Optimizing Total Knee Arthroplasty in Young Patients: Strategies for Enhancing Durability and Function

Authors

• Bridger Bell, Thomas Jefferson UniversityFollow

Abstract

Introduction

The subspecialty of orthopaedics focuses on the prevention, diagnosis, and treatment of diseases and injuries impacting the musculoskeletal system.1 Within orthopaedics, surgery for arthritis and related conditions make up half of those performed.² Of the surgical interventions for arthritis, total knee arthroplasty (TKA) is one of the most frequent, with over 700,000 performed per year in the United States and an expectation that nearly one million will be performed by 2030.3 Interestingly, since the 1980s, the prevalence of surgery in younger patients has continually increased.⁴ This has been accompanied by a declining average age of primary TKA now reported as 67 years old.⁵ This rise in prevalence is likely multifactorial, but a substantial component may reflect accumulating evidence that, in appropriately selected patients, operative management yields superior functional outcomes and improved quality of life. Despite advances in implant materials, biomechanical stability, kinematics, and fixation techniques, nearly one in five patients remains dissatisfied with their surgical outcome.⁴The percentage of TKA patients left dissatisfied has changed very little over the last 20 years,^4,6 with mild increases and mild decreases in perceived outcome both being published in the literature. Price et al report that given the steady dissatisfaction rate of TKA surgeries, there is growing recognition that the key to better outcomes may lie in alternative implantation methods, avoiding complications, and improving perioperative care. Potential strategies to expedite recovery and improve long-term outcomes include transitioning from cemented to cementless fixation, incorporating advanced polyethylene bearings, adopting robotic-assisted techniques, implementing opioid-sparing pain management protocols, and setting realistic patient expectations through preoperative education. This article will explore these methods as the increasing proportion of TKAs performed in patients under 60 years old demands strategies to accelerate recovery and optimize outcomes in this younger, higher-demand cohort.

Recommended Citation

Bell, Bridger (2026) "Optimizing Total Knee Arthroplasty in Young Patients: Strategies for Enhancing Durability and Function," Bone Bulletin: Vol. 4: Iss. 1, Article 12.
Available at: https://jdc.jefferson.edu/bone_bulletin/vol4/iss1/12