“partial vs full joint replacement”
What is the difference between a partial and a full joint replacement? Does a partial one have to be done again later?
6 Answers
Partial is inner (medial) joint replacement or outer (lateral) joint replacement. Most knee replacements are total. Age, activity, and joint surfaces make the decision between total or partial.
Partial knee replacement is addressing only one of the 3 compartments of the knee. In the properly selected patient, the results can be excellent. In some literature, even better than total knee replacement. However, the procedure is dependent on patient selection, and surgeon expertise. Otherwise, total knee replacement works very well also. Partial knee replacements can be converted to total knee replacement later, if necessary, but the goal is that it remains the one and only procedure, if at all possible.
A partial joint replacement only repairs one of three parts of the knee joint. A full replacement repairs all 3 parts.
Partial Joint Replacement typical means only replacing a portion of the joint that is most involved with Arthritic Changes. The problem may occur later that the same process that affected that portion will later involve the remaining portion requiring a revision surgery.
In a partial hip replacement (hemiarthroplasty), the acetabulum (hip socket) is not changed. A stem with a femoral head (ball) is placed in the femur and the acetabulum is left alone. This operation is generally done for a type of hip fracture (femoral neck fracture) in very elderly or frail patients who are unable to tolerate a total hip replacement.
A total hip replacement involves in addition to the above, replacing the socket with a metal implant. This provides better pain relief than a partial hip replacement. This is the standard of care for patients who are undergoing hip replacement for arthritis, and also the treatment of choice for femoral neck fractures, in most patients who are able to tolerate the surgery (with the exception being very young patients who sustain a femoral neck fracture).
If a partial hip replacement is performed in a relatively healthy active patient to treat hip arthritis, the patient is likely to return within a year or so with worsening of the arthritis in the acetabulum. That may require additional surgery to convert the partial to a total hip replacement.
A total hip replacement involves in addition to the above, replacing the socket with a metal implant. This provides better pain relief than a partial hip replacement. This is the standard of care for patients who are undergoing hip replacement for arthritis, and also the treatment of choice for femoral neck fractures, in most patients who are able to tolerate the surgery (with the exception being very young patients who sustain a femoral neck fracture).
If a partial hip replacement is performed in a relatively healthy active patient to treat hip arthritis, the patient is likely to return within a year or so with worsening of the arthritis in the acetabulum. That may require additional surgery to convert the partial to a total hip replacement.
Complex answer.... In brief, a TOTAL joint replacement resurfaces ALL articulations of the joint, of which there are 3 compartments. Some surgeons elect not to resurface the patellofemoral compartment as part of a total knee. A PARTIAL joint replacement only resurfaces some of the compartments. The hip, knee, and shoulder are all different and use different terminology. ALL joint replacements may have to be done again if they fail, partial or total.
