What Is the Best Age to Have Knee Replacement?

knee replacement
While the majority of knee replacements are performed on people aged 50 to 80 years old, there isn’t a specific age for the surgery.

Although the majority of knee replacement is performed on people aged 50 to 80 years, there is no age or weight limit, and the decision is made depending on the individual's level of discomfort and handicap.

There isn't a specific age for knee replacement; however, the majority of people with knee replacement are older than 60 years because artificial joints normally survive just 15 to 20 years.

  • The earlier you undergo knee replacement, the more likely you may require more surgery in the future.
  • Therefore, if the treatment is performed on a younger person, the joint will most likely need to be replaced again in the future.

The surgeon will propose joint replacement in cases such as:

  • Severe pain that causes considerable handicap and affects your overall health
  • Disabled by rheumatoid arthritis at the age of 30 years
  • Knee joint damage due to a car accident

Knee replacement has been performed on people who are as young as 20 years. Most surgeons will recommend people to wait as long as possible, but the goal is to eliminate knee discomfort and get the person moving. Because immobility can be harmful, painless mobility is the goal.

  • Some people can safely postpone the surgery till they are 60 years.
  • Waiting too long to get the knee replaced may not be advisable for some.
  • For example, if the knee joint deteriorates too much, the surgery to replace it may become more difficult.

However, there is evidence that if you don't wait until your knee is stiff or misshapen, the surgical outcome may be better.

Your surgeon will advise you on surgical choices available to you and the potential benefits and drawbacks of having or postponing surgery, considering your age, health, and degree of activity.

Factors that determine the need of knee replacement

An orthopedic surgeon is the best person to decide whether a person is a good candidate for complete knee replacement. They will consider the person's medical history, level of knee discomfort, and capacity to function, as well as findings of a physical exam, X-rays, and, in certain situations, other tests such as a blood test or magnetic resonance imaging.

  • The severity of disease shown in an X-ray scan:
    • Findings of an X-ray scan should establish the diagnosis of knee osteoarthritis, but there are some cases of mild to moderate osteoarthritis on the scan that have severe symptoms.
    • In other cases where severe alterations on an X-ray scan are linked with minor symptoms exclusively, using it to predict clinical deterioration is risky.
    • Walking tolerance is far more important in determining knee replacement than X-ray severity.
  • Age of the person:
    • Some surgeons have claimed that 60 to 65 years is the optimal age group to have a knee replacement. However, they should not persuade a person who is between 60 and 65 years to undergo knee replacement when it is not necessary because there is no automatic assurance of deterioration.
    • Similarly, if people in their 50s or even 40s are severely disabled by knee pain and unable to walk more than a few thousand steps per day, it may be the right decision to proceed with uncemented knee replacement earlier in life with the understanding that a revision procedure will almost certainly be required.

QUESTION

Medically speaking, the term "myalgia" refers to what type of pain? See Answer

6 factors that make you a good candidate for knee replacement

Several alternative therapies, such as anti-inflammatory drugs, cortisone and lubricant injections, and physical therapy, are usually tried first. If none of these have provided relief, it may be time to consider total knee replacement.

  1. Arthritis is interfering with your life: Severe pain that interferes with daily activities indicates that it is time for surgery. Walking, moving upstairs, sitting down, and standing back up are all examples of considerable difficulties. Using a cane or walker could potentially indicate that surgery is required. Even moderate pain at rest or during nights is an indication for knee replacement.
  2. Long-lasting pain isn’t getting better: You must consider knee replacement if the pain doesn’t subside even after exercise, physical therapy, and pain medication. The pain subsides in 90 to 95 percent of all young people following knee replacement.
  3. Abnormality in the knee structure: Surgery may be an option if the knee is swollen and stiff or bends inward or outward. Total knee replacement removes all or part of your knee joint that is damaged and inflammatory tissue that causes stiffness and swelling inside your knee and replaces it with an artificial joint. If your leg bows in or out, this prosthetic joint can correct it.
  4. Knee injury: Surgery may be a viable option if your limb is misshapen due to an injury or if you were born with a deformity. Knee replacement can mend damaged knee joints and restore normal function to them.
  5. You want to stay physically active: Artificial knee joints have a lifespan of 15 to 25 years. If you enjoy jogging, skiing, or hiking but find it difficult to do so due to knee pain, knee replacement may be a possibility for you.
  6. You want long-lasting relief: Artificial knee joints continue to function well for 9 out of 10 people 20 years following surgery. Your age and degree of physical activity may affect how well your artificial knee joint performs over time. Artificial joints, for example, tend to live longer in older, less active people. Overall, artificial joints provide long-term improvement.

Who is not eligible for knee replacement?

Although you have severe arthritis, you may not be eligible for knee replacement due to the following reasons:

  • Weak quadriceps (thigh muscles) that will not be able to support new knee joint
  • Deep or long-lasting open sores (ulcers) in the skin below the knee because they increase the risk of infection

What is total knee replacement?

Whole knee replacement, also known as total knee arthroplasty, comprises contouring and resurfacing the damaged or deformed knee joint, followed by replacing the tibia and femur ends with metal alloys and cartilage with high-quality polymers and plastics.

During knee replacement, the worn ends of the bones and any remaining hard cartilage are removed and replaced with metal and plastic components. The plastic functions similarly to hard cartilage, allowing your joint to move freely. The prosthetic joint's connecting pieces allow your knee to bend while also making it sturdier.

Arthritis hurts and prevents your knee from functioning normally. These things make it harder to move around. Knee replacement is used to treat severe knee arthritis.

Surgeons want to accomplish the following goals by replacing your damaged knee joint with an artificial one:

  • Relieve your knee pain
  • Make it easier for you to move
  • Enhance your quality of life

What is partial knee replacement?

If only part of the knee is worn out, such as the inner or medial area, partial knee replacement is preferable for younger people. Because only one section of the joint is replaced with a prosthetic component, this surgery is known as medial inner knee replacement or partial knee replacement.

  • Unicompartmental knee replacement may be used to treat advanced osteoarthritis that is restricted to a single compartment.
  • The damaged compartment is replaced with metal and plastic during this technique. 
  • All the ligaments, as well as the healthy cartilage and bone, are retained.

Because partial knee replacement is performed through a smaller incision, people typically spend less time in the hospital and resume normal activities sooner than with total knee replacement.

Artificial knees typically have a lifespan of roughly 20 years. Following that, partial knee replacement may need to be replaced with whole knee replacement, which is a relatively uncomplicated process. Then you receive an additional 20 years.

What is arthritis?

Arthritis means inflammation and wear and tear of the joints. It may affect any joint in the body and wear down the firm cartilage that covers bone surfaces, causing the surfaces to rub against each other. 

If you have knee arthritis, you may require knee replacement if stiffness, joint pain, and reduced mobility affect the physical quality of your life.

Your healthcare team will always attempt alternative options first, such as pharmacological therapies, physiotherapy, and weight loss, before recommending knee replacement. You may opt to wait if your symptoms are still controlled and your medicine is effective.

Three types of arthritis include:

  1. Osteoarthritis:
    • Osteoarthritis is the most common form of arthritis. It occurs when the joints are overused and usually affects older people, but it can affect people with joint injuries or weight problems.
    • Weight-bearing joints, such as the knees, hips, feet, and spine, are the most vulnerable to osteoporosis. It is cartilage loss that produces inflammation and makes movement unpleasant.
    • Reduced work of the injured joint, physical therapy and exercise motions, prescribed pain relief medication, dietary changes, and heating and icing are all options for treatment and pain management.
  2. Rheumatoid arthritis:
    • Rheumatoid arthritis is an autoimmune illness, which means the immune system attacks certain parts of the body, particularly the joints.
    • Nobody knows what causes rheumatoid arthritis. Some believe that the immune system might become confused following an infection or virus, whereas others feel that it is triggered by substances in the body.
    • This condition, in any case, can strike gradually or suddenly, producing pain, stiffness, and edema in various joints. Simple daily actions such as opening a jar, going for a stroll, or driving a car might become difficult, if not impossible, due to the swelling.
  3. Psoriatic arthritis:
    • Psoriatic arthritis affects the skin and joints and causes swelling in the fingers and toes. This type of arthritis often affects individuals who are between 30 and 50 years and both men and women equally.
    • Psoriatic arthritis is best diagnosed by a rheumatologist. A thorough review of your medical history, as well as a thorough physical examination with special attention paid to the joints, skin, and nails, is essential to make a diagnosis.

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References
Image Source: iStock Images

Am I too young for a knee replacement? https://www.health.harvard.edu/staying-healthy/am-i-too-young-for-a-knee-replacement

Total Knee Replacement: https://orthoinfo.aaos.org/en/treatment/total-knee-replacement/

Unicompartmental (Partial) Knee Replacement: https://orthoinfo.aaos.org/en/treatment/unicompartmental-knee-replacement/

Unicompartmental Knee Arthroplasty: https://orthop.washington.edu/patient-care/articles/knee/unicompartmental-knee-arthroplasty.html