I’m 84-years-old and hope to see the sun shine another 20 years at least! Two years ago, I had a unicompartmental knee replacement for one-sided arthritis. I’m still having such pain and difficulty walking, I want them to either put a totally new joint in there or just cut the leg off. How do I convince my doctor this implant isn’t working?

For those readers who don’t know, a unicompartmental knee replacement (also known as a unicondylar knee replacement) is designed to replace only the portions of the joint that are most damaged by arthritis. This approach is less invasive than a full knee replacement.

Usually the medial side of the joint is removed and replace. The medial joint is the side closest to the other knee. But sometimes it is the lateral (side away from the other knee) that needs replacing.

Since the time that unicompartmental replacements were first used, the design and surgical technique have improved quite a bit. The result has been an implant that lasts almost as long as the complete knee replacement. That’s good news for most patients.

It doesn’t happen very often but sometimes there is a patient with a unicompartmental knee replacement that has failed. Removal and replacement with a total knee replacement becomes necessary.

Often before going to that extreme, the surgeon will recommend conservative care for pain management, postural alignment, gait training, strengthening, and anything else that might help the patient live well with the implant and overcome the disability. If you have not worked with a physical therapist for at least three months to overcome your current symptoms, then such a move might be the place to start.

Talk to your surgeon about what he or she would suggest for you. Ask what your options are and if conversion to a total knee replacement might work for you.