My husband is 46 and needs a knee replacement but his doctor (who is highly recommended and specializes in this stuff) tells him he is too young yet. He's tried all the different procedures to try and get by until he's in his 50's and none of them worked, he is in so much pain with every step he takes. His doctor did tell him he could buy him some time with surgery by cutting away some of the bone below his knee and do something else that I can't remember but this would mean 6 weeks in a cast and physical therapy afterwards. Is this necessary? The doctor said this surgery is far more serious than a simple knee replacement, but it would get him out of pain and buy him about 10 years. We've heard conflicting information as to the age a person needs to be to have a knee replacement. Since this surgery is far more serious than a knee replacement, he's chickend out and won't do it, instead he's been walking around with a limp and in pain for many years now. What are your thoughts?

-- Phyllis Mandel (Phyl80@aol.com), July 01, 2001

Answers

46 is young for a knee replacement. The reason is that at that age most people are too active and the prosthesis will not last very long. A person that age will like ly need revions in the future. The results are not as good with these procedues, and there are higher complication rates. If a person is not very active you could considere replacing the knee, but I too would tend to wait. Other nonsurgical options include medicine, steroids, and other injections. There are surgeries like the one you described. They are called osteotomies, but they cannot be used to treat all types of arthritis. It's a "more sreious" surgery, because it is more difficult. The results can be good if done in the right patient. EVen the early fifties is young for a knee replacement, but at some point you have to weigh the pain and dibility against the complication rate. It is up to your husband and if he wants to live with the pain and limp, it may let his replaced knee last longer. ONce he does have his knee replaced there is no going bacg. I think he's young enough that I would be very hesitant to suggest a replacement.

-- Paul Khanuja, MD (drkhanuja@cs.com), July 13, 2001.

The decision to recommend surgery is based upon many factors, including the risks of surgery, the potential benefits, the condition of the specific patient and is based on an indepth personal assessment including physical exam and review of x-rays. No specific treatments should be made over the internet. There is no specific age restriction on total knee replacements, but the risks are greater in young people, particularly active males, of wear or other forms of failure. You can browse our web site for lots of other information about total knee replacement. You can always get a second opinion if you don't like your first.

-- David S. Hungerford, M.D. (dhunger@jhmi.edu), July 24, 2001.

I decided to respone to your question from a patient point of view. I'am 44 years old, and just celebrated 5 weeks post surgery of TKA yesterday. As to the age of when to have one, it depends on the doctor. Some doctor's won't do a TKA until at least until you are in your 50's. The doctor's I go to, don't beleive in that. They look at your quality of live. I was to the point, that I would work, come home and be pretty useless for the rest of the evening. We have 4 boys from the ages of 8 to 17. All 4 of them are in scouts and 3 of them are in sports. I was missing out on so much of there lives with my pain, that I felt I had no other alternative. I tried all the injections in the knee, steriods, thearpy etc. Nothing really worked that great. Everything I did try, bought me an additonal 2 years before TKa had to be done. I would recommend that you get a 2nd opion from another doctor. I was also told, that my knee would last anywhere from 15 to 25 years. Depending on how well I take care of it. If I abuse it, it would be less. How long it last, is somewhat up to how I take care of it.

-- shirley dominik (dominiwe@sssnet.com), July 28, 2001.

Quality of life, in my own opinion is more important than quantity of life. If your partner is in that much pain and restricted in his every day life activities then he should push for that operation. I had a full knee replacement done on one of my knees at the beginning of September this year. I am 27yrs old - I have suffered Juvenile Stills Disease from a very young age and over the past 18 months had been diagnosed with Secondary Osteo-Arthritis. It had gotten so bad that my quality of life has suffered considerably for over 12 months. The decision to go ahead with the operation was not an easy one,as I had all the risks drummed into me by my specialist and I did seek a second opinion to ensure I was making the correct decision. Although the op has been a success I have no desire to suddenly change my lifestyle to that that a person of my age is enjoying, I am just glad to be in less pain now and in the future will have to make the decision when to have other joints operated on.

-- Carolann Cassidy (calcass@blueyonder.co.uk), December 17, 2002.

I am a 31 year old female veteran of the u.s. army. I have to go through the VA cause the problems I am having are on a service connected limb. I have been wasting my time for 6 months now. I am so dibilitated to the point I have no life. I have 2 sons 7 and 14 and I can't do things with them. I am the bread winner for my family because my husband is disabled and just recently had a kidney transplant. I can't get out of bed sometimes, I can't stand up for more than it takes me the time to go to the bathroom. They VA Ortho doctors tell me they can do a Patellectomy. Just remove the knee cap and the pain will go away. THye say I'm too young to have a replacement and that in the long run I'd probably be better off with an Above the knee amputation! I am unemployed I have no other financial benefits and no health insurance to go find a second opinion Please...if anyone knows or can suggest an alternative I'll take it. I have done therapy, shots, medications, my gut is killing me cause of the anti-inflamatories and pain killers They don't work just make me sick. Help! Please...

-- Melissa (melissajrayl@yahoo.com), June 21, 2003.

You're too young for a knee replacement.

-- Timothy Johnson, M.D. (tjohns55@jhmi.edu), June 24, 2003.

I had a TKA at age 50. The left knee was done in Dec. of 2001 and the right in May of 2002. It has taken a year for me to actually say that the pain is better and that it was the right thing to do. But when I got to the point that mere grocery shopping was a very painful experience, I knew I had to do something! I was "bone on bone" and this seemed to be the only alternative after having tried Synvisc, Celebrex, Vioxx, and who knows what else! It was the right decision for me. My only problem now is that I can only flex my knees to about 90 degrees.

-- Debbie Riggs (ckriggs@peoplepc.com), July 22, 2003.

HI...I AM IN THE SAME BOAT + QUITE DESPERATE TO RELIEVE THIS CONSTANT PAIN. I HAVE BILATERAL OA. I AM A REGISTERED NURSE THAT REQUIRES A LOT OF TIME ON MY FEET. BEING ONLY 45 Y.O., MY DOCTOR SAYS I AM "TOO YOUNG" FOR REPLACEMENTS. I INJURED MY RIGHT KNEE YEARS AGO PLAYING BASKETBALL + RECEIVED A RIGHT KNEE OPEN MENISECTOMY. THIS IS THE END RESULT OF THAT INJURY + SURGICAL PROCEDURE...SEVERE BONE TO BONE CONTACT. AT 20 Y.O., AFTER MY FIRST KNEE SURGERY I WAS TOLD I HAD "DEGENERATIVE JOINT DISEASE" NOW CALLED OSTEOARTHRITIS. I JUST WONDER WHERE "QUALITY OF LIFE" COMES IN. BECAUSE LIVING LIKE THIS IS NO SUCH QUALITY. TO BE IN CONSTANT PAIN HOW DOES ONE CARE FOR THEIR PATIENTS PROPERLY WHEN THEY TOO ARE IN NEED OF CARE? I WILL GO FOR THE "SYNVISC INJECTIONS" STARTING THIS FRIDAY AS I HOPE TO BUY SOME TIME. ALTHOUGH I AM A NURSE I DO NOT KNOW HOW PAINFUL THEY MIGHT BE. I WILL STICK TO MY ORIGINAL THOUGHTS OF QUALITY OF LIFE. AND IF "QUALITY OF LIFE" IS AFFECTED SO GROSSLY AT A YOUNG AGE KNEE SURGERY SHOULD BE RESPECTED BY OUR DOCTORS. AFTER ALL, WE ARE LIVING IT + NOT THEM. SHARON

-- SHARON PEKROL (STOPPECK@AOL.COM), September 24, 2003.

I am so furious I could kick, and kick hard, the idiots,uncaring, unfeeling, un-understanding, who don't know what they are talking about when it comes to total replacements of the hip and knee due to osteo-arthritis. Especially if it is a "bone on bone" situation. My sorrow and rage is deepened when the reply, "You are too young" to ANYONE at ANY AGE, comes mainly from doctors. I CAN do the kicking required, due to the following story. In the past five years, in Toronto, I have experienced four major surgeries, left hip, then right knee, then right hip, and most recently, left knee. It's not easy. But...... My quality of life is transformed. I used to sit in a corner, before the first hip replacement. The pain was so profound that I would look through the constant flow of tears and accumulate five tasks that needed to be accomplished. When I got to five, I would begin the horrendous task of getting to my feet, trying not to groan too loudly, because my two teenage sons were so stressed by the condition of their formerly very active mother, and I would accomplish the minimum, and retreat to my corner like a wounded dog. After many interviews with surgeons, I found a truly compassionate surgeon who said the magic words, "You're too young....to PUT OFF THE SURGURY! You have too much living of an obviously vital life ahead of you. Ready? It's a long, hard journey, but it's worth it." As technology furthers itself, so too the life span of these materials used, and the operating techniques, only improve with time, experience and research. Please, all of you who are suffering the excruciating pain that those who aren't there just don't get...which is all too often friends, family and to my greatest sorrow, the lordly medico-mad surgeon/gods, please, keep searching. Get Those Replacements! I also lost 50 pounds. I cannot tell you how much that helps, if that is part of your story. Of course, pain and depression keep us from exercising. But find a way! Live the life the Creator has offered to us! Inspire others! DON'T TAKE 'NO' FOR AN ANSWER! It is only a curse! Get on that waiting list NOW! With hope for us all, especially 'cause knee recovery hurts truly a lot, and doing the exercises WILL give you up to 100 degrees of bend. Please save yourself and your loved ones. Michele George michele@michelegeorge.com P.S. My work is not yet done. The body is exhausted from four major invasions. There have been some errors, but if I am willing to be an active participant in my own healing, I can accomplish miracles.

-- michele george (michele@michelegeorge.com), April 21, 2004.

I am 47 and had my first knee replacement 5 weeks ago and I am amazed at the difference. I too was very hesitant but when I saw my Reumotoligst back in January he told me I was no longer to young and that it was a "no brainer". My Orthopedic Doctor didn't hesitate either. He said my bones were on the verge of fusing together. Iam already getting so much more movement and flexibility from my new knee with no more pain. In July I will have the other one done. (I'll still be 47). I had my hips replaced 18 and 19 years ago and so far so good. Needless to say I don't lead a very active lifestyle and I expect my knees to last a long time too. I would say go for the TKR but take good care of them.

-- Teresa Ward (teamac46@msn.com), May 04, 2004.

I had TKR on March 15, 2004, after having had a Unicondylar replacement 2 years ago (that did not work). Already I am enjoying life again. Dr. David Miller at West End Orth. Clinic performed the total knee surgery and I am only 43yrs.old. I say if the pain is so great and the only quality of life prior to surgery is pain medicine I say go for it. I ride my bike, swim, go shopping. Never once have I regretted having the surgery

-- Lorraine Pearson (Lichlaw@aol.com), June 05, 2004.

I am 43 and had a TKR - left knee 2 yrs ago. I am scheduled a TKR - right knee in three wks. (Insist on this surgery. It may change your life). I am looking forward to hiking long distances again. I know a few people my age who are suffering with the same ailment but their Dr won't perform surgery because they are TOO YOUNG. I watch as they undergo procedure after procedure and different drug therapies. My Dr. believes in QUALITY OF LIFE and I am so glad. I want to LIVE an ACTIVE life and osteo arthritis prevents this! GET IT DONE. You won't be sorry.

-- Kelly Bennett (kellybennett84@hotmail.com), June 22, 2004.