Arthritis Procedures

Partial medial or lateral knee replacement

Partial knee replacement surgery is indicated if only one compartment in the knee is affected by arthritis. Generally, despite being one joint, we divide the knee into three anatomic areas. The medial (inner), the lateral (outer) and patellofemoral (anterior) compartments of the knee. Presenting with arthritis means that 1, 2, or all 3 of these compartments are damaged. Depending on the damage in each specific compartment we make decisions whether replacement is needed or not. If the decision is made that only one compartment has arthritis advanced enough to consider replacement, then my recommendation would be to proceed with replacement of only this compartment, a so-called partial knee replacement. This is generally best for patients who are more active and attuned to their knee. A partial knee replacement generally feels better and more natural than a complete knee replacement. A potential downside is that the other, unreplaced compartments, over time can deteriorate as well. Because of this, I always obtain a good-quality MRI scan to determine the amount of damage in the other compartments. Partial knee replacements are expected to last anywhere between 10 and 20 years prior to needing revision to a complete knee replacement. During this time they tend to function better with better range of motion than total knee replacements. In moderation, tennis, skiing, golfing and gym activities are acceptable with partial knee replacements.

Dr. Gomoll uses a robotic assisted technique to improve precision. Click here for more information.

Patellofemoral replacement

If only the anterior (patellofemoral) compartment is arthritic, a special partial knee replacement called a patellofemoral replacement can be used.

Medial implantable shock absorber (MISHA) for medial knee arthritis

A new treatment approach to medial compartment arthritis that is not advanced enough to perform knee replacement surgery has recently become available after over a decade of clinical trials and extensive testing. A medial shock absorber (MISHA) reduces the loading on the damaged medial compartment, thereby improving pain and function. Rehab is more accelerated and patients are generally off crutches within 2 weeks. The goal of the device is to delay knee replacement surgery, ideally for up to a decade and it can then be revised to either osteotomy or knee replacement without difficulty.

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