Brief Answer:
partial knee replacement when arthritis affects part of the knee

Detailed Answer:
Dear XXXX,

Thank you for trusting us at HCM, I will make sure to answer your question to the best of my Knowledge.

As you probably informed yourself already knee replacement surgery is done when patients have Knee arthritis, however it is important for you to understand that the surgery should be your last option. In order for a patient to really need a knee replacement the pain in the knee should be not tolerable anymore meaning it wakes the patient from sleep, it prevents daily activity, the knee does not move, stays in one position, limitation of movement and range of motion. Moreover the pain does not respond to medication anymore or to localized steroids injection to reduce inflammation. Once the patient reaches to this stage Knee replacement can be considered.

Another important factor is life style changes that will help in reducing the pain. Among which is weight control, if you happen to have some extra kilograms losing any extra weight will reduce the pain dramatically. But it can be hard to be active and lose the weight with knee pain; therefore diet not eating after sunset for example will help reduce weight. Plus swimming or in pool sports will help in staying active without putting pressure on the knee that hurts.

Finally to answer your question when is it possible to only need a partial replacement?

Partial knee replacement is considered when the knee still has a good range of motion, the ligaments are stable, the deformity is minor. Usually a total knee replacement is what is done.

Risks are the same as any other surgery anesthesia complication for example, but knee replacement surgery has a specific risk of blood clots formation, pain after surgery in the knee afterwards even.

What I am trying to convey is if you can tolerate the pain and as long as it is possible to control it and reduce it without surgery please consider doing so.

Please feel free in contacting me for any further quesitons.

Best regards,
Dr. Nazzal

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Brief Answer:
follow up

Detailed Answer:
Dear XXXXXXX

Thank you for your follow up question. I totally agree with what you said, and I always inform my patients that they need to keep surgery as the last option. A healthy human body once given the right nutrition and enough space to recover has great self-healing abilities; things get a bit slower once we age but still our bodies are our best doctors.

It is good to hear that you avoid NSAIDS, although sometimes when NSAIDs are taken as described they help reduce the inflammation which can help in recovery so not only beneficial to control the pain, but they have some side effects. If you manage to control the pain with other natural remedies its good, but make sure those natural remedies are safe. Yes the injections are not one of the best options.

For stem cell research as a matter of fact I am very familiar with it, I work in Germany and we have center for stem cell therapy research but in neuroscience field. In case you want to educate yourself about the topic there is an open access research paper you can look it up, its title is "current perspective in stem cell research for knee cartilage repair". From what I read it seems that the technology seems to be still in its infancy, more clinical trials will be needed before it becomes approved. Nevertheless it has the potential for sure, it may take a while though to be accessible.

Finally I would like to remind you of what I said in the pervious response, at this stage conservative therapy will help you alot, and will stop the osteoarthritis from progressing. Conservative therapy includes weight reduction and making the muscles around the knee stronger.

Thank you again for your interesting questions, and I wish you a full recovery.

Kind regards,
Dr. Nazzal     

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Brief Answer:
Thank you

Detailed Answer:
Thank you, and feel free to keep me updated.

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Brief Answer:
I encourage you also to do the exercises given to you.

Detailed Answer:
Yes exercises are good way to strengthen the muscles supporting the knee.

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