Knee Replacement in Young Patients

Knee replacement in a doctor's hand
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Total knee replacement surgery has long been used to treat severe arthritis in elderly patients. However, concerns arise when a patient in their 40s or 50s has severe knee arthritis that is not relieved with simpler, non-surgical treatments. Once reserved for elderly patients, total knee replacement surgery is becoming more common in the younger, active population. However, there are concerns about performing this procedure in such young patients.

How Young Is Too Young?

No one can definitively answer this question, but what we do know is that the benefits of performing total knee replacement surgery in younger patients may outweigh the risks of surgery. The benefits are primarily quality of life, pain reduction, and maintaining proper fitness. By accomplishing these goals, patients may also reduce the risk of developing other problems associated with poor fitness such as cardiovascular disease.

The primary risk of performing total knee replacement surgery in younger patients is the concern of wearing out the implant. Developments in manufacturing have sought to reduce the magnitude of this problem, but it is a concern. Furthermore, the amount of wear to a knee joint replacement does appear to be related to the amount of activity. Therefore, young patients with joint replacements should be cautious and perform only suggested activities (see below).

The Knee Society recommends specific activities for patients with total knee replacement, these include:

  • Cycling
  • Calisthenics
  • Swimming
  • Low-resistance rowing
  • Skiing machines
  • Walking & Hiking
  • Low-resistance weightlifting

Activities which The Knee Society specifically recommends to be avoided are:

  • Baseball
  • Basketball
  • Football
  • Hockey
  • Soccer
  • High-impact aerobics
  • Gymnastics
  • Jogging
  • Powerlifting

These lists are meant to give patients an idea of what to expect if they undergo knee replacement surgery. Before you begin a new exercise program, it is important that you discuss this with your doctor. If there is an activity you do not see listed, and you are curious about your participation, ask your doctor.

Results of Knee Replacement in Young Patients

Numerous studies have evaluated patients considered to be young to have a knee replacement. The average age of having a knee replacement in the United States is right around 65 years old. Generally, surgeons consider anyone under the age of 50 to be 'young' for the purposes of having a knee replacement. Interestingly, this segment of the population--under 50-year-old patients--is the fastest-growing segment of people having knee replacement surgery.

The studies of these patients have found very good results. Better than 85% of people having a knee replacement in this age group consider their results to be good, and the complication rate remains low. More than 98% of the knee replacements placed in this patient age group were still functioning 10 years after surgery.

Risks of Surgery

As with any surgical procedure, there are risks related to having knee replacement surgery. As mentioned, the primary concern in the younger, more active population is early wearing out of the knee replacement implants. However, there are also other risks of knee replacement that people considering the procedure should be aware of. Among these other concerns are infection, stiffness, and blood clot.

A Word From Verywell

Knee replacement surgery is a major surgical procedure and has some serious possible risks associated with surgery. Anyone considering this surgical procedure, regardless of age, should try a physician-supervised trial of nonsurgical treatments before undergoing a knee replacement. However, when all else has been tried, and a young patient has severe arthritis, a knee replacement can be an effective means to maintain both physical health and mental health. By giving patients pain relief and improved function, people often are happier and healthier, even when having a knee replacement at a young age.

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Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Aujla RS, Esler CN. Total Knee Arthroplasty for Osteoarthritis in Patients Less Than Fifty-Five Years of Age: A Systematic Review. J Arthroplasty. 2017 Aug;32(8):2598-2603.e1 doi:10.1016/j.arth.2017.02.069

  2. D'lima DD, Steklov N, Patil S, Colwell CW. The Mark Coventry Award: in vivo knee forces during recreation and exercise after knee arthroplasty. Clin Orthop Relat Res. 2008;466(11):2605-11. doi:10.1007/s11999-008-0345-x

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