Just as medicine changes, so do patients. An increasing number of people younger than 60 are opting for a total knee replacement (TKR). According to a report from the Agency for Healthcare Research and Quality, of 600,000 TKRs done in the United States in 2009, the greatest increase was among patients ages 45 to 64.

That doesn’t mean you have to jump on board. Some people are eager to have their knees replaced because they’re in pain and want their active lives back. But others prefer to delay surgery for as long as possible. How to decide? Here are the pros and cons.

The Upside

  • Goodbye to (most) pain. “The number one reason to have TKR is for pain management,” says Brian S. Parsley, MD, clinical associate professor and director of Adult Reconstruction Fellowship at Baylor College of Medicine in Houston. The success of TKR in younger patients: about 90 to 95 percent.
  • A long-lasting fix. An implant can last from 15 to 25 years. “If you’re under 60, you’re probably facing a revision [or redo], but the most common revision is usually just an exchange of the plastic insert,” says Dr. Parsley. That means most of the original implant stays, and the surgeon won’t need to remove more bone.
  • Resuming what you love. These days, 60 is too young to give up activities you love because of disabling pain, says Andrew Glassman, MD, chief of Adult Reconstructive Surgery, The Ohio State University Wexner Medical Center in Columbus. “If a procedure can [extend] your ability to do those things for 25 years, that’s reasonable to do.”

The Downside

  • A second replacement – or revision – surgery. “Younger patients do have a higher rate of failure and early revision because of obesity, more activity, and because they are living longer than older patients,” says Dr. Parsley.