Help Weekend Warriors Reclaim Their Lifestyles After Joint Replacements

Five tips for getting younger arthroplasty patients back to their activities sooner, safer and happier than ever.

Joint replacement surgery continues to trend toward younger and younger patients who are eager to resume their active lifestyles post-procedure. For example, according to 2023 research from the American Academy of Orthopaedic Surgeons, about 28% of hip replacements are performed on men and women younger than 55. By 2030, people younger than 65 are expected to account for 52% of hip replacements and 62% of knee replacements.

Raring to go

The shift toward joint replacements in younger, healthier patients obviously provides facilities with a larger potential patient population, but the goals among younger patients for these surgeries and their recoveries can differ from those of older patients. Many younger patients are looking to recover from their surgeries and get back to their physical activities more quickly than older patients may be.

Fortunately, trends in joint replacement surgery are making it increasingly easier for surgeons and centers to satisfy the goals of these more insistently active patients, particularly advancements in minimally invasive techniques, better implants and quicker recovery times, says Stephen Longenecker, MD, medical director of the joint replacement program at Reading (Pa.) Hospital.

“Ten years ago, we were cautious about what patients could do postoperatively due to concerns about implant wear,” says Dr. Longenecker. “But today, modern materials and surgical techniques allow implants to last decades rather than years. Patients can pursue more activities without worrying about premature wear, but it’s all about setting proper expectations and pacing their recovery.”

This level of efficiency and safety doesn’t happen by accident.
Stephen Longenecker, MD

Facilities like The Steadman Clinic in Vail, Colo., understand that their patients want to return to their active lifestyles, so they have tailored their approaches accordingly. In fact, to celebrate the success of its outpatient joint replacement program, The Steadman Clinic hosts an annual Ski Day and a hike up Vail Mountain — traditions that have drawn hundreds of its patients over the past eight years.

“The vast majority of our patients who come to us for joint replacements are highly active, participating in sports like skiing, hiking, cycling and pickleball,” says Raymond H. Kim, MD, an orthopedic surgeon at the clinic. “Everything we do is focused on achieving a quicker recovery, reducing pain and helping patients reach a higher level of performance so they can get back to doing what they love.”

Here are five crucial elements that inform a winning strategy for joint replacement among active patients.

1. Manage expectations

As with all joint replacement patients, the path to recovery for more active individuals begins with focused education and realistic expectation-setting. Preoperative education and postoperative guidance play a vital role in ensuring these patients understand the realistic timelines and limits of their recoveries. This patient population often comes to the surgical table with particularly high expectations for a quick return to full activity.

Ten years ago, we were cautious about what patients could do postoperatively due to concerns about implant wear.
Stephen Longenecker, MD

“The biggest challenge is ensuring active adults understand the timeline for recovery,” says Dr. Longenecker. “The technology enables a faster return to activity, but we emphasize the importance of safe, gradual progression to avoid setbacks. Rapid recovery doesn’t mean skipping the healing process.”

At Reading Hospital, patients benefit from a unique program that offers 90 days of preoperative conditioning. Included are exercise classes and regimens aimed at building strength and improving overall fitness before surgery. Patients also receive education about what to expect during recovery. The preoperative programming helps them set realistic goals and develop a proactive mindset for their rehabilitation journey, says Dr. Longenecker.

2. Leverage technology for precision and efficiency

Advancements in surgical techniques and technology play pivotal roles in tailoring joint replacements to the needs and goals of active adults. Less invasive methods such as the direct anterior approach, used in a growing number of total hip cases in the U.S., have revolutionized the field, notes Dr. Longnecker. “This technique, combined with robotics, allows us to precisely match surgical plans to a patient’s unique anatomy,” he says.

The quality of the implants themselves is also improving. “Older implants were made from materials that would wear out or degrade after 10 to 15 years,” says Dr. Kim. “Modern implants are much more robust. Now we expect multiple decades from the newer bearings and implant designs. Technology continues to get better and better as we strive to improve joint replacements from a material science perspective and with better rehabilitation protocols.”

Custom implants were once seen as the future of joint replacement, but the value proposition of these pricey options isn’t as tantalizing as it once seemed due to advances in surgical precision and the wider variety of implant sizes that are now available. Dr. Longenecker says navigation systems and robotic assistance ensure every step of the procedure is guided with unprecedented precision, which in turn reduces complications and enhances joint longevity. Using these new technologies and techniques, surgeons can make real-time adjustments based on each patient’s unique anatomy like never before. While the implant might not be customized to the individual patient, the surgery itself is becoming more individualized than traditional methods thanks to these advancements.

“The accuracy of implant placement has reduced the need for custom implants,” says Dr. Longenecker. “Robotics and navigation systems now enable us to achieve the same outcomes with less cost and complexity compared to custom implants.”

“Navigation in joint replacements is a highly accurate and efficient tool that allows us to properly implant the components,” adds Dr. Kim. “This technology has been around since 2000 and, over the years, it has become increasingly more efficient. It also minimizes blood loss and embolic events such as blood clots, which is extremely important in reducing medical risks when performing outpatient joint replacements.”

3. Innovative anesthesia and comprehensive rehab

Anesthesia techniques have evolved significantly to enhance recovery and reduce discomfort for joint replacement patients. Both Dr. Longenecker and Dr. Kim highlight that their patients receive multimodal anesthesia, which can include spinal anesthesia and nerve blocks. Long-acting nerve blocks and localized injections around the joint provide targeted relief for 24 to 36 hours after surgery, reducing reliance on opioids and enabling smoother transitions from surgery to recovery.

“Anesthesia is a critical component of successful outpatient joint replacements,” says Dr. Kim. “We use a short-acting spinal anesthetic in conjunction with nerve blocks to control pain and allow a rapid recovery. This technique reduces blood loss, is low-risk to the heart, reduces blood clots and allows for a quick recovery with very little ‘hangover’ after surgery.”

Reading Hospital additionally employs innovative methods such as cryotherapy to minimize pain and facilitate early mobility. Approximately two weeks before surgery, patients undergo cryotherapy to temporarily numb sensory nerves, which reduces pain for up to 90 days without affecting motor function, says Dr. Longenecker.

“It’s an exciting development that’s still gaining traction but has great potential for widespread use in the future,” he says.

4. Balance speed with safety

POST-OP GUIDANCE A nurse discusses what can be expected immediately after a surgical procedure with a younger patient.

For many active adults, the desire to return to their favorite activities can quickly lead to overexertion. Some experts emphasize the importance of finding a balance between expedited rehabilitation and protecting the integrity of the new joint.

One key factor is the experience of the surgeon and their team, says Dr. Kim. He notes that data shows surgeons who perform a high volume of joint replacement cases produce better outcomes and lower complication rates.

“Fast recovery, safe surgery and long-term success are not mutually exclusive,” he says. “Safe surgery is performed by a skilled and experienced surgeon who works with a highly trained team that does thousands of these procedures.”

Remote care monitoring is an emerging tool in joint replacement recovery that leverages wearable technology to track patient activity levels and provide real-time feedback to care teams. Devices such as fitness trackers can monitor metrics such as step counts, alerting clinicians if a patient is exceeding safe activity thresholds too soon postoperatively, says Dr. Longenecker. While this technology is not yet widely adopted, it holds significant promise for enhancing recovery by helping patients strike the right balance between activity and healing.

“Rapid recovery should mean getting out of the hospital quickly and regaining mobility without jeopardizing tissue healing or implant ingrowth,” he says. “Remote monitoring, though we’re not quite there yet, could be key in the future by helping us guide patients back to activity safely.”

5. Redefine possibilities after joint replacement

The success of outpatient joint replacement surgery relies heavily on the seamless coordination of an experienced and well-organized surgical team. From preoperative preparation to postoperative care, every phase of the patient’s journey requires careful planning and collaboration.

“This level of efficiency and safety doesn’t happen by accident,” says Dr. Longenecker. “It’s the result of a dedicated team and an exceptional program that keeps everything running smoothly, from the equipment in the OR to the support patients receive before and after surgery. Seconds count in an outpatient environment, and that’s where an organized team really shines.”

With the demand for joint replacements among active adults on the rise, the most forward-thinking outpatient joint replacement programs are deftly balancing safety, recovery and patient expectations to enable individuals to reclaim their active lifestyles more rapidly than ever before.

“The ultimate goal is not just to get patients moving again but to help them become as active as they were before surgery,” says Dr. Longenecker. “Through modern technology, advanced techniques and comprehensive care, we’re enabling people to reclaim their lives and redefine what’s possible after joint replacement.” OSM