Am I too old for knee replacement surgery?
It is the question we are asked most, usually by someone who has already decided the answer is yes. Very often it is not.
Age is not the deciding factor
There is no age at which a knee replacement stops being possible. What matters is whether you are well enough to come through an anaesthetic and an operation, and whether you are able to do the rehabilitation afterwards. Those are questions about your health, not your birth certificate.
Patients in their seventies and eighties have knee replacements at this hospital and do well. A fit 82-year-old is often a better candidate than an unwell 60-year-old.
What we actually assess
- Heart and lung health – can you safely have an anaesthetic?
- Diabetes control – poorly controlled blood sugar raises the risk of infection and slows healing.
- Bone quality – severe osteoporosis affects how the implant is fixed.
- Mobility now – how much walking you currently do, and with what support.
- Support at home – who is there in the first weeks.
- What you want back – a patient who wants to walk to the temple has a different plan from one who wants to sit cross-legged.
The argument for not waiting too long
Patients often postpone surgery for years, managing with painkillers. The difficulty is that waiting has costs of its own. Walking less weakens the muscles that a new knee depends on. Pain disturbs sleep. Painkillers taken daily for years carry their own risks to the stomach and kidneys. And general health rarely improves with age, so a patient who is a good surgical candidate at 72 may be a more complicated one at 79.
This is not an argument for rushing. It is an argument for being assessed rather than assuming, and for making the decision deliberately instead of by default.
When we advise against it
We do sometimes recommend against surgery – for an active infection, for heart or lung disease that makes anaesthesia genuinely dangerous, where the leg muscles are too weak to support a new joint, or where someone is not going to be able to manage the rehabilitation. In those cases we say so plainly and treat the pain another way.
How long will the joint last?
Modern implants commonly last 15 to 20 years. For a patient in their seventies that generally means one operation for life. It is younger, more active patients who are more likely to need a revision later – which is a reason to think carefully at 50, not at 75.
The honest answer
Come and be assessed. It costs a consultation to find out, and it is better than spending another three years assuming you are too old when you are not.
Find out rather than assume
Bring any X-rays you have, and a list of your medicines and other medical conditions.
