Any patient who has pain and arthritis who has not benefited from non-operative treatments will benefit from knee replacement surgery. I follow the three-strike rule with pain interfering with activity of daily living, the x-ray showing arthritis, and on examination the pain coming from the joint as criteria for bringing up the conversation of joint replacement surgery. There is no patient who is too young. There is no patient who is too old for this procedure.
There’s excellent literature to show that patients who are in their eighties and nineties have also done very well after joint replacement surgery. On the other end of the spectrum, it is not acceptable today to keep younger patients with arthritis is pain and to let them suffer until they become a certain age. With improved anesthesia and improved surgical materials we have been doing joint replacement surgery in very young patients.