You don’t have to be old to get a new knee, hip or shoulder

Sue Scheible

Donna O’Connor was 55, traveled constantly for work and lugged 45 pounds of workshop materials.

“I was hobbling around and couldn’t really do my job,” she says. “But I had five years until I could retire and needed to keep working.”

The problem: Osteoarthritis had destroyed the cartilage in both knees. Instead of gliding over each other, bones rubbed on bones, causing searing pain.

Physical therapy and fluid injections helped for a while. In August 2008, O’Connor had both knees replaced at Quincy (Mass.) Medical Center by orthopedic surgeon Peter Dewire.

“I was up walking the next day and back at work six months later,” O’Connor says. Last October, she enjoyed a trip to China, walking the Great Wall.

“You lose a great deal of your self when you can’t walk,” she says. “I love to take my dog out and I’m back doing that.”

O’Connor joined a growing group of people in their 50s and 60s having joint replacement surgery – often so they can pursue sports and active lifestyles. Getting a new hip, knee, shoulder, ankle or wrist has almost become a midlife passage.

Surgeon Michael Berry’s waiting room in Milton, Mass., is usually crowded, but not just with older folks. Patients in their 40s, 50s and 60s are well-represented.

There are risks to any surgery, but most benefit from advances in surgical technique, the parts used, faster rehabilitation and higher success rates – more than 80 percent in knee replacements.

Surgery can be performed with smaller incisions, computer-assisted measurements and precise cuts tailored to how the person moves. Metal, ceramic and polyethylene replacement parts are harder and last longer, and doctors say the innovations will keep coming.

“Having a joint replaced is no longer done in desperation or just to end pain,” said Dr. Leonid Dabuzhsky of Weymouth, Mass.

“Patients considering a new knee or hip sometimes ask, ‘Am I ready?’ I tell them, ‘My job is to give you the information, to educate you. Your job is to make the best decision for you.’”

Here are basic facts on joints you can have replaced, what it involves, alternatives to surgery, questions to ask – the when, where and how it can be done.


Joint replacement surgery is most often done to treat pain and loss of movement caused by osteoarthritis, rheumatoid arthritis and traumatic injury or sports injuries such as a rotator cuff tear.


A joint replacement surgical procedure. The diseased bone and cartilage tissue are removed and replaced by an artificial joint component.


In some joints, arthroscopy may be an alternative. In this surgical procedure, small incisions, a tiny telescope and miniature instruments are used. The surgeon can look inside the joint and clean out damaged cartilage, repair torn cartilage, remove loose particles and clean the joint. Other problems such as a torn meniscus in the knee can be corrected. Arthroscopy may delay the need for surgery for six months to a year or more.



Tried and halted in the 1980s. Making a comeback after parts improved, FDA approved. Complicated. Longevity of ankle components unknown. Ankle fusions used more often with younger people. Metal components. Cement and cement-less techniques.


Rare procedure. Consult a specialist at a major medical center.


Knuckle joint of the big toe can be replaced.


Many innovations, with new components. Expected to last 15-20 years. Standard components use metal ball-and-stem with polymer plastic socket. New bone resurfacing techniques replace the socket and resurface the thigh bone (femur). Walking soon after. Physical and occupational therapy.


The body’s largest joint. Most common: 581,000 knee replacements a year in U.S. Implant uses metal alloys on end of thigh bone and plastic cup at top of tibia. New minimally invasive techniques. Can be done as outpatient procedure or inpatient. Expected to last 20 years or more. Restrictions after replacement on high-impact sports. Three- to six-month rehab with physical therapy.


The joint with the most range of motion. Highly technical surgery. Metal alloy ball and stem components with a plastic socket and cement. Consult a surgeon who specializes in this joint. 23,000 surgeries a year.


Bone fusion is more standard treatment. Thumb knuckle can be replaced using tendon and tissue from the forearm. Metal components used with plastic polyethylene spacer. Restrictions after surgery on use of tools, lifting weights, no roller sports. May last 10 to 15 years.


There are risks and complications to any surgery. Here are some for joint replacement. They could require further surgery:

- Infection.

- Blood clots.

- Implant loosens.

- Dislocation. More common with hips than knees.

- Scar tissue and bone loss.

- Tiny particles created by the friction of the joint surfaces rubbing against each other. These particles accumulate around the joint.

- Pain or joint instability.

Patients who are younger and more active and obese patients have a higher risk of joints wearing and loosening.

Patriot Ledger writer Sue Scheible may be reached