Are You Too Old for Total Knee Replacement Surgery?

Age does play a role if you are a candidate for knee surgery, but how much?

Orthopedic Surgeon Dr. Ganji

Why are People Waiting to have Knee Surgery?

Many potential candidates for total knee replacement surgery (TKR) feel they are too old for knee surgery & simply tolerate the discomfort.old man knee pain However, now more than ever people are opting to have the procedure done. In 2017, over 700,000 patients had knee surgery in the USA. In Iran, that number was 100,000 in 2017. Generally speaking, worldwide the number of patients seeking this specific operation has, and still is, increasing.

More often than not, patients who suffer from severe osteoarthritis wait till the pain is so unbearable they cannot walk unassisted any longer before coming in for a consultation. Having  a knee surgery helps people of all ages return back to their daily routine, without the nagging knee pain of course.

Am I too Old for Knee Surgery?

First of all, your orthopedic surgeon must make that assessment. The orthopedist assesses many factors before making their decision such as standing X-ray, medical history & general physical exam.

Based on these preliminary examinations, the surgeon will make the decision to move forward for more tests & plan for the procedure.

In North America, surgeons are much more conservative due to malpractice concerns. Although the patient may be at fault for not doing the recommended physical therapy afterwards or other issues that depend on the patient, surgeons typically remain overly cautious when deciding on knee surgery for the patient.

In many other countries this is not the case, which is not to say doctors are more reckless, quite the contrary. This is to say that surgeons are not hindered by bureaucracy.

This is why you can see 80 and 90 year old patients having successful simultaneous bi-lateral knee replacements on a regular basis in other countries. Despite this, orthopedic surgeons in North America would never operate on these same patients.

The main objective is to have the patient, regardless of age, return to normal. This is so they can once again become active & productive without any pain.

In many other countries this is not the case, which is not to say doctors are more reckless, quite the contrary. This is to say that surgeons are not hindered by bureaucracy.

Why Does Knee Pain Happen More Often Later in Life?

The main reason why patients need knee surgery is because of osteoarthritis. Osteoarthritis is when the cartilage in the knee starts to breakdown or wear-down, usually becomes apparent in the middle ages.

The cartilage acts as a kind of pillow between the bones that keeps the bone moving smoothly. That way, when you move you have a painless gliding motion when bending the knee.

Arthritis inevitably occurs & the cartilage wears down. The aforementioned pillow starts to thin and wear away. That is when the pain begins because bone is actually rubbing against bare bone. This is what leads to pain & stiffness in the knee. Think of gears grinding without any lubrication.

Another issue why it happens later in life is because knee deformities such as valgus and varus knee. Valgus knee is better known as bowlegged. Varus knee is better known as knock-kneed.

You may have seen toddlers that suffer from some form of malalignment when they wobble around, but they usually grow out of it as they get older.

In middle-aged adults, these knee deformities could be caused by many factors such as various forms of arthritis, some sort of injury (brute force trauma to the knee), or a birth defect that was left untreated.