Compare Total Knee to MIPKR

 Total knee vs MIPKR

MIPKRTotal Knee ReplacementMIPKR
3 – 4 inch incision8 – 9 inch incision
Quadriceps muscle not cut, kneecap not dislocatedQuadriceps muscle cut and kneecap turned over and dislocated 
ACL and PCL left in place to stabilize knee ACL and usually PCL (stabilizing knee ligaments) removed 
very little bone removed large amount of bone removed       
very little blood losssignificant blood loss 
formal therapy usually not needed, patients exercise on own formal physical therapy required average about 2 months
walker about 3 days, cane a week*walker 2-3 weeks, cane another 2-3 weeks*
narcotic pain meds 3-7 days*narcotic pain meds 2-4 weeks*   
infection rate 1 per thousandinfection rate about 15 per thousand
antibiotics not required for dental proceduresantibiotics required for dental procedures   
natural gaitgait permanently altered (to a small degree)   

* There is great variation among patients, these are general observations I have made

Operation differences
Scars of a partial knee (left) vs a total knee (right)

Why would anyone choose Total Knee that has unicompartmental OA?

If they are given the choice it is rare for a patient to do so, but the reasons would be:  

  1. Since all of the compartments are resurfaced, the possibility of progression of OA to other compartments is not there. Fortunately this does not occur frequently with partial knees
  2. There are lots of long term studies that show good durability of total knees, fewer studies long term on partial knees, although mid term studies like my own look promising
  3. In the presence of morbid obesity a total knee spreads out the weight bearing surface to a larger area and might be a better choice. This has not been proven though