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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—relieving pain and restoring mobility—the 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 ����TV Grossman School of Medicine, today’s patients are more proactive and unwilling to settle for physical limitations—even if that means surgery. “It’s not athletes,” Dr. Schwarzkopf explains. “It’s 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.”

Traditionally, hip and knee replacements have been performed on patients with advanced arthritis and significant limitations in daily activities. That’s still the core population, but Dr. Schwarzkopf notes that the average age is dropping. Why? It’s 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. “They can do their activities of daily living with reasonable pain control,” he explains, “but when they try and do their leisure activities, the arthritic pain is too much.”

It’s 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. “Even if somebody says, ‘I was told I’ll need the surgery in 10 years, let’s just do it now when I’m younger and healthier,’ I say no,” he asserts. “It’s not a prophylactic surgery. It should only be done when it’s appropriate.”

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. “Keeping your weight in check is the number one thing anyone can do to decrease the wear and tear on their joints,” Dr. Schwarzkopf emphasizes.
• Stay active. Regular, moderate exercise helps maintain joint function without accelerating degeneration.
• Avoid high-risk activities. Particularly if you’re 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’s instructions. Even if you feel great early on, healing takes time. “Many patients feel very good very early, but we have to remember that it takes our body three months to heal,” 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 ����TV 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.

“These tools help us plan for the ideal implant and positioning prior to the surgery, and then execute that plan with precision,” he says. As a designer of several robotic systems himself, Dr. Schwarzkopf emphasizes that ����TV 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. “If you were doing pickleball or tennis or golf before surgery, then there’s a high likelihood of you returning to that level,” he says.

Still, there are caveats. High-impact sports like marathon running or aggressive skiing aren’t necessarily off-limits, but they come with increased risks. “I tell my patients they’re not more prone to get injured, but they’re also not less prone to get injured. Recovering from an injury is more complicated around a joint replacement,” 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: “You can get injured in any sport but if you want to continue enjoying your life and staying mobile, this surgery can make it possible—with the right preparation and recovery.”

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—a prestigious professorship that underscores his tremendous dedication to ����TV Langone’s mission and his accomplishments within and influence on the field of orthopedic surgery.

About ����TV Langone Health

����TV 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 ����TV 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. ����TV 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.