My First Knee Replacement at Age 35: How I Got Here

Knee replacements are a topic that usually comes up later in life. But GearJunkie’s Nicole Qualtieri is facing down two knee replacements at age 35. This is the first part of her story, told as it unfolds.

The first time I severely dislocated my knee I was in second grade. A few kids had gathered to play soccer in a cul-de-sac, and upon kicking the ball, I felt a screaming pain in my right knee. I looked down and my kneecap was gone. It had slid to the underside of my knee.

I don’t remember screaming or crying at that point, but I do remember an instinct sweeping over me that left nothing else to be considered but the obvious.

I sat down on the curb, and I put the kneecap back into place on my own. The whole event rings so clearly: the ER visit, the big blue brace I had to wear, being on crutches, and people not believing me when I said my kneecap had been out of place and I’d put it back.

It took a while to convince people that I needed help. It’s the kind of lesson that sticks.

Since then, I’ve had a lifetime of dislocations in both knees. It’s a bit of anatomical bad luck combined with a few decades of soccer, lacrosse, running, hiking, and general mayhem. And a bout of Lyme’s disease in my twenties exacerbated the whole thing.

A Final Attempt at Salvage

The author backpacking in Glen Canyon National Recreation Area in 2018

The first time osteoarthritis was mentioned to me I was 27 years old, and I’d just experienced what would be my last catastrophic injury in soccer.

As soon as I hit the ball and felt my left knee come apart, I knew I’d never play again. X-rays showed bone spurs that were in development and other issues, but I didn’t expect that I’d need two new knees within a decade. At that point, I was young, at the beginning of my professional life, and I couldn’t afford the time or money for surgery. So, I carried on.

At 32 years old, I’d transitioned out of sports into hiking, backpacking, and hunting. My knees were certainly both in decline, but daily activity was still possible. I’d been pushing through pain and injuries for years; my threshold for pain had grown rather high.

I was fit enough to get around the mountains, but I decided that my knees would probably benefit if I got back into lifting and more high-intensity workouts to really strengthen my core and legs. Downhill walking was growing increasingly impossible, so my goal was to increase strength to combat pain.

When Your Best Option Is the Only Option

I jumped into my local CrossFit gym. The cross between team atmosphere, short bursts of intense cardio, focus on range of motion, and adaptable workouts brought me back to my days as an athlete. I was having a blast, getting really fit and strong, and loving the crew.

But my knee pain wasn’t getting better. I was physically forced to cut back to working out 3 days a week to give my knees a chance to recoup. I would wake up barely able to walk from my bed to the bathroom. Something was seriously wrong.

I walked into my first orthopedic appointment since my last knee injury in my 20s. After some X-rays, I sat and waited. The doc came in and pointed out that my knees were mountainous with bone spurs and lost cartilage.

“You have the knees of a 60- or 70-year-old man who played sports all his life,” he said. “At this point, your only option is total knee replacement for both knees. And you’re way too young. I won’t do it, and insurance probably won’t cover it.”

I asked if we should get MRIs or if there was anything we could do to help in the meantime. He said he knew all he needed to know, that my options were limited. An MRI would be a waste of time.

He then juiced up my knees with cortisone shots and sent me out the door. The steroids helped, but they were a cover solution. Once again, I was left to fend for myself.

New Doc, New Take

My knees didn’t get better. And the interaction with that doctor was crushing. His bedside manner was severely lacking in tact and empathy, and I felt stuck in severe pain with no way out of it.

It took 2 years before I sacked up, did a bunch of research, and decided to try a new doc. I could no longer hike, bike, or run, and even long days on my feet became utterly brutal. Something needed to change.

I chose Alpine Orthopedics of Bozeman, Montana, and it was Dr. Timothy O’Brien and his fabulous P.A. Jessi Pelton who would finally step in and help me regain my quality of life.

Over the course of a year, Dr. O’Brien did X-rays, MRIs, an arthroscopy on each knee, and kept my pain muted by cortisone throughout the process. The arthroscopies brought the extent of my now advanced osteoarthritis to light.

I stayed awake for each surgery, which was way cooler than it sounds. The team put a sheet up between me and my knee, and I was then able to watch a large screen as they used a camera and various tools to clean up my torn meniscus and some other junk in my knee.

It was bad inside both knees. Really bad. Or, as Dr. O’Brien put it was “impressive.”

Waves of Change

Initially, Dr. O’Brien partially agreed with the first doctor. I was too young for knee replacements. I’d likely need revision surgery within the next 15-20 years, and revisions don’t usually go as well as initial replacements.

But surgeries that could have helped earlier were no use at this point. The damage was done. It would be all or not at all. And the latter option wore me down physically, emotionally, and mentally.

I was on the precipice of getting a third opinion when I met with Dr. O’Brien in November. He asked me if my quality of life was being affected by my knees. And of course, it was — unequivocally.

We set the date for my right knee: January 29, 2020. In order to get approval for surgery, I needed to go to the dentist to make sure none of my teeth were rotting in my head, get a physical, and line up a ton of ducks in a row. I passed all the tests, readied my home, and …

It Happened

13 days post-op

It is now February 13. I am about 2 weeks out of surgery today, sitting in my recliner, with ice packs piled on top of and below my knee. I just finished a physical therapy session. I’m still on narcotics for pain and balancing so many meds that it makes my head spin.

The story continues. My left knee goes under once the right knee is willing and able to support me fully. The work goes on. And as I had a hard time finding stories from others who had been through this surgery, I’ll be continuing to write about rehab, what gear has helped my healing process, the second replacement, and recovery.

My hope is that I’ll be feeling good this summer and that over the next year I can get back to all the things I love to do: hiking, backpacking, horseback riding, snowboarding, hunting, fishing, and the like. I miss the mountains. But this process is a mountain in itself. For now, it’s PT, ice, and rest. I can deal with that.

An Update From The Author, Two Years Later

Many folks have reached out with questions regarding my decision to replace my knees and whether or not I regret it.

Nearly two years in, it’s the best decision I’ve made regarding my physical health in my life. I’ve had zero issues with the replacements, and I’m thrilled with my ability to be physically active again.

Obviously, I can’t help people make the right decision for their situation. That is a decision that happens between you and your medical team. But I will note that advocating for what you think is right for you can be difficult. And if you’re unhappy with one doctor’s decision, get a second, third, or fourth opinion.

If you’re curious about how I’m doing, you can read my recovery story here. This past fall, I was back to 12-mile days in the field with my dogs, I packed full packs of meat out on my back in hunting season. And I experienced no noticeable issues. I’m back on a running regimen and still gaining the strength and endurance back that I lost in the entropic stage of my arthritis.

The answer is this: I have no regrets.  -Nicole, December 2021



Nicole Qualtieri

Based in Montana, Nicole Qualtieri is GearJunkie's Hunt + Fish Editor. She also serves as a Board Director for Orion the Hunters Insititute, a non-profit promoting fair chase and hunting ethics nationwide. A DIY hunter, she comes from a non-traditional hunting background and began hunting and fishing in her 30s. She's been a voice for hunting, fishing, and conservation since 2014, when she got started working on the television show MeatEater. She's an avid horsewoman, bird dog aficionado, snowboarder, hiker/backpacker, food nerd, and all-around outdoorswoman. Find her online at @nkqualtieri.