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Partial Knee Replacements Become More Common as Knees of Active Baby Boomers Begin to Wear Out

Less invasive than total knee replacement, partial gets them back on their feet faster

(New York, N.Y. November 27, 2007). At one time, the best option for people with advanced knee arthritis was a total joint replacement for permanent relief of severe, unrelenting pain. Now a less extensive procedure is gaining favor for people whose arthritis is limited to just one area of their knee. This partial, or "unicompartmental", joint replacement is easier on the patient and recovery is faster. Yet it relieves their arthritis pain and allows patients to return to activities they were forced to give up, according to Dr. Geoffrey Westrich, an orthopedic surgeon with offices at the Hospital for Special Surgery in Manhattan and in Fresh Meadows, Queens.

"The partial joint replacement is much less invasive than a total knee replacement," says Westrich, an Associate Professor of Orthopedic Surgery and Co-Director of Joint Replacement Research at Hospital for Special Surgery. "There's a smaller incision, patients generally experience less pain right after surgery, and rehab and recovery are much faster." The hospital stay is also cut in half, from the usual three or four days for a total joint replacement to just one or two days for a partial knee replacement. Another advantage is that it preserves the normal bone and cartilage in the rest of the knee that would typically be replaced in a total joint procedure, according to Westrich.

Right Diagnosis is Key

As the knees of baby boomers and "weekend warrior" athletes start to wear out, Westrich is seeing more candidates for the less invasive procedure. Generally, these patients are younger than those needing a total joint replacement, and many are eager to return to athletic activities.

Not all patients qualify for a partial joint replacement, though, and the proper diagnosis is critical, according to Westrich. The main requirement is that the patient's arthritis is confined to a limited area. The knee has three compartments -- medial, lateral and patellofemoral (kneecap region) -- and arthritis can involve one, two or all three areas. One would be a candidate for a partial joint replacement if only the inner (medial) or outer (lateral) part of the knee is damaged. Patients whose arthritis is widespread would need a total joint replacement.

Joint Replacement-Kind of Like Capping a Tooth

An estimated 21 million Americans have osteoarthritis, a disease in which wear and tear causes cartilage, the smooth substance that lines the end of bones, to wear away, resulting in pain and a loss of mobility. When more conservative treatments such as pain medication and physical therapy fail and pain persists, patients consider joint replacement.

Westrich likens knee replacement to the way a dentist caps a decayed tooth. It entails smoothing out the worn surfaces of bones and then covering them with a prosthesis, or implant. In partial knee replacement, only one side of the joint is resurfaced, either the inner or outer area. The day after surgery, patients are generally able to put weight on their knee and start to walk. Usually within two weeks to four weeks after surgery, they can drive a car and resume normal daily activities.

Almost 500,000 knee replacements are performed in the United States each year. With the aging of the baby boomer population, Westrich expects the number to rise, and the partial knee replacement may be a viable-and easier-option for many.

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