Knee Surgery for Osteoarthritis: When Is It the Right Time?

If you’ve been following our information on knee osteoarthritis for a while, you probably already know we talk a lot about the three big keys to knee health:

• Exercise

• Knowledge

• Inflammation

These are the pillars of osteoarthritis management, and for plenty of people, they work remarkably well. They feel better, move more freely, and many even avoid surgery altogether.

But let’s be honest. That’s not always the case.

This post is for anyone who feels like they’ve tried everything non-surgical and are still stuck. If you’re doing all the right things—moving, strengthening, learning—and still dealing with daily pain, then yeah, it might be time to consider something more.

So, when should you think about knee osteoarthritis surgery? And what does that actually mean at different stages of life?

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Under 40: Protect and Preserve the Knee

Most younger adults with osteoarthritis tend to have post-traumatic OA. Maybe from an old ACL tear, a torn meniscus, or a structural issue that’s been brewing for years.

At this stage, it’s not about replacement. It’s about preservation. The idea is to protect what’s left and avoid a major surgery for as long as possible. Here are some common surgical options:

● Meniscus Repairs – Especially root or radial tears. Sometimes paired with ACL surgery.

● ACL Reconstructions – Stabilise the knee and helps prevent more damage.

● Osteotomies – Realigns the joint to offload damaged areas.

● Cartilage Repairs – Techniques like microfracture or grafts to patch up small defects.

The goal? Delay or prevent full-blown OA and keep the knee functional for decades.

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Age 40–55: The “In-Between” Zone

This is where things get a bit murky. Many people in this group—especially active folks on the Gold Coast—don’t want a full replacement yet, but they also can't ignore the pain anymore.

Some options during this phase include:

● High Tibial Osteotomy (HTO) – Helps shift load away from the worn side of the knee.

● Meniscus Transplant – Useful if the original meniscus is gone and pain persists with minimal arthritis..

● Nerve Ablation & Injections – Like radiofrequency ablation or genicular nerve blocks.

Total replacement is usually avoided before 50, if possible, since earlier surgeries tend to need revisions down the line.

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Over 55: The Window for Replacement

At this point, the joint might be significantly worn out, and if non-surgical options aren't working anymore, it might be time to discuss replacement surgery.

You’ve got two main paths:

● Partial (Unicompartmental) Knee Replacement – Targets one section of the knee. Quicker recovery, preserves more natural tissue.

● Total Knee Replacement (TKR) – Still the standard for severe, multi-compartment arthritis.

Quick reminder: the success of your surgery starts way before the actual operation. Good preparation makes a big difference.

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Why Pre-Surgery Rehab Matters

Regardless of your age, your body will do better in surgery—and after it—if you go in stronger and more mobile.

At Gold Coast Knee Group, we focus on:

● Building strength and load tolerance

● Managing inflammation through movement, food, and stress management

● Educating clients about imaging and pain

● Trying bracing or injections if surgery isn't urgent

● Coordinating surgical referrals at the right time

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Final Thoughts

There’s no universal answer to knee pain. For one person, it’s preserving an old football injury at 35. For another, it might be planning a replacement at 70.

Surgery doesn’t mean you’ve failed. Sometimes it’s just the next chapter in your journey. And with the right plan, it can be the step that gives you your life back.

There’s no universal answer to knee pain. For one person, it’s preserving an old football injury at 35. For another, it might be planning a replacement at 70.

Surgery doesn’t mean you’ve failed. Sometimes it’s just the next chapter in your journey. And with the right plan, it can be the step that gives you your life back.

Dr Adam Walker
Director & Head of Rehabilitation
Gold Coast Knee Group
adam@gckneegroup.com.au
www.gckneegroup.com.au