Am I too young or too old for a knee replacement?

Why age is not the deciding question

Most knee replacements are done for osteoarthritis in people over 60, but that describes who gets arthritis, not who is allowed surgery. UK guidance on osteoarthritis says people should not be kept from being referred for a joint replacement because of their age alone. The real questions are about the knee and the person.

• How much pain do you have, and does it wake you at night?
• Can you walk to the market, climb stairs, pray, kneel or get on and off the toilet?
• Does the X-ray show the joint space has worn away?
• Have weight loss, exercise, physiotherapy and painkillers been tried properly?
• Are your heart, lungs, sugar and blood pressure well enough controlled for an anaesthetic?

If you are in your 40s or 50s

Younger people are more active, and an artificial knee is a mechanical part that can loosen or wear over many years. If it does, a second operation (a revision) is bigger and harder than the first. That is why a surgeon will usually push hard on the alternatives first: losing weight takes load off the knee, strengthening the thigh muscles often reduces pain, and a walking stick in the opposite hand helps on bad days.

But waiting is not always right. If the knee has collapsed on the X-ray, if you cannot work, or if you are taking strong painkillers every day just to function, years of that carry their own harm. Some younger people with arthritis in only one part of the knee may be offered a partial knee replacement instead. A good surgeon talks through both sides with you, not just the operation.

If you are in your 70s or 80s

Many people in their 80s have knee replacements and walk better afterwards. What matters is fitness for surgery and the ability to do the exercises after it. Before an older parent is listed for surgery, expect checks on the heart, kidneys, blood count and blood sugar, and a frank talk about who will be at home in the first weeks.

The surgery is the start, not the end: the knee only bends and straightens well if the exercises are done every day for weeks. A parent who lives alone needs someone with them, or a plan for help at home, before the date is set.

When a knee replacement is usually not the answer yet

Surgery is usually not advised when the X-ray shows only mild change, when the pain is coming from the back or hip rather than the knee, when an infection anywhere in the body has not been treated, or when diabetes or blood pressure is badly out of control. In those cases the surgeon will treat the other problem first or try other options, and review you again.

What to bring to the consultation

Bring any knee X-rays you have had, a list of your medicines including herbal ones, and your most recent blood sugar and blood pressure readings if you have them. Say plainly what you want to be able to do again. If you are booking for a parent from abroad you can join the consultation by phone or video and pay online.

Common questions