THA and TKA in patients under 25 improve function and quality of lifeJoint Replacement Surgery Improves Quality of Life for Young Patients

JBJS reviews Published September 24, 2026 Study authors: Hoveidaei Amir Human, Ramezanpour Mohammad Reza, Omouri-Kharashtomi Mahyaar, Shahrokhi Raha, López V… PubMed ↗ DOI ↗ Editorial oversight: Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

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Key Takeaway

Note that THA and TKA in patients under 25 improve function and quality of life despite inherent revision risks.

This meta-analysis evaluates the outcomes of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in patients younger than 25 years with end-stage joint disease. The analysis synthesized data from 3317 patients and 5,632 joints to assess postoperative complications, functional outcomes, quality of life, and revision rates.

Key findings indicate that THA resulted in substantial improvements in functional scores (SMD = 4.9) and quality of life (SMD = 1.8). Reported complication rates for THA included 1.6% for periprosthetic joint infection (PJI), 5.4% for aseptic loosening, 1.4% for periprosthetic fracture, and an 8.7% all-cause revision rate. For TKA, the reported rates were 2.9% for PJI, 9.9% for aseptic loosening, and 12.4% for all-cause revision.

The authors note limited evidence specifically for patients under 25 and highlight the need for prospective studies with standardized reporting. While outcomes improved in more recent cohorts, the association between more recent years of inclusion and lower revision or infection rates suggests advancements in surgical techniques and implant design. Clinical application is tempered by the fact that revision and infection risks are generally higher in this younger population compared to older adults.

This analysis looked at the outcomes of total hip arthroplasty (THA) and total knee arthroplasty (TKA) for patients under the age of 25. The study included data from 3,317 patients and 5,632 joints. The results showed that these surgeries led to substantial improvements in both functional scores and quality of life measures for these young patients.

While the surgeries were successful in improving daily life, there are known risks involved. For example, the study reported specific rates for complications like infection, loosening of the joint, and fractures. Specifically, the hip replacement showed a 1.6% infection rate and an 8.7% all-cause revision rate. The knee replacement showed a 2.9% infection rate and a 12.4% all-cause revision rate.

It is important to note that this evidence comes from a review of older records rather than a new, direct trial. Because the data comes from a variety of past cases, the results may not perfectly predict what every individual patient will experience. Patients should discuss these specific risks and the potential for revision with their surgical team.

What this means for you:

Joint replacement can improve function for young patients, but risks like infection and revision remain possible.

Study Details

Study typeMeta analysis

Sample sizen = 3,317

EvidenceLevel 1

Follow-up300.0 mo

PublishedSep 2026

PMID42777096

View Original Abstract ↓

BACKGROUND: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are rarely performed in children and adolescents but may be required for end-stage joint disease. Evidence regarding safety, survivorship, and patient-reported outcomes in patients younger than 25 years remains limited. The aim of this study was to systematically evaluate postoperative complications, functional outcomes, quality of life, and revision rates following THA and TKA in this age group. METHODS: A systematic review and meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. MEDLINE, Embase, Scopus, and Web of Science were searched through October 2025 for studies reporting outcomes of THA or TKA in patients aged younger than 25 years. Random-effects models were used to pool complication rates, functional outcomes, quality of life, and all-cause revision separately for THA and TKA. Meta-regression explored the influence of age, sex, year of patient inclusion, arthroplasty indications, and bearing surface types. RESULTS: A total of 44 studies involving 3,317 patients and 5,632 joints were included. Following THA, pooled rates of periprosthetic joint infection (PJI), aseptic loosening, and periprosthetic fracture were 1.6%, 5.4%, and 1.4%, respectively, and all-cause revision rate was 8.7%. Functional scores (standardized mean difference [SMD] = 4.9) and quality-of-life measures (SMD = 1.8) improved substantially after THA. For TKA, pooled PJI and aseptic loosening rates were 2.9% and 9.9%, with an all-cause revision rate of 12.4%. Subgroup analyses demonstrated that more recent years of patient inclusion were associated with lower revision and infection rates following THA. CONCLUSION: THA and TKA in patients younger than 25 years can improve function and quality of life, although the risks of revision and infection remain higher than those in older adults. Outcomes have improved in more recent cohorts with advances in implant design and surgical technique. Further prospective studies with standardized reporting are needed to define optimal implant selection and long-term outcomes in this population. PROSPERO REGISTRATION CODE: CRD420261303010. LEVEL OF EVIDENCE: Therapeutic Level III (systematic review of retrospective cohort studies). See Instructions for Authors for a complete description of levels of evidence.

THA and TKA in patients under 25 improve function and quality of lifeJoint Replacement Surgery Improves Quality of Life for Young Patients

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THA and TKA in patients under 25 improve function and quality of lifeJoint Replacement Surgery Improves Quality of Life for Young Patients

Study Details

Evaluating Text Message Video Interventions for Improving Infant Sleep Safety Practices

Text message videos for safe sleep show mixed results

Clinical research that matters. Delivered to your inbox.

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