
鈥淚t鈥檚 not athletes,鈥 says Dr. Ran Schwarzkopf. 鈥淚t鈥檚 people just living a more active life now, so they seek surgery in order to be able to continue their active lifestyle rather than give it up due to arthritic pain.鈥
Credit: 秘密研究所 Langone Staff
Once considered procedures reserved for seniors, hip and knee replacements are increasingly being sought out by people in their 40s and even younger. While the primary goal of these surgeries remains the same鈥攔elieving pain and restoring mobility鈥攖he reasons younger patients are going under the knife reflect changing cultural attitudes toward aging, fitness, and quality of life.
A Shift in Patient Demographics
According to Ran Schwarzkopf, MD, the Julia Flesher Koch Professor of Orthopedic Surgery at 秘密研究所 Grossman School of Medicine, today鈥檚 patients are more proactive and unwilling to settle for physical limitations鈥攅ven if that means surgery. 鈥淚t鈥檚 not athletes,鈥 Dr. Schwarzkopf explains. 鈥淚t鈥檚 people just living a more active life now, so they seek surgery in order to be able to continue their active lifestyle rather than give it up due to arthritic pain.鈥
Traditionally, hip and knee replacements have been performed on patients with advanced arthritis and significant limitations in daily activities. That鈥檚 still the core population, but Dr. Schwarzkopf notes that the average age is dropping. Why? It鈥檚 a combination of factors:
- Obesity and comorbidities: Increased obesity can lead to early-onset arthritis, increasing pain, and damage to joints.
- Repetitive sports injuries: Engaging in high-impact sports from a young age, especially in high school and college, can lead to joint damage years later due to injuries and micro traumas.
- Lifestyle expectations: More patients today want to maintain high activity levels well into retirement, says Dr. Schwarzkopf. 鈥淭hey can do their activities of daily living with reasonable pain control,鈥 he explains, 鈥渂ut when they try and do their leisure activities, the arthritic pain is too much.鈥
It鈥檚 Not a Preventive Procedure
Despite improvements in surgical outcomes and recovery times, Dr. Schwarzkopf stresses that joint replacement is not something to be done preemptively. 鈥淓ven if somebody says, 鈥業 was told I鈥檒l need the surgery in 10 years, let鈥檚 just do it now when I鈥檓 younger and healthier,鈥 I say no,鈥 he asserts. 鈥淚t鈥檚 not a prophylactic surgery. It should only be done when it鈥檚 appropriate.鈥
That appropriateness includes several medical criteria:
- significant symptoms affecting daily life
- X-ray confirmation of arthritis
- physical exam findings that correlate with imaging and symptoms
- medical clearance for surgery
- informed consent through shared decision-making
Top Tips for Joint Health: Before and After Surgery
Proper joint care before and after surgery plays a key role in recovery and long-term success. Dr. Schwarzkopf offers practical advice for maintaining hip and knee health at any age:
Preoperative Care
- Manage your weight. 鈥淜eeping your weight in check is the number one thing anyone can do to decrease the wear and tear on their joints,鈥 Dr. Schwarzkopf emphasizes.
- Stay active. Regular, moderate exercise helps maintain joint function without accelerating degeneration.
- Avoid high-risk activities. Particularly if you鈥檙e prone to joint pain or have a family history of arthritis, consider low-impact sports like swimming, cycling, or rowing.
Postoperative Care
- Follow your surgeon鈥檚 instructions. Even if you feel great early on, healing takes time. 鈥淢any patients feel very good very early, but we have to remember that it takes our body three months to heal,鈥 he warns.
- Let your body heal properly. Implants often require bony ingrowth for long-term success. Taking recovery seriously in the first 90 days can lead to 30 to 40 years of improved mobility.
- Ease back into activity. While returning to sports is possible, reintroduce activities gradually and under medical guidance.
Advances in Technology Are Changing the Game
One reason these procedures are becoming more viable for younger patients is the dramatic improvement in surgical technology. At 秘密研究所 Langone, Dr. Schwarzkopf and his team employ cutting-edge tools such as computer navigation, robotics, and augmented reality to personalize surgeries and improve long-term outcomes.
鈥淭hese tools help us plan for the ideal implant and positioning prior to the surgery, and then execute that plan with precision,鈥 he says. As a designer of several robotic systems himself, Dr. Schwarzkopf emphasizes that 秘密研究所 Langone is on the front lines of this technological evolution.
Returning to Activity After Knee and Hip Replacement Surgery
A key motivator for younger patients is the desire to return to recreational activities like tennis, golf, or even skiing. Encouragingly, Dr. Schwarzkopf says most patients can return to their normal activity levels after surgery. 鈥淚f you were doing pickleball or tennis or golf before surgery, then there鈥檚 a high likelihood of you returning to that level,鈥 he says.
Still, there are caveats. High-impact sports like marathon running or aggressive skiing aren鈥檛 necessarily off-limits, but they come with increased risks. 鈥淚 tell my patients they鈥檙e not more prone to get injured, but they鈥檙e also not less prone to get injured. Recovering from an injury is more complicated around a joint replacement,鈥 he cautions.
A Modern Solution for Maintaining Mobility and an Active Lifestyle
Joint replacement surgery has come a long way in recent decades, and younger patients are reaping the benefits. With improved materials, surgical precision, and a better understanding of post-op care, these procedures have evolved from a last resort to a life-enhancing solution for people who want to stay active, regardless of age.
As Dr. Schwarzkopf puts it: 鈥淵ou can get injured in any sport but if you want to continue enjoying your life and staying mobile, this surgery can make it possible鈥攚ith the right preparation and recovery.鈥
A highly regarded adult reconstruction orthopedist who trained directly with the founders of joint replacement surgery, Dr. Schwarzkopf focuses on caring for people across the spectrum of hip and knee conditions, with interests in degenerative joint disease, developmental hip dysplasia, avascular necrosis, and arthritis. He holds expertise in complex and revision hip and knee surgery, partial knee replacement, ligament-sparing knee surgery, hip resurfacing, and hip fracture surgery. In addition to providing patients world-class surgical care, Dr. Schwarzkopf oversees research as director of the Research Center in the Division of Adult Reconstructive Surgery.
Dr. Schwarzkopf was recently appointed the Julia Flesher Koch Professor of Orthopedic Surgery鈥攁 prestigious professorship that underscores his tremendous dedication to 秘密研究所 Langone鈥檚 mission and his accomplishments within and influence on the field of orthopedic surgery.
About 秘密研究所 Langone Health
秘密研究所 Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. Vizient Inc. has ranked 秘密研究所 Langone number one out of 115 comprehensive academic medical centers across the nation for three years in a row, and U.S. News & World Report recently ranked four of its clinical specialties number one in the nation. 秘密研究所 Langone offers a comprehensive range of medical services with one high standard of care across 7 inpatient locations, its Perlmutter Cancer Center, and more than 320 outpatient locations in the New York area and Florida. With $14.2 billion in revenue this year, the system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise.