Am I too young for knee or hip replacement?

A 30-year-old man came to our emergency room with excruciating pain in both hips. He had been experiencing pain for several years, but it had become so bad he hadn’t been able to walk for a couple weeks. Imaging showed advanced bilateral hip arthritis—bone was rubbing on bone.

After a total hip replacement and physical therapy, he’s back to work and tells me he has more mobility than he’s had in years. Thirty may seem young for a joint replacement, but a growing number of younger people are getting these procedures.

Our team performs more than 400 joint replacements each year, and the average age of our patients is 60. But according to the American Academy of Orthopaedic Surgeons, the number of:

  • Total knee replacements increased by 120 percent from 2000 to 2009, and 188 percent for patients age 45 to 64.
  • Total hip replacements increased by 73 percent in that timeframe, and 123 percent for patients age 45 to 64.

It’s a common misconception that knee replacements and hip replacements are just for the elderly. I’ve heard patients say, “Grandma didn’t get a knee replacement until she was 80. I figured I’d just have to deal with the pain until then.”

If you’re unable to live the life you want due to pain, consider joint replacement surgery sooner than later.

Listen: Dr. Thakkar discusses more myths about joint replacement surgery on the Medical Intel podcast.

Why are younger people getting joint replacements?

A couple decades ago, most hip and knee replacement patients were older than 70. That was largely due to the fact that our implants weren’t nearly as good as they are now. They only lasted about 10 years, so doing surgery wasn’t always worth it if you knew you were going to have to redo it two to three times during someone’s life.

Our implants now are much better and last much longer. In fact, a 50-year-old who gets a knee replacement has a 70 percent chance of it lasting until they are 80. That’s 30 years of being able to work, run, bike or play golf pain-free. And current hip replacements are lasting up to 25-30 years.

Osteoarthritis, which is a common reason for hip and knee replacements, is connected to wear and tear on the joints. It’s only natural that your risk of getting it increases as you age. But we’re also seeing it in more patients who are middle age or younger. This could be due to two factors:

  • Popularity of high-intensity sports: Repetitive actions and injuries, such as tears to the cartilage that cushions the joint, increase the risk of arthritis. More people are taking part in activities, such as running and biking. For example, according to Running USA, 17 million people finished a race in 2015, compared with less than 5 million in 1990. While healthy, these activities also can be hard on the joints.
  • Obesity: Carrying extra weight puts increased stress on the joints. Being 10 pounds overweight can put an extra 40 pounds of pressure on your knees. One study found that obesity was strongly associated with the need for knee or hip replacements, with 72 percent of the study group (age 18-59) classified as obese compared to 26 percent of the general population.

"Being overweight puts increased stress on the joints. An extra 10 pounds adds 40 pounds of pressure to the knees." via @MedStarWHC

When should I consider a knee or hip replacement?

Don’t think about your age when considering joint replacement surgery. Instead, consider your pain and mobility. Do you struggle to walk a short distance or drive a car? Are you unable to perform work duties? Do you consistently take medication to control the pain?

Conditions, such as arthritis, also can affect your general health. You may find yourself giving up activities one by one as they become too painful. Eventually, lack of exercise may cause weight gain and conditions that can accompany it, such as diabetes and high blood pressure.

You may benefit from a knee or hip replacement when:

  • Pain and stiffness limits everyday activities or interrupts rest or sleep
  • It becomes necessary to use a cane or walker to remain mobile
  • Treatments, such as anti-inflammatory medication, cortisone injections, physical therapy or less-invasive procedures fail to relieve pain
  • An abnormality develops, such as bowing in or out of the knee

Our bodies sometimes break down, affecting quality of life. Fortunately, in some cases we can replace the faulty parts and return mobility. While those new parts may wear down eventually, advancements in technology help us give younger people more years to do what they love—pain-free.

Request an appointment to see if joint replacement surgery is right for you.

Hip and Knee Reconstruction Surgeon, MedStar Orthopaedic Institute at MedStar Washington Hospital Center

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