The majority of patients undergoing knee replacement surgery are seniors between the ages of 60 and 80. And more than 90 percent of them feel a significant reduction in knee pain after surgery and a significant improvement in their ability to perform daily activities. However, there are still questions about how the physical function of the new knee may decline after a long period of work, even though the transplant itself poses no problems. This year, at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons, a new study evaluated patients 20 years after undergoing knee replacement surgery. “There is widespread concern among older adults about whether their new knee joints will remain in good shape years after undergoing total knee replacement surgery or, if further repair surgery is needed.” said study article author John B. Meding, M.D., an attending orthopedic surgeon at the Hip and Knee Surgery Center in Mossville, Illinois. Although aging brings with it increasing physical mobility, the remarkable functional ability and activity level (of the replaced knee) can last for more than 20 years after total knee replacement surgery. Between 1975 and 1989, the Mossville Hip and Knee Surgery Center in Mossville, Illinois, performed 1,757 ACL (ligament behind the knee) preserving primary total knee replacements. This study performed physical examinations on 128 patients who remained alive for more than 20 years after surgery. In a group of 171 total knee replacements, the average age of the patients at the time of surgery was 63.8 years. Eighty-two percent of the patients in this group had osteoarthritis, and 73 percent were women. The average follow-up period for the study was 21.1 years, and the average age of the patients at follow-up was 82.3 years. The study found that: 95 percent of the patients were able to walk at least five blocks; nearly half of the patients (48 percent) reported walking with no difficulty at all; all but two patients were able to walk up and down stairs without the use of a handrail; only three patients were confined to their homes; and there were no grafting problems for 20 years after surgery. “These findings certainly bring the patient’s voice to the discussion of this type of surgery. If patients are really living that long, then a new, well-functioning knee can help them maintain significant functional capacity and activity levels for not just five to 10 years, but upwards of 20 years.” Dr. Meding said, “This study refutes any notion that the importance of a new, well-functioning knee diminishes over time due to a decline in overall functional status. Older adults are still able to maintain a fairly active daily life years after surgery with the help of their new replacement knee.”