What are the different types of knee replacement surgery?

Knee replacement surgery is a common procedure with high rates of success. Your doctor may recommend it if your knee pain and mobility issues aren’t responding to medications and other nonsurgical treatments. Depending on the extent of the damage to your joint, you may either have a partial or total knee replacement (TKR). TKR is the more common of the two procedures, and there are a few different approaches your surgeon may take during the operation that may affect your recovery experience. Read on for a full breakdown of the different types of knee replacement surgery.

What’s the difference between a partial and total knee replacement?

When your knee joint is damaged by arthritis, a knee replacement may be your best option to relieve pain and restore your range of motion. Most people will need a total knee replacement (TKR). This procedure removes and replaces the damaged parts of all three bones in the joint — the femur (thigh bone), tibia (shin bone), and patella (kneecap).

A partial knee replacement, on the other hand, is performed when only one part of the knee is damaged enough to need a prosthetic replacement. The different parts of the knee that may be replaced are the:

  • Medial compartment: The inside of the knee joint, closest to the opposite knee.
  • Lateral compartment: The part of the knee that is on the outside, farthest from the opposite knee.
  • Patellar compartment: The front part of the knee between the thigh bone and the kneecap (patella).

During a partial knee replacement, a surgeon cuts away the damaged tissue and bone from part of the knee joint, preserving the rest of the knee. Then, they attach a prosthetic to that part of the joint with bone cement. Surgeons often use small incisions to perform partial knee replacements, so patients who have this procedure typically experience shorter recovery times.

When is a partial knee replacement recommended?

It is rare for knee pain and immobility to be solved by a partial knee replacement. Only about 5 to 6% of people with arthritic knees are good candidates for this procedure. Those eligible usually:

  • Only experience pain in one part of their knee
  • Are older, thin, and not very physically active
  • Still have a good range of motion in their knee
  • Do not have bad arthritis in the non-painful part of their knee

A partial knee replacement may also be recommended for younger patients (under 65) who have plenty of healthy bone left in their knee joint.

What are the different types of total knee replacement (TKR) surgery?

There are two types of total knee replacement surgery: cruciate-retaining TKR and posterior-stabilized TKR. The main difference between them is how the surgeon treats your posterior cruciate ligament (PCL). Your PCL is one of the bands of tissue that connect your thigh bone to your shin bone. (The other is the anterior cruciate ligament, or ACL.) 

During a cruciate-retaining total knee replacement, the PCL is left intact to help stabilize the artificial knee. Keeping the PCL may help preserve more bone in your knee and reduce the load on the bone cement attaching the artificial knee to the joint. However, this is only an option if your PCL is strong enough to support the new joint. 

During a posterior-stabilized total knee replacement, the PCL is cut and replaced with special components added to the artificial knee. This option can give you a more predictable range and quality of motion for your artificial knee. 

Both types of knee replacement surgery have high rates of long-term success and are associated with similar improvements in knee pain and range of motion. The type of surgery you get will depend on the state of your PCL and your surgeon’s training and experience.

What are the different methods of performing a total knee replacement?

When planning your TKR, your surgeon will recommend either traditional (open) surgery or minimally invasive surgery. Over 85% of all knee replacements are performed traditionally, meaning that the surgeon operates through a single large incision. Typically, this incision will cut into the quadriceps tendon on the front of the knee.

During open knee replacement surgery, the surgeon has a clear view of the joint while they operate. This unobstructed view of the bones in your knee makes it easier for the surgeon to get correct placement and alignment for the artificial knee joint. However, traditional surgery tends to come with longer healing and recovery times than minimally invasive surgeries.

In a minimally invasive knee replacement surgery, the surgeon only makes a small cut in a quadriceps muscle instead of cutting through the tendon. This procedure is more technically challenging than open surgery, and it often requires special tools and training. Minimally invasive knee replacement surgery may not be recommended if you:

  • Are obese or overweight
  • Are very muscular
  • Have severe knee instability or deformity
  • Need a more complex knee replacement

How should you decide between the different types of knee replacement surgery?

The type surgery you get will depend on your surgeon, your medical history, and the health of your knee joint. If you’re still searching for a physician, the New Choice Health Patient Assist program can help. Our partner surgeons are dedicated to providing high-quality medical care at a fair, affordable cost. Visit our Orthopedic Surgery Assistance page to learn more about finding the best price for your knee replacement, no matter which type you need.

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