Summary

There appear to be no long-term studies of people who do serious strength training or powerlifting in particular after joint replacement.

Current total knee replacement prostheses utilizing ultra-high molecular weight polyethylene bearings can be expected to last more than 20 years, with a cumulative rate of revision surgery of less than 10% at 20 years.

Polyethylene wear due to contact pressure and other consequences of higher load force may be responsible for up to 40 to 50% of problems resulting in revision surgery.

Polyethylene wear rates appear to be well-described by Archard’s Law which states that the wear rate is essentially proportional to the contact pressure on the polyethylene surface and hence to the loading force on the joint.

From analysis of videos of my lifts, I estimate that time under a loaded bar for a single squat is around 11 seconds and for a single deadlift around 5 seconds. I have estimated the total time under loads higher than bodyweight is 10 minutes per week averaged across two of my typical powerlifting training programs for squat and deadlift. This works out at the equivalent of an additional 22 minutes per week with bodyweight load. 

Based on reported average activity levels of people aged 65 and over, the additional 22 minutes under load results in an average increase in the rate of cumulative wear debris of 1-2%. This would result in a 2% increase in the expected TKR revision rate at 20 years from 8.7% to 8.9%. Calculations for hip replacement result in a similar increase in expected revision rate.

Powerlifting training after joint replacements by an experienced lifter with attention to technique and careful progression appears unlikely to significantly decrease hip or knee replacement lifetimes. Indeed, the improvements in muscular strength around these joints from training may result in less forces acting in the joint across all activities and more than offset the effects of higher loads on wear.

I discovered I had osteoarthritis in both knees in early 2015. I found strength training very helpful and I took up powerlifting, competing at national level from 2017 to 2021 in the 60-64 then 65-69 year age category. I had a total knee replacement (TKR) of the left knee in March 2022. 

Before doing the TKR, I spoke to my surgeon about what I would still be able to do with a TKR and also searched the web for information. My surgeon echoed the standard advice that high impact activities such as running and jumping should be avoided completely, as should activities that involve aggressive pivoting (tennis, basketball, most martial arts). A few specifically mention Olympic weightlifting as involving high impact and should be avoided (for example here). Even so, I have come across people who have continued to run or do martial arts after joint replacement.