knee replacement and young patients

Knee Replacement For Young Patients (9 Pieces of Advice)

Do you feel like you’re too young for knee replacement surgery? I thought I was too young and put my surgery off for several years.

In this article, I’ll share my thoughts on when to have TKR and several things to consider before making the decision to have TKR. We all know it’s a big decision, in fact, it’s life-changing.

Your doctor may have already told you that your knee joint is ready to be replaced, but only you can decide how long you can tolerate the pain and be happy with your quality of life.

Learn From My TKR Experience

I initially injured my leg in my 20’s. It was the result of a sport’s injury and it was followed by two medial meniscus surgeries in my 20’s.

I continued to stay active, playing basketball and softball on a regular basis. As time went by my remaining cartilage began to wear.

The pain began to present itself regularly in my 40’s and the knee would often swell after activity. I began to take anti-inflammatories and I would often ice my knee after activity.

Around the same time, I began to get an occasional cortisone shot. I also tried a series of hyaluronic acid injections without any improvement.

In my early 50’s I made an appointment with an orthopedic surgeon. He took x-rays and said I was definitely a candidate for knee replacement.

He told me that when the pain became unbearable that I should come back and schedule the surgery. I had done some research and knew at that time that knee replacements would last about 15 years.

I did not want to have a replacement too early and risk the chance of having a second replacement (once is tough enough). I continued to participate in my regular activities but my quality of play decreased.

In my early 60’s I had quit playing basketball and softball and began to cycle, swim and hike. Hiking was by far the most painful.

At this time I developed a pronounced limp and my leg began to bow. If you’re a young guy or gal and considering TKR, I want to share 10 pieces of advice with you – take it from someone who could have had knee replacement in my 40’s but waited for twenty years.

9 Pieces Of Advice For Young TKR Patients

#1 TKR Will Not Take You Back To Your Youth

You won’t be able to run long distances or jog daily. You probably will not be playing basketball, racquetball or other sports that require quickness.

But, you will be able to participate in the activities that you did before TKR only with less or no pain.

#2 Find New Interests

You can definitely remain active but pick your activities wisely. You may want to take up low impact activities such as swimming and biking.

Find a buddy or a group to bike with. You may need to join a club or your local YMCA so that you can swim on a regular basis.

#3 A 2nd Replacement?

If you do have knee replacement surgery at a young age (in your 40’s and 50’s), know that you might need a second replacement 15-20 years or so down the road.

The new knees are getting better and lasting longer but they don’t always outlive you.  Know that your knee replacement will eventually need to be replaced.

#4 Expect Pain In Recovery (and appreciate the pain meds)

If you are having TKR, pain is a part of the process whether you are young or old. Expect pain in varying degrees the first two weeks after surgery and also when you are doing your physical therapy (learn about the pain I experienced after surgery).

Follow your doctor’s orders for pain medication and use it only as directed. Elevate and ice often.

#5 Gain Strength

Strengthen the muscles around your knee as best you can before surgery. If you can’t lift weights with your knee try using the stationary bike and stair stepper in the gym and go on bike rides if possible (my advanced exercises prior to TKR).

Swimming is another good exercise to prepare your knee and your entire body for surgery. The stronger you are, the healthier you are and the less weight you carry will increase your chances for a speedy recovery.

#5 Don’t Lose Your Flexibility

Improve your flexibility. Riding a bicycle and the stationary bike have both helped me. I also do flexibility exercises in the pool because there is less resistance in the water.

Beginning yoga has also been a big help. Learning to stretch with a group and a compassionate leader has helped me to regain some flexibility.

#6 Healing Should Be Easier At A Younger Age

As far as healing, youth can be an advantage when having TKR. Younger patients are probably more active than older folks and because of your age, you’ll heal better and faster than older patients.

Use that youthful energy to your advantage especially during your rehabilitation. You can expect to bounce back more quickly than older patients.

#7 Eat Quality Food

Learn to enjoy healthy food and control your weight before and after surgery. If you need to lose weight prior to surgery include a healthy diet to go along with a pre-surgery fitness routine.

If you develop a fitness routine before surgery it’s easier to keep it going post-surgery.

#8 Don’t Stop Therapy

Continue physical therapy exercises beyond your formal therapy sessions. Ask your physical therapist to help you to create a workout plan that you can do on your own after your formal sessions are over.

I still do many of the exercises that I was prescribed 6 months after surgery. I do my fitness routine at least 3 times a week and walk, ride my bike or swim on alternating days.

#9 Ice Is Your Friend (years before and after surgery)

Ice really helps. I continue to elevate and ice my leg after activity.

Sometimes while I am sitting in my recliner watching the evening news I ice my leg before dinner. If you have access to a hot tub use it often or after activity.

I can stretch and loosen my leg up and even do stretches and squats in the hot tub I use.

Conclusion

Doctors can tell you that the wear in your knee is at that point that you should consider a knee replacement. However, only you can gauge the pain and discomfort that it’s causing you.

If the pain is unbearable and it makes it difficult to work or to enjoy activity then no matter your age you may want to consider having TKR. Quality of life is important and I’ve experienced pain-free knee after my surgery.

Everyday activities, as well as the fitness activities I have chosen, have all been pain-free. The younger you are the chances are you may outlive your replacement and need another.

The advantage of being young is that you’ll likely heal faster and be able to resume work and activity sooner than older patients.

Comments

  1. Dear Ken, thank you so much for this blog. It helpt me a lot to make the decision for my TKR in may this year. You gave so much positive and honest information. I,m 44 years old and i have to ondergo two TKR operation this year, if everything wil be ok. I,m very nervous if everything wil being fine especially because i have two mentally disabled daughters . Its not going to be easy for me and my husband. I live in the Netherlands and i think the operation and stay in the hospital is similar to the US. So i take the strengh from your positiv blog.

    1. Author

      Hi Jennifer, thanks for reading and for your support. 2 operations will require more work than my recovery but I’ve heard from plenty of people who had 2 at the same time! Do your best to get in good physical shape going into surgery and it will help with recovery. Your family’s support will be important, especially in the first few weeks. I know there are great surgeons in the Netherlands so I’m sure you’re in good hands. Best wishes. Let us know how your recovery goes – it’s always good to hear if others have a similar experience as mine.

  2. Thanks Ken I’m Mike and I am 58 . My doctor told me 4 years ago that I had the knee , ( injury in my 20’s) of an 80 year old man . I had begun have some pretty painful spells with it and that is why I was having it looked at again .
    The strangest part of the exam was after telling me all that about an 80 year old knee , he watched me walk around a little he told me I was not ready for a TKR yet . It was quite a mixed message . But I was glad to agree with him that I was not ready for that at this time .
    Then to confuse me even more he looked at me with a smile and said , ” but don’t wait to long ” ?
    I asked him how will I know its time ? Without missing a beat and still smiling he said ” you’ll know ” . lol,
    I liked this doctor immediately . Saw him last month and he agreed with me this time , that yes , it is time now .
    He laughed when I quoted everything he said to me 4 years ago . I’m having my TKR in 2 weeks . I have been making a concerted effort at strengthening my legs , hips & core , and getting my aerobic endurance up for the last 2 months .
    I had a couple of questions : Did you get yourself one of these ” Cold Therapy ” machines , and how do you like it ?
    I ordered one today and it should be here shortly .
    Also , I read where you had mentioned you had some “bowing ” of your leg and I have had the same thing happen to mine over the years . Was your bowing corrected in the surgery to your satisfaction ? I’m not sure how much of an added complication this presents to the surgeon but my doctor certainly sounds like this is an added condition he deals with regularly and is able to correct . He said that I will be straightened back out to 3 degrees , what ever that means ?
    Thank You , & God Bless Your Efforts , Mike

    1. Author

      Thanks for the comment Mike. My situation seems a lot like yours. An injury in my 20s and I lived with some pain for decades and remained active. I also visited a number of doctors and they said the longer you wait the better the technology/surgery will become. I’m glad I waited, but my 60’s were the telling time for me. The pain became serious and I knew surgery would take longer to heal from as I aged. My surgeon told me he straightened out my leg for me…I had bowing and my alignment is great now. I no longer lean to a side when walking and my body strength has leveled out on both sides of my body. You and your doctor know best, but a comment from my surgery – bend your knee often in the weeks after surgery. Stay moving. It will hurt but it’s important to break up the scar tissue so you don’t limit the bend of your knee. If all goes well, I think you’ll be pleased with the outcome. Lastly, the cold therapy machine (Cryo Cuff) worked well for me for the first few weeks (save a lot of ice too). After a couple weeks I transitioned to a gel ice pack (you can read about ice packs on my blog too). Best wishes.

    2. Just a little update Ken,
      I had my surgery on April 22 so I am a little over a month out . Spent two nights in the hospital , which seemed to be the standard , and they were happy with my making a lap around that floor of the hospital , climb 4 stairs , get on & off the toilet . All with a walker . Also I was able to bend my knee to 90 degrees before leaving the hospital .
      My doctor said the one thing he did notice about me during the surgery was that I had an good amount of laxity in my joints , which can be both a curse & a blessing , that required him to do a little extra tweeking during the surgery .
      Standing and looking at myself now my legs are equal in terms of being straight . I only needed the narcotic pain pills
      for 5 days and then went to Tylenol & Ibuprofin from there . I really do not feel the need for any pain medication the last couple of weeks , even after therapy . Just some icing .
      It just feels slightly uncomfortable and tight , but not to the degree I would call it painful.
      Just using a cane now when I leave the house , but I find that I am not really able to work on walking in a normal gait when I have the cane . When I don’t have the cane my walk is much more natural , so I think I am about done with that .
      Doing the stationary bike , standing TheraBand extensions of both my surgical leg and the other in all directions , reps of 30 at a time .
      The therapist explained doing the good leg as well trains the stabilizing muscles around the surgical knee .
      Also started using my elliptical machine this week with no problem .
      All in all I am very pleased and thankful to God for things going so well so far .
      The one other complication my doctor encountered that I was not even aware of was that he said I had a fairly large ” Bakers Cyst ” on the back of my knee that had to be drained during the surgery .
      I had no idea it was even there which tells you how bad my knee was .
      He said there is always a possibility that it could come back which I guess is something he will be looking at as I have my checkups with him .
      Thank you again for your encouraging and detailed blog I found it to be very helpful and reassuring .
      Take Care & God Bless , Mike

      1. Author

        Great to hear you’re recovering well. A lot of what you shared sounds similar to my experience – slowing reducing pain med, getting rid of the cane, stationary bike and band workouts. It was a slow process but I sure feel a lot better than I did going into surgery. Fortunate that your surgeon took care of the cyst as well…that’s amazing! I’m thankful for comments like these – there are so many of us and the support is nice to have. Continue to improve!

        1. Ken , one last issue I thought you may be able to relate to given our similarity in history .
          I remember before the surgery my doctor looking at my knee with his assistant discussing the incision to be made .
          I had an old school ACL reconstruction in the early eighties that left a pretty good scar on the medial side of my knee just off center about 2 to 3 inches ,He was looking at it and he seemed to have some reservation about putting the incision
          down the middle just a couple of inches away from the old scar . I had never even considered the issue until I sat there watching him think about it . I asked what the issue was and he thought it might put some excessive stress on the tissue in between the two scars , so he seemed to conclude he was just going to recut the old existing scar , which was fine with me . I guess add the hardware & swelling into the mix and the available space comes at a premium ?
          Well I wake up after surgery and one the first things you do of course is look at it , and low & behold he must have changed his mind last minute and took the traditional route , right down the middle .
          I know that he must have other considerations to weigh so I will ask him about it later .
          Everything healed up fine , but one thing I have just really noticed this past week is that as the overall swelling of the knee has gone down nicely there is a well defined triangle area area , maybe two inches at it’s widest that has become more prominent in its slight puffiness and a little more pink than the rest of knee in between the two scars . No pain associated with it all and it does go away when I elevate . It seems to become most prominent right after I have done some range of motion exercises .
          Scared me a little when it first became noticeable and I went and had it looked at and the attending physician took a good look at it and determined based upon the fact my pain is getting less every day and that the exercises are becoming easier not more painful , and it is so well defined & bordered between the two scars that there is some tissue distress going on and it should gradually dissipate .
          I will see my orthopedic next week and hopefully it will look less noticeable by then and he can confirm my suspicions about the tissue in between the two scars reacting to some added stress.
          I know you mentioned you had surgery a long time ago but depending on where you old scar was this may have not been an issue with you ?
          Just thought I would add this to the blog in case anyone out there runs up against the same circumstances & maybe help prevent them from getting overly concerned .
          Of course always call your doctor and get it looked at if it does not look right being the Golden Rule .
          Thanks Again Ken , Mike

  3. I am off tomorrow for a bilateral TKR in Australia. Super confident in the doctor and the outcomes, although I would love to have a time machine for the next 3 weeks or so. I am 47, and have a combination of sports injuries, genetically bad knees and carrying weight. All I want to be able to do is Jaywalk without worrying that my knee will collapse :>

    Some great real info here, was amazed of your short time in hospital, I am due to be in for 5-6 days with the chance of rehab.

    1. Author

      A longer stay might be better if it means you’re getting attention and early rehab. The first couple weeks will be a challenge but good you have a long term mindset. Best wishes to you Down Under. Let us know how it goes!

  4. Hello Ken,
    I am so happy I’ve found your blog! I am a very active and strong woman, going in for a TKR in 6 weeks. I’ve been exercising and stretching like crazy and losing weight, although I’m already at a normal weight, all to prepare for faster healing and better abilities after surgery.
    It is great that you answer so many questions I’ve had-better than the ‘official’ medical sites. Between reading your experiences and others’ I’m feeling much better about it all.
    Just, Thank you for having this blog to read!
    Doreen

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