You still hit the trail, the gym, or the back nine, even though your knee or hip complains a little more every month. Staying active is something to be proud of, and it often feels like proof that surgery can wait.
Maybe you switched from cigarettes to vaping years ago and felt good about the change. Now a new hip or knee is on the horizon, and you are wondering whether your vape counts as smoking in your surgeon’s eyes.
Ask five different people about hip replacement, and you'll likely hear five different opinions about which surgical approach is best. The truth is more nuanced than any single answer suggests, and it has as much to do with individual anatomy as it does with surgical philosophy.
The assumption that hip replacement is a surgery for people in their seventies has been quietly falling apart for years. Orthopedic surgeons across the country are seeing more patients in their forties and fifties whose hips have deteriorated well past the point where conservative treatment is keeping up, and who are no longer willing to sit out the activities that define their lives. The question is not whether younger patients can have hip replacement.
For decades, knee replacement followed a relatively uniform formula. Patients with severe arthritis received a standard implant using a standard surgical approach, and success was measured largely by whether pain improved. Today, that model is changing rapidly. Advances in imaging, robotic technology, implant positioning, and muscle-sparing techniques allow surgeons to tailor knee replacement to the individual rather than forcing every patient into the same surgical template.
