Many active people are told that knee replacement means giving up running, racquet sports or higher intensity exercise. That advice is changing. A growing body of research, including a recent book chapter co-authored by Dr Jobe Shatrov in Orthopaedic Sports Medicine (Springer), shows that with careful patient selection, modern surgical technique and structured rehabilitation, many patients can return to sport after a partial knee replacement, also called a unicompartmental knee arthroplasty (UKA).

Read the chapter: https://link.springer.com/rwe/10.1007/978-3-030-65430-6_164-1

What is a partial knee replacement

A partial knee replacement resurfaces only the damaged portion of the knee. Most commonly this is the medial compartment on the inside of the knee where osteoarthritis often starts. By preserving healthy bone, ligaments and the cruciate ligaments, the joint can feel more natural than a total knee replacement in the right candidate. Patients often report faster early recovery, better knee awareness and improved proprioception, which are all helpful for returning to sport.

Why return to sport is realistic for many patients

Three advances are driving better return-to-sport outcomes:

1. Better indications and patient selection
   Surgeons now use clearer criteria to choose UKA for the patients most likely to benefit. This typically includes isolated compartment disease, intact ligaments, correctable deformity and a stable knee.

2. Refined surgical technique and implant design
   Modern implants and techniques aim to restore native alignment and ligament tension. When the knee feels stable and balanced, patients can load the joint more confidently.

3. Structured rehabilitation with objective milestones
   Rehabilitation focuses on range of motion, quadriceps and hip strength, dynamic balance and a graded return to impact. Programs that use testing rather than the calendar to progress are safer and more predictable.

What the evidence says

The chapter co-authored by Dr Shatrov reviews contemporary studies on activity levels after UKA. Key messages include:

• Many patients return to low and moderate impact activities such as cycling, swimming, hiking, golf, doubles tennis and social basketball.

• A proportion of patients safely resume higher impact activities including singles tennis and jogging when strength, control and symptoms allow.

• Return to sport is more likely after UKA than after total knee replacement in comparable cohorts, particularly for agility and pivoting activities.

• Outcomes are best when the joint is well aligned, soft tissues are balanced, and rehabilitation milestones are met before increasing impact.

No surgery guarantees return to a specific sport. The overall trend is positive when surgery and rehabilitation are tailored to the individual knee and the patient’s goals.

Read the chapter: https://link.springer.com/rwe/10.1007/978-3-030-65430-6_164-1

A practical pathway back to activity

Every patient starts from a different baseline. The outline below shows a common structure that Dr Shatrov uses with physiotherapists. Your plan may differ depending on age, fitness, prior activity and surgical details.

Weeks 0 to 2

• Swelling control, wound care and gentle range of motion

• Early quadriceps activation and gait re-training

• Short, frequent walks within comfort

Weeks 2 to 6

• Progress range of motion toward full extension and at least 120 degrees flexion

• Stationary bike and pool walking when wounds are healed

• Strength: closed-chain exercises, hip and core work, balance drills

Weeks 6 to 12

• Longer cycling sessions and incline walking as tolerated

• Step-downs, mini lunges and controlled single-leg work

• Light agility patterns without impact when alignment and control are good

Months 3 to 6

• Graduated return to impact if pain and swelling are well controlled

• Jog-walk intervals on flat surfaces, then progress distance and pace

• Sport-specific drills with changes of direction when strength symmetry improves

After 6 months

• Full participation in chosen sports when objective criteria are met and the knee remains quiet between sessions

Progress is based on objective criteria, not just time. Typical readiness checks include minimal swelling, near-symmetrical strength, good single-leg control, and pain that settles within 24 hours after a new activity.

Sports that are commonly resumed

• Low impact: cycling, swimming, elliptical, rowing, hiking, Pilates, yoga

• Moderate impact: golf, doubles tennis, skiing on groomed runs, social basketball or netball

• Higher impact: singles tennis, jogging, field sports at a social level for selected patients who pass testing and progress slowly

Your surgeon and physiotherapist will help match activity intensity to your knee, your goals and your training history.

Frequently Asked Questions

Can I run after a partial knee replacement
Some patients can, once strength and control are restored and swelling is minimal. A jog-walk progression on flat ground is the safest way to start. Not everyone will choose to run, but many are comfortable with short, regular runs for fitness.

Will sport wear out the implant faster
Modern implants are durable. Higher impact places greater load on any joint, natural or replaced. The safest approach is to keep a steady training pattern, avoid sudden spikes in activity and maintain strength and body weight. Your surgeon will review your radiographs at regular intervals.

Is robotic assistance useful for patients who want to stay active
Robotic and computer-assisted techniques can help reproduce planned alignment and balance, which may support a more natural knee feel. Technology is a tool. The benefit comes from using it to deliver an individualised plan.

What if I have pain or swelling when I increase activity
Reduce load, return to low impact work and review your plan. A short step back protects the joint and usually allows steady progress in the following weeks.

How Dr Shatrov plans return to sport

• Sets clear goals with you before surgery so the procedure, implant and rehab plan match what you want to do

• Restores alignment and balance with modern techniques, including robotic assistance when it adds value

• Coordinates rehabilitation with your physiotherapist and uses milestones to progress activity

• Reviews your knee at key checkpoints and adjusts training loads to keep the joint quiet and confident

Key takeaways

• Partial knee replacement can support an active lifestyle when the patient is well selected and the rehabilitation plan is followed.

• Many patients return to low and moderate impact sport. Some resume higher impact activity with structured progression and monitoring.

• Outcomes are best when alignment, soft-tissue balance and strength are optimised.

• Your plan is individual. Objective milestones and symptom response guide the pace of return.

Read the chapter: https://link.springer.com/rwe/10.1007/978-3-030-65430-6_164-1

Learn more

• Total and partial knee replacement

• Robotic knee surgery

• Physiotherapy and post-operative rehabilitation

• About Dr Jobe Shatrov