Advances Allow for Safe and Successful Outpatient Partial Knee Replacement Procedures
Alan L. Valadie, MD
As a result of our more and more active society as well as injuries suffered in sports, we are seeing more patients with early wear and tear of their joints. This is especially true in the knee, and we are seeing higher numbers of patients with osteoarthritis of the knee limiting their activities. Fortunately, we have many nonsurgical measures to help manage the pain of arthritis. In a growing number of patients, however, the breakdown is severe enough that knee replacement is necessary to continue activities. While this procedure is typically successful, it may not restore the normal level of activities desired. In 10 percent to 20 percent of patients with knee arthritis, however, the breakdown of the cartilage in the knee is limited to just one area. This typically involves the inner or medial aspect of the knee, although can involve the outer (lateral) part of the knee or underneath the kneecap.
In these patients, a partial knee replacement may be an option. In this procedure, just a small part of the knee is resurfaced. With advances in technology, procedures and pain management, this can now be done safely and successfully as an outpatient. For over a year, we have been performing this procedure with great success in our outpatient surgical center. Patients are discharged from the surgical center to recover in the comfort of their own home. In addition, this allows them to avoid hospitalization and minimize the risk of potential complications such as infection.
Important elements for successful outpatient procedures such as this include a healthy, motivated patient with a home environment suitable for appropriate recovery. One aspect of this is family who can assist with exercises and mobilization, which start immediately upon arrival home. Also important is a surgical center and surgeon who have assembled processes and protocols to safely and effectively perform these procedures. Finally, implant and instrumentation systems designed for minimally invasive procedures are critical. The Arthrex iBalance unicondylar knee system (UKA) is an example of a system built on efficiency, reliability and ease of use. In the outpatient setting, this facilitates consistent and reproducible results.