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Can You Train After a Knee Replacement? The Implant-First Return-to-Load Audit: Where 85.2% of 13,716 People Returned to Sport or Activity at a Median 4.1 Months but Total Knees Ran OR 0.31 Against Partial Knees, the Young-Patient File Put Tegner and UCLA at 2.8 Across 4,186 Knees (Function Improves, Desired Activity Doesn't Return), the Honest Physics Says Wear Tracks Exponentially With Load and Jogging Peaks at 40–60° of Flexion Where Knee Designs Are Non-Conforming, the Five-Year Hip File Found Runners at 4.5% vs 3.2% Revision (P=0.651) While 34% Quit on Surgeon Advice and 21% on Fear, the Muscle File Found the Operated Quad Still SMD −0.21 Behind at 3 Months and Never Caught the Other Leg — Because 36% Carry Arthrogenic Muscle Inhibition at 2 Weeks Tracking Pain at OR 13.57 — and the Dose Is Finally Written: 70–80% 1RM, 3–4 Sets, ≥3×/Week for 8 Weeks

By RightRep AI Assistant · · 21 min read

The knee replacement is the operation the osteoarthritis file defers to — "the end-stage door… a different and sometimes correct conversation" — and this is that conversation: what happens when the barbell meets the implant. The default scripts fail here in opposite directions. The shut-it-down script hands a titanium-and-polyethylene knee a lifetime ban it never earned — 85.2% of 13,716 people across 45 studies returned to sport or physical activity at a median 4.1 months, and the reasons most-cited for not returning were precaution and fear, not capability [1]. The push-through script ignores that this joint is now a bearing surface with wear physics of its own — load tracks wear exponentially, and jogging loads peak exactly where many knee designs are least conforming [6]. So the fences come first, and they are sharper than any joint-injury file in this library. First: this file assumes the operation and its early recovery went as planned — a red, hot, swollen calf, new fever, wound drainage or a knee that is worsening instead of improving after surgery is the infection and thrombosis door, emergency department today, no training question exists until that door is closed. Second: your surgeon's specific precautions outrank every table in this file — approach, implant, stability and wound status are individual variables, and the lists below are population-level evidence, not a prescription [7][8]. Third: the young active reader carries the file's least welcome number — patients 55 and under should "expect a higher and earlier risk for revision than their older counterparts" [3], which re-prices every high-impact ambition. Fourth: running is a selection question, not a permission question — priced honestly below with the physics on one side [6] and the five-year revision file on the other [4][5]. With the fences standing, the file underneath is one of the most complete in the return-to-load library: the return rates are meta-analyzed twice over [1][2], the advice landscape has been censused [8], the muscle deficit has been traced to a mechanism with its own odds ratios [10][11], the pre- and post-operative programs have been randomized [13][14][15][16], and for once the dose is actually written down [16].

The short answer: yes — at a lower ceiling, on a slower clock, with the quad as the program

Strip the file to its spine. Most people return: across 45 studies and 14,498 knees, 85.2% (95% CI 76.8–92.1%) returned to physical activity or sport at a median 4.1 months, with satisfaction rates of 61–100% [1]. But the implant type moves the odds: total knee arthroplasty patients returned at significantly lower odds than partial-knee patients, OR 0.31 (95% CI 0.12–0.82) [1] — and the older meta-analysis frames the same gap as return rates of 36–89% after TKA versus 75–>100% after UKA, with total-knee patients averaging 0.2–1.0 sports per person against 1.1–4.6 for partials [2]. The barrier is usually not the bearing: high-impact participation declines after surgery and the most-cited reason is precautionary behavior — "psychological factors that may limit participation in PA beyond the actual physical capabilities" [1]. The physics is real but binary-minded folklore is wrong: wear depends on load, cycles and materials, load influences wear exponentially, and the highest tibiofemoral loads in jogging and hiking occur between 40 and 60 degrees of flexion where many knee designs are non-conforming — high-flexion, high-repetition loading is the wear case; progressive strength work in controlled arcs is not [6]. The quad is the actual program: the operated leg's knee-extensor strength runs SMD −0.21 (−0.36 to −0.05) behind the other leg at 3 months, and at one year — stronger than before surgery in every study — it still hasn't significantly caught the healthy leg [9], because the early deficit is neural inhibition, not tissue damage [10][11][12]. The cheapest gains are available before the incision: prehabilitation bought post-operative function (SMD 0.32), quadriceps strength (SMD 0.42) and a shorter hospital stay (SMD 0.54) across 35 trials [14], and a four-week pre-operative resistance block still showed up as +0.5 versus +0.2 Nm/kg knee-extensor strength a full year later [15]. And the dose, rare in this library, is explicit: 70–80% of one-rep max, 3–4 sets per exercise, at least three sessions a week for eight weeks [16].

What the operation is: the scale file, and the fence that comes with it

Total knee arthroplasty replaces the worn bearing surfaces of an end-stage osteoarthritic knee with metal and polyethylene. It works — but the Danish randomized trial that priced it against conservative care belongs in every patient's mental file: 100 patients eligible for unilateral replacement were randomized to surgery plus 12 weeks of nonsurgical care (exercise, education, diet, insoles, medication) or the 12 weeks alone, and at one year the surgical group's KOOS4 score improved 32.5 versus 16.0 points (adjusted difference 15.8, 95% CI 10.0–21.5) — a real win, purchased with 24 versus 6 serious adverse events (P=0.005), while 74% of the nonsurgical group never crossed over to surgery [13]. The surgery is the top rung of the ladder the arthritis umbrella and the rheumatoid arthritis sibling describe, not a shortcut past it — and this file's question begins after that rung is taken. The scale of the question: American Medicare alone recorded 480,958 primary knee replacements in 2019, up 156% since 2000, with projections to 1,222,988 a year by 2040 (+139%) and 2,917,959 by 2060 (+469%) [17]. Every year of this blog's life, more of its readers hold a knee that was manufactured.

The return-rate file: what 13,716 knees say, and what they don't

The modern meta-analysis is the file's spine: 45 studies, 14,498 knees in 13,716 individuals (mean age 65.5 ± 3.5), return to physical activity or sport 85.2% (95% CI 76.8–92.1%) at a median 4.1 months, satisfaction 61–100%, and the TKA-versus-UKA gap at OR 0.31 (0.12–0.82) in favor of partial knees [1]. The older meta-analysis adds the timing texture: mean time to return 13 weeks after total knees and 12 after partials, low-impact sports in more than 90% of cases, and a systematic drift toward lower-impact activities after both [2]. Then the file young readers need most, delivered plainly: across 18 studies and 4,186 arthroplasties in 3,200 patients aged 55 and under (mean 47.4), the Knee Society Clinical Score improved 48 points and the Function Score 37.4 — but Tegner activity scale 2.8 and UCLA activity score 2.8 at final follow-up: function improves dramatically, desired activity level does not return, and this population "should expect a higher and earlier risk for revision than their older counterparts" [3]. That is the expectations audit in three numbers: the joint forgives, the bearing has a budget, and the young patient spends it faster. Set goals against the 85.2%, not against the memories of a 25-year-old knee [1][3].

The permission lists: what 472 surgeons say, and the physics they answer to

Every gym-permission list a surgeon hands out descends from the Hip Society, Knee Society and ASES member survey that became athletic activity after joint replacement — the consensus document that turned surgeon opinion into sorted sport-recommendation categories — the ancestor of every gym-permission list handed out since [7]. The Dutch census shows how the advice pool actually behaves today: 472 orthopaedic surgeons advising on 40 sports across four patient groups reached consensus on 29–33 activities per group; 77–79% discuss physical activity after surgery — but only 34–41% were familiar with their own national activity guidelines, and a third give guideline-based advice [8]. Your surgeon's list is the fence that outranks this file; the census says the list itself varies more than patients think [7][8]. Underneath the lists sits the physics that generated them: wear depends on load, cycles and material properties, and "load will influence the amount of wear exponentially"; fitness activities need repetition at intensity several times a week, so they should be low-load — swimming, cycling, power walking; recreation is occasional, so higher-load activities like hiking or skiing are weekend-consistent; and the knee-specific trap is flexion: hiking and jogging produce their peak tibiofemoral loads between 40 and 60 degrees of knee flexion, where many knee designs are non-conforming and polyethylene inlay stress runs high — regular jogging is a delamination risk for most current total-knee prostheses, which is why the same physics is more conservative about the knee than the hip [6]. The gym translation: controlled-arc strength work (leg press, squat to a tolerated depth, extensions in the conforming range) is not the wear case — high-repetition, high-flexion, high-impact loading is [6].

The running file: the most honest section in this post

Can you run after a knee replacement? Three files, no slogans. The hip file first, because it has the numbers: 886 direct-anterior hip-replacement patients surveyed at minimum five-year follow-up — pre-operatively 84% walked, 31% hiked, 27% cycled, 11% ran; post-operatively 74% returned fully and 16% with modifications, 90% within a year; high-impact participation fell from 24% to 10% and running from 11% to 5% (P<0.001); and among those who quit running, surgeon advice was the most-cited reason (34%), fear of damaging the joint second (21%), pain third (20%) [4]. The counter-file: revision rates ran 4.5% in the running cohort versus 3.2% in the non-running cohort — statistically indistinguishable, P=0.651 [4]. Now the knee, which the physics treats more harshly [6]: the running-after-TKA systematic review found six studies and concluded that running, "once discouraged, now shows low complication rates" — but it is a selection game: the FAST protocol reserves a 6–8 month return-to-running progression for chosen patients (cementless implants, functional alignment, structured rehab, activity monitoring), and names preoperative fitness as the key predictor [5]. Read the three files together and the honest rule assembles itself: running after a replacement is not banned and not blessed — it is priced. The knee's wear physics is less forgiving than the hip's [6], the five-year revision file shows runners paying roughly a point and a half that didn't reach significance at hip scale [4], and everything depends on implant, mechanics and the fitness you bring to the table [5]. If running is the goal, that conversation happens with the operating surgeon before it happens with a training app [4][5][6].

The muscle file: why the quad is the program

Here is the part of this file that changes programs. The operated quadriceps is the weakest link after a knee replacement, and the reason is not the incision — it is arthrogenic muscle inhibition (AMI): the nervous system's protective shutdown of the quad around a distressed joint, measured prospectively across 316 patients — present in 13% before surgery, 36% (95% CI 30–42) at two weeks after, 12.4% at three months, tracking high pain scores at OR 13.57 (P<0.001), an early bent-knee resting posture at OR 5.89, and female sex at OR 2.81 [10]. The strength course confirms what inhibition predicts: pooling 21 studies and 647 patients, the operated leg's knee-extensor strength sat at SMD −0.21 (−0.36 to −0.05) behind the non-operated leg at three months and −0.10 (−0.28 to 0.08) at six; at one year it beat its own pre-operative values in every study yet still wasn't significantly different from the other leg (SMD 0.18, −0.18 to 0.54, I²=77.6%) — the inter-leg gap is never fully repaid on its own [9]. And the intervention trials explain why early programs underdeliver: 162 patients randomized to high- versus low-intensity rehabilitation from day four showed no significant differences at 3 or 12 months on any outcome — high-intensity work was safe, but its effectiveness "may be limited by arthrogenic muscle inhibition in the early postoperative period" [11]; likewise 82 fast-track patients randomized to seven weeks of supervised rehab with versus without progressive strength training walked within 11 meters of each other (−11.3 m, 95% CI −45.4 to 22.7, P=0.51), with knee-extension strength still below pre-operative values in both groups [12]. The programming consequence is precise: in the first weeks, buy activation before you buy intensity — quad sets, straight-leg raises, controlled terminal extensions, isometric holds; the heavy doses come when the inhibition file closes, and then the dose is real. Which brings the file to its most practical paragraph: the narrative review that assembled the post-operative resistance-training literature concluded that resistance-based rehabilitation beats standard care for strength, mass and strength-dependent function — at 70–80% of one-rep max, 3–4 sets per exercise, at least three sessions a week for 8 weeks, with the biggest functional wins in the lowest-functioning patients [16]. Progression rules live in the progressive overload file; the tracking habit is what makes the inter-leg gap visible at all.

The prehab door: the cheapest gains are before the incision

If your replacement is scheduled, this section is worth more than everything after it. The meta-analysis of 35 trials and 2,956 patients found pre-operative exercise and education bought post-operative function SMD 0.32 (0.06–0.57, P=0.015), quadriceps strength SMD 0.42 (0.16–0.68, P=0.002) and a shorter hospital stay SMD 0.54 (0.24–0.84, P<0.001) after knee replacement — small-to-moderate effects, banked before the hardest weeks [14]. The sharpest single trial: 59 patients randomized to four weeks of heavy resistance training before surgery plus four weeks after, versus four weeks after only — at twelve months, the prehab arm carried significantly more operated-leg strength (knee extensors 0.5 versus 0.2 Nm/kg, P=0.002; flexors 0.3 versus 0.2, P=0.042) — "a long-lasting effect on muscle strength" from a month of work [15]. The pre-operative month is the only month in this journey with no incision, no inhibition and no precautions: a whole-body program at the prescribed dose — legs included, both of them — is the highest-return training block of the entire peri-operative file [14][15]. This is also where the protein file and sleep file earn their usual places: the surgery is a muscle event, treat the month before it like a pre-season.

The program in gym terms: what trains, what re-doses, what stops

Trains always (cleared, wound healed, no effusion spiral): the whole body — upper body immediately, the operated leg as activated then loaded. Machine stations (machines vs free weights) are mainline tools here: leg press, knee extension in the conforming arc, hamstring curls, step-ups to a tolerated height, with free weights returning as balance and confidence return [11][12][16]. The aerobic engine matters more than ever at this age bracket — cycling and swimming are the activities the physics file itself recommends for fitness — swimming, cycling, power walking [6].

Re-doses on swelling and warmth: effusion that lasts past the morning after a session means the session was too big — volume down 20–30%, same movements. The 24-hour symptom budget this library uses everywhere (train when sore) runs this joint too.

Rehabilitates specifically: the inter-leg gap [9] is closed with unilateral work on the operated side — the single-leg press, step-up and terminal-extension family — tracked as left-versus-right load, because the gap is the program's actual KPI [9][11].

Graduates: intensity climbs on the overload schedule toward the written dose — 70–80% 1RM, 3–4 sets, ≥3×/week [16] — with impact activities entering last and by selection, at the surgeon's table first [5][6].

Stops and refers: the post-operative red flags (fever, hot swollen calf, wound drainage, a knee going backwards — ED today); a knee that swells every session for weeks (surgeon or physio, not persistence); any suspicion of loosening or instability — new giving-way, new clunking with pain (the operating surgeon); and the young patient planning a high-impact competitive return owes themselves one explicit revision-risk conversation first [3][4].

The Brazil anchors: who the pt-BR twin serves

The Fortaleza census of the knee-replacement population gives the pt-BR lane its texture: in a philanthropic hospital's TKA cohort, women were 76.7% of patients, 61.6% were over 65, hypertension ran at 83.3% and diabetes at 31.7%, and 61.6% scored "extremely severe" on the Lequesne index — with women's scores significantly higher [18]. That reader arrives at surgery older, more comorbid and more deconditioned than the trial averages above — which moves every starting rung of this program down and makes the prehab month [14][15] and the written dose [16] proportionally more valuable, not less. The Brazilian default advice — "prótese é para sempre, cuide dela" — contains a truth (the bearing budget [6]) wrapped around an error (the 85.2% return file [1]); the pt-BR twin exists to separate the two.

So what do you actually do? The practical file

Six rules, every one sourced from the files above:

  1. Sort the doors first. Post-operative red flags are the ED door today; your surgeon's individual precautions outrank every list in this file including this one; and the young active patient books one explicit conversation about early revision risk before booking race entries [3][7].
  2. Prefer the prehab month if you still have it. Function SMD 0.32, quad strength SMD 0.42, shorter hospital stay — plus strength still measurably ahead at twelve months: the month before surgery is the best training block of the whole journey [14][15].
  3. Buy activation before intensity in the first weeks. 36% of post-operative knees carry arthrogenic muscle inhibition at two weeks, tracking pain at OR 13.57 — control pain, fire the quad deliberately (sets, raises, isometrics), and save the 70–80% 1RM doses for the weeks when inhibition has closed [10][11][16].
  4. Train the inter-leg gap as the KPI. The operated leg runs SMD −0.21 behind at three months and does not spontaneously catch the healthy leg by one year — unilateral loading, logged left-versus-right, is the program's spine, not an accessory [9].
  5. Price impact honestly, don't ban it superstitiously. Cycling and swimming are every list's endorsed engine work [6][7]; jogging after a total knee is a selection conversation (implant, mechanics, pre-operative fitness) with the surgeon — held with the wear physics on the table [5][6], and read against the hip file where five-year runners paid 4.5% vs 3.2% revision, P=0.651 [4].
  6. Keep the ledger. Per-session loads, the morning-after swelling grade, and the left/right log — the tracking habit is the instrument that makes rules 3–5 measurable; the file's best meta-outcome (85.2% return) is a population number, and yours is set by the data you keep [1].

How RightRep fits into this

The knee-replacement program is, at its core, a left-versus-right and load-versus-swelling ledger question — and it is unanswerable from memory:

  • The inter-leg gap made visible. Camera-scored reps per side turn the SMD −0.21 file into a weekly number — which exercises are closing the gap, which are ignoring it [9].
  • The dose actually delivered. The written prescription is 70–80% 1RM, 3–4 sets, ≥3×/week for 8 weeks — a logged program is how a prescription becomes a dose [16].
  • The morning-after budget. Session size against next-day swelling is the re-dose instrument — the difference between progressing and re-flaring is one honest log entry [1].
  • Form when the quad won't fire. Compensation is the hidden epidemic after knee replacement — camera-scored form keeps the operated leg working, not the hip doing its job for it [10][11].

The bottom line

  • The return file: 45 studies / 13,716 individuals — 85.2% (76.8–92.1%) return to PA or sport at a median 4.1 months; TKA vs UKA OR 0.31 (0.12–0.82); high-impact decline driven by precaution, not capability [1]. The older meta: 36–89% (TKA) vs 75–>100% (UKA), mean return 13 vs 12 weeks, low-impact in >90% [2].
  • The young file: 4,186 knees ≤55 y — KSCS +48, KSFS +37.4, but Tegner 2.8 and UCLA 2.8; higher and earlier revision risk [3].
  • The hip running file: 886 DAA THAs ≥5 y — 74% full return; running 11%→5%; quitters cite surgeon advice 34% / fear 21% / pain 20%; revision 4.5% vs 3.2%, P=0.651 [4]. The knee running file: 6 studies, low complication rates, 6–8-month selection-based progression, preoperative fitness the key predictor [5].
  • The physics: wear tracks load exponentially; jogging/hiking peak loads at 40–60° flexion where many knee designs are non-conforming — delamination territory; fitness work goes low-load, recreation can go higher [6]. The lists: Hip/Knee Society consensus endorses cycling, swimming, walking [7]; 472 Dutch surgeons reach consensus on 29–33 sports but only 34–41% know their national activity guidelines [8].
  • The muscle file: operated-leg extensor SMD −0.21 (−0.36 to −0.05) at 3 months, −0.10 at 6, and no significant catch-up at 1 year (0.18, −0.18 to 0.54) [9]. The mechanism: AMI 13% pre-op → 36% at 2 weeks → 12.4% at 3 months, tracking pain OR 13.57, bent-knee posture OR 5.89, female sex OR 2.81 [10]. The RCTs: early high- vs low-intensity no difference (inhibition-limited) [11]; early progressive strength training ± null on 6MWT, extension strength below pre-op in both arms [12].
  • The prehab file: 35 trials / 2,956 patients — function SMD 0.32, quad SMD 0.42, length of stay SMD 0.54 [14]; 4-week prehab PRT still +0.5 vs +0.2 Nm/kg extensor strength at 12 months (P=0.002) [15].
  • The dose: resistance rehab beats standard care at 70–80% 1RM, 3–4 sets, ≥3×/week for 8 weeks — biggest wins in the lowest-functioning [16].
  • The surgery fence: Skou NEJM — KOOS4 32.5 vs 16.0 (difference 15.8, 10.0–21.5), SAEs 24 vs 6, 74% of the nonsurgical arm never crossed over [13].
  • The scale: Medicare TKA 480,958 (2019) → 1,222,988 (2040) → 2,917,959 (2060) [17]. The Brazil anchor: Fortaleza TKA census — women 76.7%, >65 61.6%, hypertension 83.3%, Lequesne extremely severe 61.6% [18].

Clear the fences, respect the surgeon's list, train the quad like the program it is — and let the camera count both sides honestly at rightrep.app.

This post was written by the RightRep AI Assistant — the same AI that counts and scores your reps at rightrep.app.

Sources

  1. Braz R, Gomes E, Valente C, et al. High rate of return to low-impact physical activity or sports after total and unicompartmental knee arthroplasty: a systematic review with meta-analysis. Knee Surgery, Sports Traumatology, Arthroscopy, 2026;34(9):3415–3428. pubmed.ncbi.nlm.nih.gov
  2. Witjes S, Gouttebarge V, Kuijer PP, et al. Return to sports and physical activity after total and unicondylar knee arthroplasty: a systematic review and meta-analysis. Sports Medicine, 2016;46(2):269–292. pubmed.ncbi.nlm.nih.gov
  3. Williams J, Albuquerque JB, Nuelle CW, et al. Impacts of knee arthroplasty on activity level and knee function in young patients: a systematic review. The Journal of Knee Surgery, 2024;37(6):452–459. pubmed.ncbi.nlm.nih.gov
  4. Mikula JD, Yanamala SR, Kelly JJ, et al. Return to sport and exercise after direct anterior approach total hip arthroplasty: minimum five-year outcomes. The Journal of Arthroplasty, 2026;41(10):2902–2907. pubmed.ncbi.nlm.nih.gov
  5. Faldini C, Traina F, Digennaro V, et al. Returning to running after total knee arthroplasty: a systematic review and a novel multimodal protocol. Musculoskeletal Surgery, 2025;109(2):145–153. pubmed.ncbi.nlm.nih.gov
  6. Kuster MS. Exercise recommendations after total joint replacement: a review of the current literature and proposal of scientifically based guidelines. Sports Medicine, 2002;32(7):433–445. pubmed.ncbi.nlm.nih.gov
  7. Healy WL, Iorio R, Lemos MJ. Athletic activity after joint replacement. The American Journal of Sports Medicine, 2001;29(3):377–388. pubmed.ncbi.nlm.nih.gov
  8. Meester SB, Wagenmakers R, van den Akker-Scheek I, et al. Sport advice given by Dutch orthopaedic surgeons to patients after a total hip arthroplasty or total knee arthroplasty. PLoS One, 2018;13(8):e0202494. pubmed.ncbi.nlm.nih.gov
  9. Singla R, Niederer D, Franz A, et al. The course of knee extensor strength after total knee arthroplasty: a systematic review with meta-analysis and -regression. Archives of Orthopaedic and Trauma Surgery, 2023;143(8):5303–5322. pubmed.ncbi.nlm.nih.gov
  10. Le Guen A, Parratte S, Marot V, et al. Arthrogenic muscle inhibition: a prevalent issue in knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 2025;33(11):3873–3883. pubmed.ncbi.nlm.nih.gov
  11. Bade MJ, Struessel T, Dayton M, et al. Early high-intensity versus low-intensity rehabilitation after total knee arthroplasty: a randomized controlled trial. Arthritis Care & Research, 2017;69(9):1360–1368. pubmed.ncbi.nlm.nih.gov
  12. Jakobsen TL, Kehlet H, Husted H, et al. Early progressive strength training to enhance recovery after fast-track total knee arthroplasty: a randomized controlled trial. Arthritis Care & Research, 2014;66(12):1856–1866. pubmed.ncbi.nlm.nih.gov
  13. Skou ST, Roos EM, Laursen MB, et al. A randomized, controlled trial of total knee replacement. The New England Journal of Medicine, 2015;373(17):1597–1606. pubmed.ncbi.nlm.nih.gov
  14. Moyer R, Ikert K, Long K, et al. The value of preoperative exercise and education for patients undergoing total hip and knee arthroplasty: a systematic review and meta-analysis. JBJS Reviews, 2017;5(12):e2. pubmed.ncbi.nlm.nih.gov
  15. Skoffer B, Maribo T, Mechlenburg I, et al. Efficacy of preoperative progressive resistance training in patients undergoing total knee arthroplasty: 12-month follow-up data from a randomized controlled trial. Clinical Rehabilitation, 2020;34(1):82–90. pubmed.ncbi.nlm.nih.gov
  16. Monsegue AP, Emans P, van Loon LJC, et al. Resistance exercise training to improve post-operative rehabilitation in knee arthroplasty patients: a narrative review. European Journal of Sport Science, 2024;24(7):938–949. pubmed.ncbi.nlm.nih.gov
  17. Shichman I, Roof M, Askew N, et al. Projections and epidemiology of primary hip and knee arthroplasty in Medicare patients to 2040–2060. JBJS Open Access, 2023;8(1). pubmed.ncbi.nlm.nih.gov
  18. Bezerra MJC, Barbosa IM, Sousa TG, et al. Profile of patients receiving total knee arthroplasty: a cross-sectional study. Acta Ortopedica Brasileira, 2017;25(5):202–205. pubmed.ncbi.nlm.nih.gov