, a partial knee replacement can be a reasonable option instead of a total. The decision depends on examination and standing X-rays, says Doha knee surgeon Dr. Pablo Gelber of Aman Hospital.

What "only the inside is worn" means

Many people in Qatar hear after an X-ray that they have "bone on bone" on the inner side of the knee. This is called medial compartment osteoarthritis and it is the most common pattern of knee arthritis. It often goes with a slightly bow-legged alignment, which pushes more of your body weight through the inner side with every step.

The key question is whether the outer compartment and the joint behind the kneecap are still in good condition. If they are, replacing everything may not be necessary.

Signs a partial replacement might suit you

Your pain is mostly on the inner side, and you can often point to it with one finger
The knee bends reasonably well and nearly straightens
It feels stable and does not give way
Standing X-rays show wear on one side only
You have tried physiotherapy, weight management and painkillers without enough relief

Pain all around the knee, at the front when climbing stairs, or a knee that is very stiff or wobbly points more towards a total replacement.

Why the surgeon may still say total

Some knees look one-sided on a single X-ray but are not. Early wear in the outer compartment, a torn ACL, a fixed deformity or inflammatory arthritis can all make a partial replacement less reliable. In those cases a total knee replacement usually gives a more predictable result. Neither option is "better" in general; the right one depends on your knee.

In younger, active patients with a bow-legged knee and less advanced wear, a high tibial osteotomy, which realigns the leg and keeps your own joint, may also be discussed.

What to bring to your appointment

Bring any X-rays or MRI scans you already have, a list of treatments you have tried, and what you want to get back to, whether that is walking at Aspire Park, praying comfortably or keeping up at work. Dr. Gelber at Aman Hospital will usually request weight-bearing X-rays and may add stress views to confirm which compartments are affected before recommending an option.

Frequently asked questions

If I choose a partial now, can I have a total later?

Yes. A partial replacement can usually be converted to a total knee replacement if arthritis spreads or the implant wears, although that later operation is a revision procedure.

My other knee is also sore. Can both be done?

Sometimes both knees are suitable. Whether they are treated together or separately depends on your general health and the findings in each knee.