How Old is too Old for a Knee Replacement?

Orthopaedic & Spine Center
Telehealth banner Dr. Boyd Haynes, III

Boyd W. Haynes III, MD

In my orthopaedic practice, I am often asked age-related questions when it comes to certain surgeries.  “What’s the cut-off age for this surgery and what age do I have do be before I can I have that procedure?”  Only a few years ago, those questions probably mattered a lot more than they do now for orthopaedic surgeons, at least that’s the case for me.  Our surgical techniques were not nearly as advanced, joint replacement implants were not made to withstand the wear and tear that today’s prosthetics can, and our understanding of post-surgical pain management needed improvement.  While knee replacements are still major surgeries, with uncomfortable and lengthy rehabilitation periods, we’ve made great strides in improving all aspects of the knee arthroplasty surgical experience for the patient.  So much so, that age typically is not the major consideration for me when it comes to a patient’s fitness for surgery.  Instead, here’s where my focus lies….

Overall health – I have done knee replacements on patients of all ages.  You may be interested to know the age of my youngest knee replacement patient thus far was 32 and the oldest was 102 at the time of surgery! I’m really interested in how healthy the patient is overall.  I’ll give you some examples so that you can understand what I mean.  A patient can be 90 years old, and have terrible knee arthritis, but be fit as a fiddle otherwise, with great blood pressure, no diabetes, a healthy weight, and a love of life. I can feel good about doing surgery on this patient because they are healthy and want to get better so they can keep on living!  On the other hand, I can have a patient who is 50, overweight, depressed, with high blood pressure and pre-diabetes along with knee arthritis, whom I will be concerned about doing surgery upon.  Even though quite young, this patient has many health issues going on, as well as depression, that could adversely impact how well the surgery and subsequent recovery would proceed.

Positive Attitude – Everyone has a bad day once in a while and it’s hard putting on a smile when your knee is killing you, isn’t it? However, physicians like being around patients who have a sunny disposition and a good outlook on life.  Why?  Because we know positivity promotes better healing and recovery than a negative attitude.  We’ve seen it in our practices and there are scientific studies that back that up.  How is this related to age?  I often say that the older patients I have often do better after a knee replacement than the younger patients, because they’ve seen it all, been through it all and they know they can get through this too.  The younger patients tend to have more complaints of discomfort after the surgery, the long recovery time can be problematic as well as the time spent in Physical Therapy.  The older folks seem to take it all in stride, literally and figuratively!

Realistic Expectations – Finally, I think patients who have a clear understanding of what a knee replacement will give them and what it won’t and are content with that are way ahead of the game.  Yes, it is a new knee, but no, you probably won’t be able to do all of the things that you could do when you were sixteen.  Your replaced knee will not be perfect in every way and you may still get stiff or sore.  You will still have to exercise regularly or become deconditioned.  No one can do your Physical Therapy for you after Knee Replacement surgery.  You must put in the work and you must make the effort.  For those who do so, they can count on having an implanted knee that will most likely serve them for the rest of their lives, which will carry them on countless journeys to the many places they want to go.  Now isn’t that why you have a knee replacement in the first place?

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