The best knee replacement isn’t really a knee replacement at all. Partial knee resurfacing transforms lives by alleviating (and often removing entirely) the pain of osteoarthritis and restoring movement.

What is knee resurfacing?

Knee resurfacing is a procedure that treats osteoarthritis of the knee joint. As osteoarthritis develops, the smooth cartilage that covers the surface of the bones in the knee wears away, leaving bone to grind on bone.

If you suffer from osteoarthritis, you’ll know how painful and limiting this can be.

In a knee resurfacing procedure, your knee surgeon resurfaces the worn parts of the bone with metal and plastic implants. These implants protect the healthy bone, ligaments and soft tissue of the knee joint, enable the knee to operate freely, and dramatically reduce or even eliminate pain.

What is partial knee resurfacing?

The knee is a complex joint which comprises three ‘compartments’. There’s an inner (medial) and outer (lateral) compartment. The third compartment is the kneecap (patellofemoral joint). Osteoarthritis can eventually affect all the compartments of the knee, but you might notice pain in a particular area.

> Discover more about osteoarthritis, YKC & you

Where the osteoarthritis is confined to a single area, you may be suitable for partial, rather than total knee resurfacing. There are several advantages to this, as we’ll explore below.

Around half of patients requiring knee resurfacing are suited to partial knee resurfacing. Those that aren’t will still be able to benefit from total knee resurfacing.

Am I suitable for partial knee resurfacing?

Partial knee resurfacing is a surgical procedure and, as with any surgical procedure, it’s one that should be considered only after non-surgical alternatives have been exhausted.

We will usually meet patients at the point at which these other options (over the counter painkillers, physiotherapy, weight loss etc) have been exhausted. Usually, and especially if you’ll be using medical insurance to fund your surgery, you will be referred to us by your GP.

At your consultation, we’ll explore the right treatment for you in the following ways:

Your experience: By the time patients talk to us about their arthritis, it’s often causing them real issues with work or sleep. They may be finding that they are having to forego the things they love (golf, skiing, hiking etc). Even the simplest tasks, like climbing the stairs or driving, may be very painful. Listening to patients can help us understand whether other treatments may be appropriate, or whether surgery is the best next step.

Physical examination: Amongst other things, we’ll look at the way you move and check for signs of pain or swelling of the knee joint.

Scans: An x-ray will reveal signs of arthritis and support our diagnosis. We may use other scans (such as MRI) in certain cases.

What difference will partial knee resurfacing make to my life?

Our patients say that partial knee resurfacing/replacement has transformed their lives. You can read more about their experiences here.

More objectively, a study of 229 patients by the Yorkshire Knee Clinic in Harrogate, supported by the European Knee Society, found very high levels of satisfaction with their ‘new knees’ (96% at five years, compared with satisfaction scores around 80% for total knee resurfacing).

Other independent studies report similar findings. This study, for example, found patients undergoing partial knee resurfacing reported significantly less pain, higher activity levels, and greater satisfaction than total knee resurfacing patients.

What benefits does partial knee resurfacing offer over total knee resurfacing?

It may be the use of that word ‘partial’ but there’s a common misconception among some potential Yorkshire Knee Clinic patients that partial knee resurfacing is of less value than total knee resurfacing. While total knee resurfacing is an extremely effective procedure, the reality is that, for patients suited to partial knee resurfacing, it would almost always be the preferable option. Here’s why:

• Partial knee resurfacing is a less invasive, less complex and quicker procedure than total knee resurfacing or replacement. That means there’s less time under anaesthetic and less risk.
• You’ll usually spend less time in hospital. Often, you’ll be home the next day. Occasionally, you may be home the same day.
• Recovery is quicker because the surgery was less invasive. That means you can get back to work – or to doing the things you love – faster.
• Patients rate partial knee resurfacing higher than total on the Forgotten Joint Score (that is, after recovery from partial knee resurfacing, many patients say it feels so natural they forget they’ve got an implant).
• Function, that is, the performance of your knee after partial knee resurfacing, tends to be higher for partial knee resurfacing than for total. Simple activities (walking, stair climbing etc.) feel more natural but more advanced activities (such as golf, tennis, hiking etc.) are much more likely to be achieved to a higher level with a partial knee resurfacing.
• If a partial knee implant wears out or loosens (uncommon), you still have the option of total knee replacement, giving you a further 15-20 years of knee function. Options are considerably more limited when your first knee resurfacing is total knee resurfacing.

What will happen during and after my operation?

1. Where will my knee resurfacing operation take place?

Yorkshire Knee Clinic’s knee resurfacing specialists operate from three hospitals, and you can choose the surgeon and hospital most convenient to you:

• The Duchy Hospital Harrogate
• Nuffield Hospital Leeds
• Spire Methley Park Hospital

2. Will I need a general anaesthetic?

Partial knee resurfacing usually takes place under a spinal rather than a general anaesthetic but both options are usually available and offered by our anaesthetists. The procedure takes around 40-60 minutes.

3. How long will I spend in hospital?

Most patients require no longer than one night in hospital. During that time you’ll be encouraged to mobilise, taking a few steps to build confidence, prevent complications like blood clots, and promote faster healing.

Occasionally, you may be able to go home the same day.

4. Will it be painful?

Yes. Once the anaesthetic has worn off, you can expect your knee to be very sore for a few weeks (and especially the first few days), but most people find that, with the medication they are given, the pain is manageable. After a few days the acute pain begins to subside. Many patients feel they can manage entirely without painkillers after six to eight weeks.

YKC’s Jim Newman explains more about pain after knee resurfacing

5. How quickly will I recover from partial knee resurfacing?

With assistance, you should be able to start walking small distances right away.

At six weeks, when you will have a check-up with your Yorkshire Knee Clinic consultant, most patients are able to walk unaided. They should be driving again. Some may have returned to work (depending on their job). It’s not uncommon for patients to be walking several thousand steps a day by this point, although they may still feel some discomfort afterwards. This can be managed by ice, rest and over-the-counter painkillers.

Full recovery from knee resurfacing can take three to six months. It’s worth remembering that, however good your knee feels at six weeks, it will feel significantly better still by six months.

Partial knee resurfacing – FAQs