Ordination Dr. Maximilian Kasparek
MK Orthopädie Währing
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15. October 2025

Par­tial Knee Re­pla­ce­ment vs. To­tal Knee Arthroplasty

In­ter­view with Priv.-Doz. DDr. Ma­xi­mi­lian Kas­pa­rek, MSc

Many pa­ti­ents are faced with the ques­tion: par­tial knee re­pla­ce­ment or to­tal knee ar­thro­plasty? Both op­ti­ons have ad­van­ta­ges and di­s­ad­van­ta­ges – and the de­cis­ion de­pends on in­di­vi­dual fac­tors. A con­ver­sa­tion with Dr. Kas­pa­rek cla­ri­fies what truly matters. 

Af­ter an ACL tear, your ath­le­tic fu­ture is de­ter­mi­ned not by chance, but by the cor­rect therapy.
1. What exactly is a par­tial knee re­pla­ce­ment and how does it dif­fer from a to­tal knee arthroplasty?

A par­tial knee re­pla­ce­ment (of­ten also cal­led a “uni­com­part­mental pro­sthe­sis”) re­places only a por­tion of the knee joint, such as the in­ner or outer com­part­ment. With a to­tal knee ar­thro­plasty (to­tal en­do­pro­sthe­sis), the en­tire joint is re­pla­ced – all com­part­ments. The main dif­fe­rence lies in how many he­althy struc­tures are pre­ser­ved. The par­tial knee re­pla­ce­ment is less in­va­sive, of­ten has a shorter ope­ra­ting time, and po­ten­ti­ally fas­ter re­co­very – but it is not sui­ta­ble for every knee con­di­tion and every form of osteoarthritis. 

2. When do you re­com­mend a par­tial knee re­pla­ce­ment, and when is a to­tal knee re­pla­ce­ment the bet­ter choice?

I weigh se­ve­ral fac­tors: the ext­ent of the os­teo­ar­thri­tis, how many com­part­ments are af­fec­ted, how sta­ble the joint is, and how ac­tive the pa­ti­ents are. If only one com­part­ment is af­fec­ted, there is little to no ma­la­lignment, and the other parts of the car­ti­lage and knee are he­althy, then a par­tial knee re­pla­ce­ment is ideal. In ca­ses of ad­van­ced joint de­ge­ne­ra­tion in mul­ti­ple com­part­ments, unsta­ble joint gui­dance, or a se­vere de­gree of de­for­mity, to­tal knee ar­thro­plasty is of­ten the safer and long-term bet­ter choice. 

3. How do the re­ha­bi­li­ta­tion pro­cess, mo­bi­lity, and ever­y­day ex­pe­ri­ence dif­fer bet­ween par­tial and to­tal knee replacement?

Pa­ti­ents with par­tial knee re­pla­ce­ments of­ten ex­pe­ri­ence a gent­ler start: less tis­sue trauma, less post­ope­ra­tive pain, of­ten shorter hos­pi­tal and re­ha­bi­li­ta­tion times. This al­lows them to re­gain con­fi­dence in the knee more quickly and re­sume daily ac­ti­vi­ties and light sports ear­lier. A to­tal knee re­pla­ce­ment ge­ne­rally of­fers si­gni­fi­cant pain re­lief and sta­bi­lity – but usually with a lon­ger re­ha­bi­li­ta­tion pro­cess and more struc­tu­red recovery. 

4. Are there tech­ni­cal in­no­va­tions that are par­ti­cu­larly re­le­vant for par­tial knee replacements?

Yes, de­fi­ni­tely. Ro­bot-as­sis­ted sys­tems are a ma­jor to­pic: they help to po­si­tion the im­plant pre­cis­ely – espe­ci­ally im­portant for par­tial knee re­pla­ce­ments, be­cause even mi­nor mis­a­lignments have a grea­ter im­pact. Na­vi­ga­tion pro­ce­du­res and mi­ni­mally in­va­sive ap­proa­ches also play a role in pre­ser­ving the sur­roun­ding tis­sue as much as possible. 

5. How long does a par­tial knee re­pla­ce­ment ty­pi­cally last – and what is the pro­cess for con­ver­ting to a to­tal knee re­pla­ce­ment, if necessary?

With good sur­gi­cal tech­ni­que, con­sis­tent af­ter­care, and ap­pro­priate pa­ti­ent sel­ec­tion, par­tial knee re­pla­ce­ments can last 10–20 ye­ars or lon­ger. If a to­tal knee ar­thro­plasty be­co­mes ne­ces­sary la­ter, it is usually fe­a­si­ble – ho­we­ver, the ope­ra­tion can be more com­plex, as tis­sue and bone con­di­ti­ons are al­te­red. It is im­portant that the con­ver­sion is well-planned. 

6. What are the spe­ci­fic li­mi­ta­ti­ons or risks as­so­cia­ted with par­tial knee replacements?

A par­tial knee re­pla­ce­ment is not sui­ta­ble for every knee. If the os­teo­ar­thri­tis la­ter spreads to other areas of the joint, dis­com­fort may oc­cur again. A par­tial knee re­pla­ce­ment is also not the ideal so­lu­tion for mis­a­lignments or se­vere in­sta­bi­lity. The tech­ni­que is more de­man­ding, re­qui­ring pre­cise plan­ning and ex­pe­ri­ence in its ap­pli­ca­tion. With the right in­di­ca­tion and sur­gi­cal tech­ni­que, very good re­sults can be achie­ved, but the sel­ec­tion must be made carefully. 

7. How do you ad­vise pa­ti­ents re­gar­ding sports af­ter a par­tial knee re­pla­ce­ment vs. a to­tal knee replacement?

I place great em­pha­sis on rea­li­stic ex­pec­ta­ti­ons. With a par­tial knee re­pla­ce­ment, joint-fri­endly sports are of­ten pos­si­ble soo­ner: swim­ming, cy­cling, Nor­dic wal­king, etc. A to­tal knee re­pla­ce­ment of­ten al­lows for sports as well, but the re­turn re­qui­res time, good mus­cu­lar sta­bi­lity, and me­di­cal cle­arance. Strength trai­ning, ba­lance exer­ci­ses, and tar­ge­ted func­tion tests are cru­cial in this process. 

8. Which ap­proach or sur­gi­cal tech­ni­que do you re­com­mend – and in which cases?

Ro­bot-as­sis­ted knee sur­gery is fre­quently used for the knee – espe­ci­ally for par­tial knee re­pla­ce­ments – to mi­ni­mize po­ten­tial sources of er­ror. For to­tal en­do­pro­s­the­ses, I place great em­pha­sis on mi­ni­mally in­va­sive ap­proa­ches, pre­cise ali­gnment, and the ap­pro­priate im­plant sel­ec­tion. The sur­gi­cal ap­proach is al­ways cho­sen in­di­vi­du­ally – de­pen­ding on the pa­ti­en­t’s ana­tomy and ac­com­pany­ing conditions. 

In re­cent ye­ars, we have the­r­e­fore de­ve­lo­ped the ori­gi­nal knee tech­ni­que for to­tal en­do­pro­s­the­ses. This in­no­va­tive sur­gi­cal tech­ni­que, which Prim. Univ.-Doz. Dr. Tho­mas Müll­ner, PhD and I have de­ve­lo­ped tog­e­ther, re­con­s­tructs the in­di­vi­dual bio­me­cha­nics and ana­tomy of the knee be­fore the os­teo­ar­thri­tis and thus en­ables a more na­tu­ral knee fee­ling af­ter the operation.

9. How do age, weight, or com­or­bi­di­ties in­fluence the decision?

Age alone is not an ex­clu­sion cri­ter­ion. A he­althy, ac­tive 75-year-old can be an ex­cel­lent can­di­date for a par­tial or to­tal knee re­pla­ce­ment. Weight and com­or­bi­di­ties are more im­portant: se­vere obe­sity puts ad­di­tio­nal stress on the joint and can in­crease the risk of com­pli­ca­ti­ons. Be­fore the sur­gery, I of­ten work with pa­ti­ents on weight re­duc­tion and mus­cle streng­thening to im­prove the chan­ces of success. 

10. What ad­vice would you give to pa­ti­ents who are fa­cing the de­cis­ion bet­ween a par­tial knee re­pla­ce­ment and a to­tal knee replacement?

Rely on a tho­rough dia­gno­sis and in­di­vi­dual plan­ning. My task is to work with you to sel­ect the pro­sthe­sis that will give you the best qua­lity of life – long-term, safely, and sta­bly. Whe­ther par­tial or to­tal knee re­pla­ce­ment: The de­cis­ion de­pends not only on the X‑ray, but on the per­son. Tha­t’s why it’s im­portant to me to in­vest time, cla­rify ques­ti­ons, and pro­vide in­for­ma­tion – so that you can make a de­cis­ion with a good feeling. 

Con­clu­sion: Par­tial knee re­pla­ce­ment or to­tal knee re­pla­ce­ment? An over­view comparison: 
Cha­rac­te­ristic Par­tial knee replacement To­tal knee replacement
What is replaced? Only part of the knee joint (one compartment) The en­tire knee joint
Sur­gi­cal effort Smal­ler pro­ce­dure, mi­ni­mally invasive More ex­ten­sive procedure
Re­hab time Of­ten shorter, fas­ter mobilization Slightly lon­ger re­hab phase
Mo­bi­lity Very good mo­bi­lity, of­ten more na­tu­ral feeling Very good sta­bi­lity, lower risk of long-term consequences
Li­mi­ta­ti­ons Not sui­ta­ble for ad­van­ced osteoarthritis Can also be used for com­plex damage
Long-term re­sults Very good with cor­rect indication Very good with careful plan­ning and rehab
Sport & ever­y­day life Many ac­ti­vi­ties pos­si­ble again, espe­ci­ally joint-friendly Also good re­turn to ever­y­day life and sport possible
Di­s­ad­van­tage Risk of os­teo­ar­thri­tis in other joint parts Hig­her tis­sue ef­fort du­ring the procedure

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Priv.Doz. DDr.
Maximilian Kasparek, MSc
haelsi Gesundheitszentrum im Achtzehnten Theresiengasse 46/2 1180 Vienna

+43 1 399 08 63
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