Total knee replacement is commonly used for elderly people with severe arthritis. However, there are situations where doctors might advise knee replacement for younger people, too.
Knee replacement prostheses can help in situations where the patient is suffering from severe pain of the knee joint and internal medicine is of very little or no help. This is usually a condition associated with wear and tear of knee cartilage that occurs with advanced age.
Younger people can also suffer damage to knee cartilage and subsequent pain, owing to reasons like infections, obesity and accidents/trauma. When this affects the quality of life and when other treatments are not effective, surgeons might consider knee arthroplasty for middle aged and young patients.
Out of the 431,485 knee replacement surgeries that took place in 2004, 8,468 (2%) were performed for people in the 18-44 age group and 157,149 (36.4%) in the 45-64 age group. Over the period between 2000 and 2004, the percentage of knee replacement patients between age 18 and 44 remained at 2% while the percentage for patients aged 45-64 was roughly 33%.
How Young is too Young for Knee Surgery?
By conservative estimates, a person who hasn’t still entered his/her sixties is considered too young for knee surgery. The reasons lie in lifestyle patterns rather than biological factors. People in their prime of life tend to be more active, so the replaced joints wear out sooner. This need not be an issue if the patient is careful to stick to low-impact activities.
How is Knee Replacement in Youth Different from Regular Replacement?
Usually, surgeons try to avoid knee replacements in younger people. This is because people lead a more active lifestyle in youth that leads to faster wearing away of the artificial joints. Further, young/ middle aged people have more years to live and chances are very high that they will need second replacements. Revision surgery is more technically difficult and results are not as good as first time replacements.
However, knee prostheses in younger, active patients are durable and effective for about two decades. For instance, in one study conducted in New York in 88 patients aged 55 and below, the success rates were in the range of 84-90% in the first 18 years.
Benefits of Knee Arthroplasty for People in their Prime
Knee replacement surgery can bring enormous benefits to middle aged and young people in terms of quality of life. Young people will want to and need to lead an active life. Knee replacement can bring relief from debilitating pain and immobility. Benefits of knee arthroplasty include reduced pain and better mobility of the knee joints. Once you have recovered, you will be able to carry out routine activities like walking, shopping and driving.
Mobile-Bearing Prosthesis for Knee Replacement in Younger People
Most people go for fixed-bearing prosthesis. For patients who are young, surgeons may suggest using rotating platform/mobile-bearing knee prosthesis. These are designed for longer performance and less wear. In rotating platform knee implants, the upper and lower components move across a polyethylene insert. This allows for greater flexibility of knee joint movements. Rotating knee replacements can also reduce early wearing. However, compared to fixed-bearing prostheses, rotating implants are not so well equipped to manage imbalances in soft tissues.
Knee prostheses using a new material called Oxinium have been used by some surgeons for the past three years. Advocates of Oxinium claim that it is harder, more scratch-resistant and causes less friction between the femoral part and the plastic tibial surface of the implant, compared to traditional cobalt-chrome prosthesis. However, the long-term efficacy of Oxinium implants is yet to be ascertained.
Non-surgical Treatment Options for Knee Pain in Younger Patients
In knee pain caused by arthritis, treatment starts with exercise, weight management, physical therapy and medications. Exercise and weight management should, under normal circumstances, bring some relief for middle-aged patients with arthritis. Partial or full knee replacement surgery is considered only after these options are exhausted.
Knee Surgery for Younger People Abroad
An increasing number of people from the USA and other western countries are choosing to get their knee replacement in India, Costa Rica or Mexico, thanks to the high-level medical expertise available in these countries at prices much lower than US rates. Total cost of knee joint replacement in Costa Rica, India and Mexico is in the range of $7,000- $13,000 whereas it averages $40,000 in US.
Apart from the cost savings, overseas knee replacement also has the added benefit of being top quality. Well-known hospitals in medical travel destinations like India, Costa Rica and Mexico have highly qualified and experienced medical experts and state-of-the-art facilities. Consider that these hospitals today stand endorsed by thousands of happy people.