What is the best age to have a knee replacement?

Chronic pain associated with arthritis of the knee can greatly affect a person’s quality of life and ability to take part in daily activities. When conservative treatment measures are unsuccessful in addressing this pain, knee replacement surgery may be the solution, helping to restore functionality of the knee and enabling patients to get back to an active lifestyle. In this detailed article, highly respected consultant trauma and orthopaedic surgeon Mr Muhammad Adeel Akhtar addresses common questions about knee replacement surgery including what to expect from the recovery period, associated pain and the optimal age to undergo this type of operation.

What is the best age to have a knee replacement?

I do not think there is a specific age which is always best for knee replacement surgery. Each patient should be assessed and given all of the available treatment options, including knee replacement, regardless of their age.

Historically, it was suggested that knee replacement is an operation for elderly patients with limited functional capabilities. In the past, younger patients were not offered knee replacement surgery due to a high rate of dissatisfaction, as there were certain patients who were left unhappy following replacement surgery, especially when performed at a younger age and that led people to believe that young age is a contraindication.

However, with modern implants and surgical techniques as well as our improved understanding of rehabilitation following knee replacement surgery, younger patients are also suitable for the procedure. Nowadays, many patients return to an active lifestyle regardless of their age following knee replacement.

The decision about whether a knee replacement is right for the individual depends on the diagnosis or problem affecting the knee. In terms of arthritis, every patient has different level of disability as a result of the disease’s impact on the knee. It's a matter of managing each knee individually, based on the patient’s symptoms, through their treatment and rehabilitation phase in order to get the best results.

Are there other qualifying factors for this operation?

The main reason to consider knee replacement surgery is pain and its effects on activities of daily life, including walking, sleeping and enjoying life. When patients are experiencing persistent and debilitating pain which disrupts their ability to function, these symptoms suggest that they are at a stage where all conservative treatment options, such as physiotherapy, injection therapy and pain management, have failed.

In these cases, surgery is the last resort and a knee replacement can improve their quality of life and help to resolve pain.

Is a knee replacement a major operation?

I think that every operation or a surgical intervention should be regarded as a major intervention because it can change a patient’s life. Many patients come back to me following surgery and tell me that their knee replacement has given them their life back.

If we consider every operation as a major intervention, this helps us to set up the journey for patients which begins with careful preparation. Managing expectations and full patient awareness of the process through different stages makes the operation easier to recover from and helps to achieve excellent results and a full recovery from the surgery.

What does the knee replacement procedure involve?

The knee replacement involves replacing the diseased (arthritic) surfaces of the thigh and shin bone which constitute the knee joint with good quality metal implants, with a plastic part which acts as a cushion. The implants are fixed to the bone with cement.

Where the end of the thigh bone and the top end of the shin bone meet, there is a natural cushion which protects the knee when we are walking on it. When the knee gets arthritis, then the end of the thighbone and the top end of the shin bone become arthritic and the normal smooth cartilage surface is lost.

In knee replacement surgery, we shave off the end of the thighbone and the top of the shin bone and replace it with high quality metal. In between the two metal parts, a plastic part acts as a cushion in order to protect the metal parts hitting from each other.

Is knee replacement surgery painful?

Knee arthritis is an extremely painful condition resulting in unbearable and sudden episodes of sharp pain (comparable to toothache). Following surgery, this arthritic pain improves very quickly and surgical pain improves after a few weeks. Most patients recover quickly after their knee replacement and may take the same pain killers they used beforehand to control arthritic pain to help them through recovery in the post-operative period.

Most patients start to walk on the same day after their surgery and can go home in the next few days. Patients can take their painkillers if required for a short duration after the surgery for their surgery pain.

Naturally, there is some pain associated with this type of surgery. However, with advances in anaesthesia, surgical techniques and medications, knee replacement is less painful these days and is followed by enhanced recovery and rehabilitation programmes.




If you are considering knee replacement surgery and wish to schedule a consultation with Mr Akhtar, you can do so by visiting his Top Doctors profile.