Total vs. partial knee replacement: what's the difference?

Written by: Mr Andrew Port
Published: | Updated: 09/10/2023
Edited by: Lauren Dempsey

Total (TKR) and partial knee replacements (PKR) are surgical options for individuals suffering from degeneration of the knee. Although they may seem very similar, several differences between the two should be explored. Leading Darlington-based consultant orthopaedic surgeon Mr Andrew Port shares his expertise on both surgeries.


Before undergoing either a TKR or a PKR, potential patients should understand how each surgery is performed, the recovery periods associated with them, the expected side effects, and complications from both. Following an informed discussion and individual assessment with your surgeon, you should have a good understanding as to which choice is the most suitable option for your particular circumstances. In addition, those who have undergone either procedure should know the chances of needing revision surgery associated with both a TKR and a PKR.


How do I know if I need a total (TKR) or partial (PKR) knee replacement? 

A partial knee replacement can only be performed on patients with arthritis limited to the medial compartment, the inside part, of the knee. In some cases of arthritis in the knee cap joint, the benefits of a PKR may outweigh the risks and be favoured, however, it is not suitable to treat arthritis in the lateral compartment (outside part). Total knee replacement (TKR) can be performed with any type of arthritis within the knee.


Additionally, a PKR can only correct mild deformities within the knee, yet a TKR can be used to correct any deformity. 



What is the difference between a partial (PKR) and a total (TKR) knee replacement? 

A PKR only replaces the part of the knee that is arthritic, leaving the rest of the knee intact, whilst a TKR replaces the whole knee. Replacing the whole knee eliminates the risk of developing arthritis in the rest of the knee.


If only the arthritic part of the knee is replaced, there is a risk of developing arthritis in the remaining parts of the knee. Further surgery to replace these compartments may be required in the future. PKR is bone-conserving, meaning future revisions are potentially easier, but revisions for TKR can be more complex, resulting in the surgeon needing to remove more bone when performing it.  

X-ray of a partial knee replacement


X-ray of a total knee replacement


What can I expect after a partial or total knee replacement? 

The final result for partial or total knee replacement is similar, in most cases. The majority of people will not need to have the operation again; 90 per cent of PKR and 95 per cent of TKR will last more than 10 years.  


Partial replacement surgery is generally less painful as only part of the joint is being replaced and patients are likely to go home on the day of or the day after surgery. The recovery is generally easier and as the operation involves less surgery, the result is more often a more natural feel to the knee and generally a quicker return to full function in the order of 3-6 months. 


On the other hand, recovery from a TKR can take a bit longer as there is more stiffness and pain in the first few weeks after surgery since the whole joint is being replaced. Patients typically have a longer recovery and can take up to a year to settle. 



What is the likelihood of needing revision surgery after a partial or total knee replacement?  

There is a slightly higher likelihood of needing revision surgery within 10 years for a PKR than for a TKR. Approximately 90 per cent of partial replacements are intact and don’t need to be revised or changed after ten years, but in the case of total replacements, it is about 95 per cent.  



What is the mortality rate from a partial or total knee replacement? 

Although the risk of death from both procedures is extremely low, there is a slightly higher risk following a TKR than a PKR. Following a PKR, the risk of death within 3 months after surgery is approximately 0.22 per cent (22 in 10000 patients), while after a TKR the risk is approximately 0.47 per cent (47 in 10000 patients) 3 months post-surgery.  



What complications can occur after a partial or total knee replacement?  

There is a low risk of complications, such as infection, venous thromboembolism (VTE), heart attack, or stroke following a knee replacement surgery. The risk is slightly higher in patients who undergo a TKR rather than a PKR.  

The difference between PKR and TKR

If you are interested in booking a consultation with Mr Port to discuss your options for a knee replacement, you can book one directly via his Top Doctors profile.  

By Mr Andrew Port
Orthopaedic surgery

With NHS waiting times for hip and knee replacements in Cumbria currently up to two years, Mr Andrew Port, a highly experienced consultant orthopaedic surgeon, is offering the people of Cumbria quicker access for their joint replacement surgery. Mr Port offers his patients individualised care pathways for hip and knee replacements, including partial knee replacements, complex and revision (redo) hip and knee replacements, for which he is a regional specialist. As a pioneer for robotic joint replacement surgery in the UK, his patients are now able to take advantage of the quicker recovery times, reduced pain and improved function, following robotic joint replacement surgery.

His current waiting time for a joint replacement privately is four weeks, and for and NHS patient is around six months. Mr Port has more than 30 years’ experience in orthopaedic surgery, during which time he has led and guided local, regional and national directives in improving the quality of orthopaedic surgery. He has been based at the BMI Woodlands hospital in Darlington for 22 years. He performs more than 500 hip and knee replacements a year, including 50 revision surgeries and 40 partial knee replacements. The “Getting It Right First Time” (GIRFT) Department of Health directive and the British Orthopaedic Association advocate that surgeons should perform a minimum of 15 of each of these procedures per year to maintain standards. Mr Port has one of the highest patient satisfaction outcomes and lowest complication rates nationally.

Being one of the first surgeons in the UK to introduce robotic hip and knee replacement surgery, Mr Port has performed more than 300 robotic-assisted hip and knee replacements using the Stryker Mako Robotics system. From his experience he explains: “The technology combines 3D planning with accurate intra-operative reconstruction of the hip or knee replacement. Following robotic surgery, patients are reporting less pain, quicker recovery times and greater satisfaction rates” The BMI Woodlands Hospital, in Darlington, is the only hospital in the northern region that offers access to augmented surgical assistance with the Stryker Mako Robotics system. Mr Port is currently Chair of the Surgical Collaborative at South Tees NHS Trust, incorporating The James Cook University Hospital and the Friarage Hospital. He leads on the strategy to standardise the delivery and quality of orthopaedic surgery over the Tees Valley and North Yorkshire.

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