Knee Replacement in Young Patients

Once reserved for older patients with severe arthritis, total knee replacement surgery is becoming more common in younger, active people. Today, this surgery may be considered for patients in their 40s or 50s with severe knee arthritis that is not relieved with simpler, non-surgical treatments. There are concerns, however, about performing this procedure in such young patients.

This article looks at total knee replacement in younger patients, when it is indicated, and what the results might be. It also discusses some of the risks of total knee replacement.

Knee replacement in a doctor's hand
Peter Dazeley / Getty Images

How Young Is Too Young?

No one can say for sure if patients of a certain age are too young for total knee replacement, or what age marks the turning point. What we do know is that the benefits in some younger patients may outweigh the risks of surgery. These benefits primarily include:

  • Better quality of life
  • Reduced pain
  • Ability to maintain or improve fitness

When these goals are met, patients may also have reduced risk of developing other problems associated with poor fitness, such as cardiovascular disease.

The primary risk of total knee replacement in younger patients is the possibility of wearing out the implant since it will be in place for many years. Implant manufacturers are working to reduce this problem, but it's still a concern.

A patient's level of activity seems to be related to the amount of wear to a knee joint replacement. This is why young patients with joint replacements should be cautious and perform only suggested low-impact activities, like the ones below.

Healthcare providers usually only recommend specific activities for patients who have had total knee replacement. These include:

  • Cycling
  • Low-impact aerobics
  • Swimming
  • Yoga
  • Golf
  • Walking and hiking
  • Low-resistance weightlifting

People with knee replacements should avoid high-impact activities, including:

  • Football
  • Basketball
  • Hockey
  • Soccer
  • Gymnastics
  • Jogging
  • Singles tennis
  • Squash
  • Volleyball
  • Rock climbing
  • Racquetball
  • Lacrosse

These lists are meant to give you an idea about what to expect if you have knee replacement surgery. Before you begin a new exercise program, talk to your healthcare provider. If the activity you want to do isn't listed as recommended, make sure to ask your healthcare provider whether it's safe for you.

Replacement Results in Young Patients

Currently, the average age of a patient who gets knee replacement surgery in the United States is around 65 years old. Generally, surgeons consider anyone under the age of 50 to be young for knee replacement. Still, patients under 50 are the fastest-growing group of people who have knee replacement surgery.

Studies show these surgeries work well. More than 85% of patients under 50 who have knee replacement consider their results to be good. The complication rate is also low. More than 98% of the knee replacements placed in these patients were still functioning 10 years after surgery.

Risks of Surgery

As with any surgical procedure, knee replacement surgery has risks. The primary concern in younger, more active patients is that the implant will wear out early.

There are also other risks, too, including:

  • Infection
  • Stiffness
  • Blood clots

It is a good idea to discuss these risks with your healthcare provider before you decide to have this surgery.

Summary

Knee replacement has traditionally been done in older people. Today, there is growing evidence that people below the age of 50 can also benefit from total knee replacement.

Knee replacement surgery in younger people does have some risk, like the possibility that the implant will wear out early. Most people who have had knee replacement, however, can resume an active lifestyle, as long as they chose lower-impact activities.

A Word From Verywell

Knee replacement surgery is a major surgical procedure. As such, it has some serious potential risks. Anyone considering this procedure, regardless of age, should try a nonsurgical treatments, supervised by a healthcare provider, before undergoing a knee replacement.

If other treatments don't work, a knee replacement can be an effective way to maintain both physical and mental health in a young patient with severe arthritis. Knee replacement surgery can offer pain relief and improved function. Younger patients are often happier and healthier after they've had this surgery.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Thaler M, Khosravi I, Putzer D, et al. Twenty-one sports activities are recommended by the European Knee Associates (EKA) six months after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2021;29(3):694-709. doi:10.1007/s00167-020-06400-y

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By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.