Partial Knee Replacement
The partial knee procedure used by Dr. Redish was originally developed by Dr. John Repicci of Buffalo, New York; a dentist who became an orthopedic surgeon. Known as unicondylar knee resurfacing, this minimally-invasive procedure involves freehand sculpting and resurfacing of the weight-bearing half of the knee bone while leaving the other half untouched.
Performed through a small incision that does not disrupt the quadriceps muscle, Dr. Repicci’s revolutionary technique is less disruptive to the rest of the knee and results in much easier recovery than total knee replacement. Dr. Redish is one of the nation’s few orthopedic surgeons who has perfected this freehand technique.
For your partial knee replacement surgery, you will be taken to the hospital operating room, placed on the operating table and given general anesthesia. Your orthopedic surgeon will make a tiny incision to inspect the knee joint.
About 5-10% of the time, the surgeon discovers serious cartilage degeneration not visible in pre-operative x-rays. If this occurs during your surgery, the surgeon considers your age, weight, activity level and medical condition, and determines if a partial knee replacement is sufficient or if a total knee replacement will be needed. If the partial knee replacement is selected, the procedure takes about 45 minutes to an hour to complete. Afterwards, you’ll go to the recovery room for about an hour.
Following recovery time, you will return to the orthopedic floor and immediately begin physical therapy. You will be able to stand and walk down the hall. Some patients are allowed to go home the same day if they are doing very well, although most will spend the night and go home the following day. Controlling your pain is usually fairly easy and managed by self-administered, intravenous doses of morphine and oral pain medication administered as needed.
The next morning, the drain in the knee is removed and you will complete another physical therapy session. Afterwards, you will be discharged to recover at home and your care team at Parkridge Bone & Joint will follow up with you about your rehabilitation plan.
After returning home, it’s normal for pain to increase for a few days. We recommend staying around the house for those first days following surgery and taking oral pain medication by prescription as needed. Regular doses of anti-inflammatory medication will lessen the need for stronger narcotics.
There are no limitations for bending and straightening the knee, and weight bearing is allowed as much as tolerated. You might use a walker or a cane for a few days until you feel alright without them. A general rule of thumb for the first week is to work on the exercises provided by the physical therapist and avoid getting out and walking too much. Overdoing it will not damage the knee, but you may experience more pain and swelling at night and the next day. If you experience this, we recommend that you rest and elevate your knee.
Usually the surgical incision is closed with a suture that dissolves under the skin. Once the wound stops draining and at least four days have passed since surgery, the area around the wound can get wet and be patted dry from a shower. After drying the wound, it should be left open to the air at all times.
It is common to have a mildly elevated temperature following the procedure, and Tylenol may be taken to treat it. Also, it is important to keep the lungs cleared out using the incentive spirometer provided by the hospital.
The first post-operative visit occurs usually one to two weeks following surgery. At this point, your pain should be decreasing gradually, and you are encouraged to increase physical activity. You should be able to drive as long as you can operate a vehicle safely. At the first post-operative visit, we will take x-rays and give you further instructions according to your progress.
Some patients choose physical therapy to help increase activity gradually, but most commonly, actively on an exercise bicycle is recommended a week after surgery. The knee will be swollen for the first few weeks, but swelling will gradually decrease, and any bruising will slowly dissipate. One month following surgery, it is typical to still have some aches and pains, especially at night and when standing up or sitting down.
The second post-operative visit is usually about four to six weeks following surgery. Most patients are quite mobile and do almost everything they were doing prior to surgery. Although you might still have aches and pain from the procedure itself, they will slowly fade over the next few months.
After a partial knee replacement, some people experience an occasional twinge of pain now and then. Many patients report that there is no pain at all, and the knee feels perfectly natural. Of those patients who have undergone both a total knee replacement on one side and a partial knee replacement on the other, 80% prefer the partial for its more flexible, natural feeling.