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I'm only 45 years old but I have severe knee arthritis. Only one side of the joint seems to be affected. The doctors have given me several options. The best two seem to be realigning the joint and a partial joint replacement. How do I decide what to do?

Most doctors don't want to do a total knee replacement on middle-aged patients. The implants are only expected to last 10 to 15 years. You may think getting a second replacement later is all that's needed. It's not that simple. Sometimes ligaments are cut reducing the joint stability. Bone is lost putting the first implant in and taking it out again.

Just replacing the side of the joint that's arthritic is a good option. This is called a unicompartmental knee replacement (UKR). Studies show joint motion is often nearly normal after this operation. This may be because the ligaments remain intact and the joint surfaces still match.

Cutting a wedge or pie-shaped piece of bone out of the lower leg bone (the tibia) is another option. This is called a tibial osteotomy. The result is to realign the joint and change the angle. Less load is placed on the inner side of the joint after this operation. The long-term results of this surgery aren't always good. After 15 years, 25 percent of the patients need another surgery.

Listen to your doctor's advice. Find out which option he or she would recommend. This may be based on the condition of your joint as well as the surgeon's experience with each treatment method.

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