How Partial Knee Replacement Gave World Traveler a Leg Up


When it comes to joint replacement, each patient has his or her own set of circumstances and goals for surgery. David, who is from Alexandria, Virginia, not only wanted pain relief from knee arthritis. He was eager to get back to his active lifestyle. He has a fascinating job that takes him all over the world. So when unrelenting knee pain started slowing him down, he thought it was time to consider joint replacement. As a forensic psychologist with a PhD, he was accustomed to doing extensive research for his work. He explained that before scheduling surgery, he put his skills to use, setting out to find the best hospital and physician for the surgery. After consulting with a number of doctors, he decided to travel to New York City and made an appointment to see me at the Hospital for Special Surgery.  

David in Iraq

"I saw several different doctors in several different states before I made a decision, as I am very wary of surgeries, especially when it can hinder my work," David explained.  As a forensic psychologist, he designs personnel testing and other selection systems so private companies, public agencies, and even governments can find the best employees. His career has taken him to hot spots around the world, including Iraq, where he helped the country rebuild its police force and intelligence operations.

But in the past few years, his knee problems were slowing him down. He began walking with a limp and had trouble climbing stairs. Since he had no intention of giving up his work or his active lifestyle, he set out to find a hospital and an orthopedic surgeon with extensive experience in joint replacement.

"I know in my field it's all about experience, and I learned that's how it is in orthopedic surgery, too," David said, adding that the Hospital for Special Surgery and I came out on top in terms of sheer numbers. "Each knee reconstruction is probably unique in some way, and a surgeon who's performed many knee replacements will likely be able to deal with whatever challenge may come their way." 

David was a candidate for a partial knee replacement, which was just what he wanted to hear. He had learned from his research that the rehabilitation and recovery after this type of surgery is generally faster compared to a total knee replacement. The damage was limited to one area of his knee and did not affect the entire joint. 

Patients who qualify for a partial joint replacement generally experience less pain right after surgery and have a quicker recovery and rehabilitation. Yet the procedure completely relieves arthritis pain and allows patients to return to activities they were forced to give up. Another advantage is that it preserves the normal bone and cartilage in the rest of the knee that would typically be replaced in a total joint procedure."                  

The right diagnosis is key. To qualify for a partial joint replacement, also called a "unicompartmental" knee replacement, the arthritis must be confined to a specific area. The knee has three compartments – medial, lateral, and patellofemoral (kneecap region) – and arthritis can involve one, two or all three areas. One would be a candidate for a partial joint replacement if only the inner (medial), outer (lateral), or patellofemoral part of the knee is damaged, independent of the other compartments. Patients whose arthritis is widespread (in more than one compartment) would need a total knee replacement.

David says his recovery was everything he had hoped for. He had the surgery on a Thursday, left the hospital the next day, and by Monday attended a business meeting in New York. "It was like a miracle. I thought the recovery was amazing, it was so fast," he recalls.

Six weeks later, he traveled to Moldova, an Eastern European country, where he was invited to speak on how to strengthen that nation's internal security.  Now, less than five months after surgery, David, who is 71, says he has no intention of slowing down. "My travels are kicked back into high gear again." 


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