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Knee and Hip Replacement in Former NFL Players

November 13, 2020

All the quick cutting, blocking, and tackling that football players do is a showcase of their athleticism, but it can also take a toll on their joints, especially the joints of the lower body like knees and hips. Knowing that joint health is an important part of a football player’s health, we measured the frequency of knee and hip replacement in former NFL players through our First Health and Wellness Questionnaire (Q1).

What the Science Says

With increased age and/or repeated stress on a joint over time, the connective tissue of the joint can become inflamed or wear away, which can cause pain and a change in mobility and function. Sometimes a joint replacement is recommended to restore function and alleviate pain at the joint site. In other cases, a tear or rupture in the connective tissue of the joint can mean surgery is required. Whatever the cause, many athletes are at a higher risk of a joint replacement given the many sport-specific strains on the body’s joints.

What We Found

Graph of prevalence of knee and hip replacements in the US general population and Football Players Health Study cohort.

Also, compared to other populations of former athletes, our cohort of former football players reported a higher percentage of knee replacements as compared to former soccer players, former rugby players, and even other cohorts of former football players (Figure 2). Soccer, rugby, and football players do many of the same movements over the course of play; however, the elements of play that make football unique may contribute to the higher prevalence of joint replacement in football players. The comparison between sports also indicates that football players are having knee replacements earlier than other professional athletes. There may be risk factors both in the sport and for former players that could be modified, which could be addressed in future research.

graph of prevalence of total knee replacement in studies of athletes

What This Means for You

You may have already had a joint replacement or may be aware that a joint replacement could be in your future. There are many considerations for a joint replacement surgery, so make sure you discuss all your options with your healthcare provider. In general, surgery in younger patients is not recommended unless non-surgical treatment options have been tried. The goal is to have a joint replacement at an older age due to concerns that you are more active when younger, and the revision of a joint replacement is more challenging. Physical therapy, weight loss, dietary changes, and certain non-steroid based injection treatments may help delay the need for a joint replacement.


NFL Joint Replacement Program – This resource through the NFL Player Care Foundation can provide medical and financial assistance for former players who are eligible. Eligibility is determined by credited seasons. Related post-surgery rehabilitation may also be included.

Future work from our study will examine other factors that contribute to the decision to receive a joint replacement. This work will also seek to improve outcomes in situations where a patient chooses not to have a joint replacement surgery or to have a joint surgery later.

If you have questions about this information, please email our team or call us at 617-432-5000.