Is a young person with arthritis a good candidate for knee replacement? In general, osteoarthritis is less common in young people, and diseases such as rheumatoid and ankylosing spondylitis are more common. For example, the age of onset of ankylosing spondylitis is 20 to 40 years old, and juvenile rheumatoid arthritis develops at the age of 10. By the time the patient is 20 years old, the joints are so badly damaged that they are unable to lead a normal life, such as getting married, having children, or finding a job. At this point, a knee replacement is required. Although artificial joints have a certain lifespan, young people who have had their joints replaced may have to have them replaced again in 15 to 20 years. However, from a quality of life perspective, the best age for a person is at this stage, so you should not wait until you are 60 years old to replace the joint because of the possibility of a second replacement at age 20. Therefore, for young patients, knee replacement is still necessary to increase self-confidence and to integrate into social life. Is a knee replacement suitable if I have been taking hormones for a long time? Some patients with rheumatoid and ankylosing spondylitis have to take hormones because of the disease, but taking hormones can cause osteoporosis, so can such patients undergo joint replacement? The answer is yes. However, it is worth noting that it is important to let the doctor know about the hormones before the surgery so that the doctor can “hormone protect” the patient before and during the surgery. As a result of taking hormones, the patient’s own hormone production is reduced and the adrenal cortex function is suppressed. By the time the surgery takes place, the body will have a stressful reaction to the surgery and will need more hormones. But the adrenocortical function is suppressed, and it is no longer possible to produce the normal amount of cortisol, much less the amount needed during stress, so the patient will have a series of symptoms of adrenocortical hormone deficiency: high fever, gastrointestinal disorders, circulatory deficiency, indifference, depression or agitation, delirium or even coma, which is called adrenal crisis. By “hormone protection”, we mean that the doctor takes measures to avoid the occurrence of adrenal crisis. In addition to prednisone and hydrocortisone, some prescriptions for rheumatoid, asthma and skin diseases may also contain hormones. Such cases also need to be informed to the attending physician.