Hip and Knee Replacement: Alternatives, Age Limits, Approaches

Being told you need a new hip or knee often raises three questions at once: is there anything else I can try first, am I too young or too old, and which kind of operation should I have? This guide takes them in turn, using what patients themselves report, and explains how some people combine surgery with other care on one trip to China.

What are the alternatives to knee or hip replacement surgery?

For many people the first steps are non-surgical: physiotherapy and strengthening exercise, losing weight if it is putting load on the joint, walking aids, pain relief, and injections such as steroids. These can ease pain and buy time, sometimes years, but they do not rebuild a joint that is worn through. When pain limits walking, sleep and daily life despite them, surgeons usually raise replacement.

Some people try newer injections before surgery, and their experiences vary. One patient described years of benefit:

Some knees can be treated with a partial replacement, which replaces only the worn part of the joint, and some younger patients with a specific deformity are offered an osteotomy, an operation that realigns the bone. Which of these suits you depends on your scans and examination, so ask your surgeon to explain why a particular option is or is not right for you.

Do stem cell and PRP injections work for knee arthritis?

The honest answer is that results vary a great deal, and we cannot point to a figure we trust. Stem cell and platelet-rich plasma (PRP) injections are usually paid for yourself and are often not covered by insurance. Some patients report months or years of relief; others report none.

If you are considering them, ask the clinic what results it expects for someone with your degree of arthritis, how many injections are planned, the total cost, and what happens if they do not help. Keep your surgeon informed, because surgeons may ask you to wait a period after an injection before a joint replacement.

At what age can you have a knee or hip replacement?

There is no fixed upper or lower age limit. Surgeons look at your overall health, how severe the joint damage is and how much it affects your life. With younger patients they often prefer to wait, because an artificial joint may eventually need to be redone, and a second operation is more complex than the first.

At the other end, being in your eighties does not rule out surgery on its own. What matters is whether your heart, lungs and general fitness are good enough for the operation and the rehabilitation that follows. Families in China describe elderly relatives doing well:

Can you have a knee replacement with bone-on-bone arthritis or osteoporosis?

Yes, in many cases. Bone-on-bone arthritis, where the cartilage has worn away, is one of the most common reasons for a knee replacement. Osteoporosis does not automatically rule it out either, but it affects planning: the surgeon will want to know how strong your bones are, may choose the implant and fixation method accordingly, and may suggest treatment for bone density. Tell the surgeon about osteoporosis medicines and any past fractures, and bring a recent bone density scan if you have one.

What surgical approach is used for hip replacement?

Hip replacements are done through one of several approaches, mainly from the back (posterior), the side (lateral) or the front (anterior). Each has supporters, and they differ in the muscles involved and in the movement precautions you may be given afterwards. Robotic-assisted surgery is also offered at some hospitals; in the UK, Nuffield Health Glasgow lists a robotic hip at GBP 16,905 against GBP 15,057 for its standard hip (2026). You can ask about the approach, but the most useful question is which approach the surgeon uses most often and how many of those operations they do each year.

How is a joint replacement done in China, and can it be combined with other care?

The operation itself follows the same principles as in Western hospitals, and hospital stays in China can be longer: about six days on average after a hip replacement at one tertiary hospital studied in 2022. Because the stay and the recovery period are long, some visitors use the time for more than surgery.

In China, TCM is part of many public hospitals, and doctors often use acupuncture, tuina massage or moxibustion alongside rehabilitation as supporting care. A TCM doctor starts by looking at your tongue and taking your pulse, because TCM tailors the approach to each person rather than to the diagnosis alone. An acupuncture session at a public hospital is listed at around CNY 70 (≈ USD 10). How much it helps differs from person to person, and it does not replace surgery, physiotherapy or the medicines your surgeon prescribes. Tell both doctors about everything you are taking, including herbal medicines, especially if you are on blood thinners after surgery.