Knee replacement - 40 years old


My Third Post
Hi All,

First post, might as well start with a serious sobering question!

My doctor yesterday recommended a partial knee replacement. I am 40 years old. I have worn away most of the cartilage in my right knee, and it is scraping now. It gets painful occasionally. I re-aggravated it after a lot of rowing recently. Weight lifting and KB work never aggravate my knee.

I had an ACL surgery at age 21, after I blew my knee out. I was a ski instructor and played soccer my entire youth. Having ACL surgery at such a young age allowed me to be extremely active over 20 years. I was a cat 3 bicycle road/mtb racer, riding thousands of miles, did a lot of crossfit over 5 years, weight lifting, hiking, surfing, snowboarding, etc. I haven't been limited at all with my ACL, and having it so young was a good decision.

I am going to the same Dr. for the replacement, and I totally trust his opinion. He's one of the best in the US, many pro athletes use him. He says in the same way the ACL allowed me to keep being active, the partial knee replacement will do the same for me. After the surgery, I want to become Strong First certified, and train in this methodology. I know my limits and will have boundaries for myself after the surgery, like I did for the ACL.

Since this is such a major life decision, I have to put it out there. Has any of you had this surgery, or know of anyone that has, especially at such a young age? I am not looking for medical advice, just any knowledge about living with a replacement, or coping with having one. Any stories of thriving after having one would be great too, or even any words of advice or criticism for the procedure. Again, not looking for medical advice, just thoughts anyone can share.

Chris Puckett


More than 300 posts
I know lots of people who've had knee replacements are very happy with them. I'm a diehard, tho, who'd only get one as a very last resort. I believe lots of ACL's are torn because people don't learn how to squat deep as an early athletic move- and their hamstring doesn't learn how to fire with a strong quad to stabilize the knee. If it fires, the ACL doesn't get stressed, because the hamstring attaches to the top of the shin and pulls it into the knee socket. Squatting also teaches the quads and hamstrings to coordinate in other ways. Also, I've had lots of knee pains over the years, and always surprised how "proper" (whatever that is!) exercise can restore it. I had a bad hitch in one knee for a long time that went away after a few months of Simple & Sinister with cycling. If I were you, I'd try the S&S for awhile, esp if it doesn't hurt, and make sure there's no exercise cure before the surgery. btw, no medical training here- just time in the gym- fwiw.


My Third Post
Thanks Tom, will do. I am starting another cycle of KB work and mostly upper body movements(chins, bench, planks, ab wheel). I just bought Simple and Sinister, and will check it out. The funny thing is, the ACL he put in me 20 years ago is as strong as ever. Its just that the cartilage is mostly gone in my knee, causing the bone to rub on the inside of the need. Tendons are healthy. I am trying to get as lean as possible before the surgery. Gunning for September to do it.

Steve Freides

Forum Administrator
Staff member
Senior Certified Instructor
Chris, welcome to StrongFirst!

Being a cat 3 bikie is very impressive - congratulations to you for that. (I was a pretty serious, although non-competitive, roadie in my day.)

We're not doctors here on the forum but I would consider a couple of things in your place. (And I don't have a personal success story to share with you on this one although I wish I did.)

Your ACL replacement sounds like it's good for a lifetime; would your partial knee replacement be the same? I know several people who had joints replaced relatively early in their lives and are putting off the second replacement of that same joint because they've been told that two is the limit.

The other question is: what kind of trade-off do you get if you don't do the partial knee replacement? I've been told I have very little cartilage left in either knee, and my experience agrees with that diagnosis as anyone who's been around me for a while will confirm. I have, however, found plenty of things I can do still do. My personal choice would be a change in activity rather than surgery but, hey, that is me, and if you are really into a particular sport or activity that the surgery would make possible again, then maybe it's a good choice for you.

At the risk of stating the obvious to you here, these are the kinds of conversations you probably should have with your doctor as well as with family and friends to help you decide what's going to feel like the best choice 20 years from now, and 40 years from now.

We have many good instructors in and around NYC who will be able to help guide you on your journey. Again, welcome to StrongFirst.



Founder and Chairman
Master Certified Instructor
Chris, welcome to StrongFirst!

Heal fast, get training restrictions and recommendations from your doc, and we will help you with direction.



PLEASE consider PROLOTHERAPY before getting a knee replacement.

PROLOTHERAPY uses your bodies IMMUNE system to HEAL itself. It is considered ESPECIALLY effective in healing the KNEE. Studies have shown that it can regrow cartilage.

About Prolotherapy:

Prolotherapy for the knee:


I'm sure there are doctors in your area, but ensure they are using the Hackett-Hemwall technique. It is a comprehensive technique designed to ensure that you heal.

I really hope this helps.

Good luck, and God bless.


My Third Post
Thanks all for the comments. I will take this all into consideration. For now I am going to work on my bench press and pull ups, and play with the KB's to see what programming will work for me. Goblet squats have felt good so I will go down that road a little while. I will ping back with my progress.



I was scanning the internet and I just found this:

This doctor is currently looking for patients to perform a cartilage regeneration procedure on.

You should consider calling to see if you qualify as a candidate.

Again, good luck and God bless.


Quadruple-Digit Post Count
That "cartilage regeneration" does look interesting but a bit less invasive and far more available, the prolotherapy looks very promising to me. I have worn knees, not yet to the point of needing anything done outside due caution but I hear hoofbeats. Did some searching around and this has been in use quite awhile, not tons of research but pretty available in the U.S. and not very expensive. There's some good articles here

Journal of Prolotherapy

Including one w/ before and after xrays showing pretty dramatic increase in joint space/clearance which means a lot more cartilage is there.


Quadruple-Digit Post Count
All sounds very promising for those with dodgy battered knees which I am a fully paid up member. The idea that it promotes the natural healing processes is appealing certainly and it seems from the info that 'a substance' is injected into the knee to cause inflammation, that substance it appears is sugar. Makes sense, irritation, inflammation, healing, problem solved. In which diabetics would be immune from joint although not a biochemist with a phd in wound healing, I would like to know a bit more as it could be promising...on the other hand it could be nonsense. Placebo? Eh, not knocking it, if it works, it works.....and placebo works. It is very powerful. In fact sugar is often the substance used in placebo trials! You know, just a thought. So unless there is something more to this substance than sugar, and sugar alone, then I'm all ears. On that note......glucosamineglycans? That's one for the auto spell checker......they are sugars....maybe they mean that, sugar is just a catch all carb word thing. One way to get a bunch of glucosamineglycans into your system is by supplementation of glucosamine and chondroitin, of which the jury is very much still out over their efficacy or go au natural and make your own out of brewing up some bones. It is put forward that when consumed in natural form, glucosamine, chondroitin and other stuff found in cartilage of animals promote healthy cartilage in the person gleefully knocking it back or using it in stews etc. it isn't the glucosamineglycans by themselves but the synergistic effect of them all together in the right natural amounts. When consumed the body recognises them - why wouldn't it, it is a naturally occurring molecule found in us all - and triggers a epigenetic response turning on a cascade of hormones for the body to heal itself. It turns on your genes to repair the cartilage? Now if they are injecting this stuff into your knee then sign me up. Having said that, I like my bone broth and get the thinking behind it but I still have creaky knees. So.....who knows?


Second Post
I have had a knee replacement surgery a few years back and now I’m completely fine. It feels even better to live without any pain and discomfort. Make sure you follow the advice of your doctor for a complete and healthy recovery.


More than 500 posts
I'm overdue for a knee replacement, I haven't had menisci for well over 20 years in my left knee. My right knee has been doing the lions share of work since I was about 15, so it's not in good shape either.

I just can't get my head around someone removing a large piece of me and replacing it with some man made contraption.

Some of the new 3D knees seem OK but they are still a poor substitute for the real thing.

They can culture stem cells and differentiate them in them into almost all tissue types these days, so I'm holding out until they can print or grow a 3d knee from my own cultured tissue or I can't walk - whichever comes first.

Most people I know assume I'm a cranky old bastard, but that's based mostly on my facial expressions - I have a permanent grimace because I'm in pain 24/7. Compared to the pain in my back & neck the pain of bone on bone in my knee is almost trivial.

I have days where I can't walk, but also have days where I can lift moderate weights, I'll suck it up until I can't walk and then think about getting a knee replacement.


First Timer
Just on 75 , both knees have no cartilage and everything is becoming difficult. It is only my inside bones that have no cartilage and it seems I am eligible to have a partial replacement.

So I am looking into partial knee replacement but after reading up on a few forums it seems that both partial and full replacements leave people suffering worse than before the operation or for very long periods , some are never pain free ?

I wonder if these negative posts are because the people that have had no problems do not go on these types of forums ??????????????


Quadruple-Digit Post Count
@PeterSmith , the two best predictors of success after knee replacements are:
-bodyweight (you're better off being at a healthy weight)
-outlook on life (which I take to mean optimism, expectations, etc)

I have heard of a lot of people doing well after total knee replacements. I have not heard as much about partial knee replacements. I know of one person who got partials who is still having quite a bit of knee pain.
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