Duncan Spencer, who had a partial (unicompartmental) knee replacement, was able to get back to the activities he enjoys, like rowing, after his recent surgery.

Duncan Spencer thought "this is the final straw." For the first time in 12 years he did not win a medal at the Masters' World Rowing Championships and he knew his sore knees were to blame. The 67-year-old had been dealing with arthritis for years but this defeat led him to take action.

A consultation with Anthony S. Unger, MD, Director of the Minimally Invasive Joint Replacement Surgery Program at The George Washington University Hospital, offered encouraging news: Because X-rays showed that the arthritis in Mr. Spencer's knees was confined to only one side of each joint, he was eligible for a partial (unicompartmental) knee replacement. This was a surprise to Mr. Spencer, a Washington, DC resident and a retired journalist. A few years earlier, he had undergone arthroscopy (a minimally invasive procedure that removes damaged bone and cartilage) on both knees. His last surgeon had warned if his joints got worse, total knee replacement would be his only option.

Anthony S. Unger, MD Director of the Minimally Invasive Joint Replacement Surgery Program Rafael A. Lopez, MD, FACS, Assistant Clinical Professor of Orthopaedic Surgery

"Even so, I was very hesitant," says Mr. Spencer, who has been rowing competitively since he was 14. "I'd been told that total knee replacement would end my rowing career." However, Dr. Unger understood his need to get back on the water. "He was very confident that I'd be able to continue rowing," Mr. Spencer says. "He has a wonderful self-assurance that appealed to me as an athlete."

How Partial Knee Replacement Works
In a total knee replacement both surfaces of the shinbone and thighbone are replaced with plastic and metal implants. In a partial knee replacement, only the damaged areas of cartilage and bone are removed, leaving the healthy areas untouched. A small incision is made, avoiding most of the muscles and tendons around the knee. A plastic and metal implant is placed on the damaged side of the joint and secured with bone cement. If necessary, the surgeon reshapes the shinbone and thighbone slightly to fit the implant.

"As long as the arthritis is isolated in one side of the knee, there's no age limit as to who can have the procedure," Dr. Unger says. "It generally offers a shorter hospital stay, a faster rehabilitation process and better overall function, compared to total knee replacement." Rafael A. Lopez, MD, FACS, Assistant Clinical Professor of Orthopaedic Surgery at GW Hospital, who also performs partial knee replacements, notes that the procedure removes 80 percent less bone than a total knee replacement. "We're removing much less bone and leaving all the muscles and ligaments intact, which makes a huge difference in the ultimate success of the procedure."

Dr. Lopez offers a simple test to help determine if someone might be eligible for partial knee replacement. "If you can place your finger on the spot on your knee where you're feeling pain, this procedure might be appropriate. Of course, you need a thorough physical exam and X-rays."

A week after the final rowing competition in Boston last fall, Mr. Spencer had the surgery on both knees. He stresses that recovery was not easy, because he spent three days in the hospital and endured two and a half months of physical therapy; however he was training on his gym's rowing machine just one month after surgery. Now, he says, "I've regained much of my range of motion, and my pain is manageable -- just a twinge when I'm going down stairs." Best of all, "I can row 10,000 meters without a problem." At press time, he was looking forward to his next race, in Miami -- and, perhaps, another medal.

Get Your Game Back
If knee pain or injury is keeping you down, learn how GW Hospital can help. To schedule a consultation with an orthopaedic surgeon, please call 1-888-4GW-DOCS

900 23rd St., NW, Washington, DC 20037 (202) 715-4000