| Many middle aged Indian patients develop partial knee | | | | sparing the outer half and the patella unlike a total |
| osteoarthritis. In Indians, osteoarthritis of the knee | | | | knee replacement. The operation can be done by a |
| affects the inner half or medial compartment to start | | | | minimally invasive technique sparing the quadriceps |
| with and then proceeds to affect the outer half or | | | | muscle. The pre requisites are that the one half alone |
| lateral compartment. | | | | must be worn as seen on x- rays and the anterior |
| Localized attrition occurs in the beginning as a so | | | | cruciate ligament should be intact. The technique of |
| called "lesion". Later it gradually affects the front and | | | | insertion is demanding but the rewards to the patient |
| inner portion of the inner half of the lower end of | | | | are numerous. Shorter hospital stay, quicker |
| the thigh and leg bones (anter- medial wear) leading | | | | recovery, small incisions, no blood transfusion, less |
| to partial knee arthritis. This is obvious on standing x | | | | pain, less cost (vs. TKR) and better function |
| rays as meidal or inner space joint space narrowing. | | | | (squatting, kneeling, climbing stairs) are the much |
| Clinically these individuals may be bow legged since | | | | acclaimed benefits. The knee feels more natural as |
| childhood. | | | | sensations carried by the ligaments are intact. |
| In India the standard surgical treatment for OA knee | | | | The Oxford unicompartmental knee is a |
| is a total knee replacement. However the ideal | | | | representative type and is a mobile bearing uni knee. |
| candidate for a TKR is a person older than 65 years. | | | | It replicates the function of the meniscus. The wear |
| Clearly someone in their fifties is not suited for a | | | | rates are low. Survivorship analysis is 98% at 15 |
| TKR as his/her life span would exceed that of the | | | | years. |
| joint and he would need a revision knee replacement | | | | Advantages of partial knee replacements |
| later on. | | | | 1) minimally invasive surgery- Since the surgery |
| Indian surgeons offer osteotomy or a Uni condylar | | | | involves a small exposure to see the affected half |
| knee replacement for partial knee affliction. In an | | | | alone, surgeons can make the incision smaller, |
| osteotomy, the thigh or leg bone is divided and re | | | | producing less post operative pain and smaller scars |
| aligned so that the abnormal weight bearing axis is | | | | 2) less blood loss- Since the surgery is minimally |
| normalized. Pain relief is provided for a period of up | | | | invasive, less blood loss occurs. |
| to 10 years but is not total. An osteotomy is the | | | | 3) Faster rehabilitation- Patients can stand up and |
| logical operation for patients with bow legs and knock | | | | walk on the same day, squat by week one and |
| knees in the working class whose work demands | | | | return to work earlier. |
| would wear out an artificial joint. It is not the right | | | | These innovative knee replacement procedures are |
| procedure when there is no deformity. | | | | available in India. Baby boomers and young patients |
| A unicondylar or partial knee replacement substitutes | | | | with partial knee arthritis lacking Mediclaim or Medicare |
| the worn half of the joint with prosthesis. The bony | | | | can now fly to India and have their surgery |
| resection is restricted to the affected half alone | | | | performed in hospitals with international standards. |