Repair Not Replace: What Every Endurance Athlete Needs to Know About Their Knees, With Dr Marc Pietropaoli

I have had three knee surgeries, a ruptured ACL and a right kneecap that niggles me regularly. The question I really wanted answered in this conversation was simple: how do I avoid a knee replacement in the next 10 to 15 years?

Dr Marc Pietropaoli is an orthopaedic surgeon and sports medicine specialist based in Buffalo, New York. He trained under Dr James Andrews, widely regarded as the greatest sports medicine doctor of all time, and has spent 35 years challenging one of the most deeply held assumptions in his own profession. His book, Repair Not Replace, is an Amazon number one bestseller and the title tells you exactly where he stands.

This is a personal conversation as much as a clinical one. If you are an endurance athlete in your 50s or 60s with creaky knees and a little voice in the back of your head asking how long you can keep doing this, it is well worth your time.

IN THIS EPISODE WE COVER:

What is actually happening inside an ageing knee, and why bone on bone is not the death sentence most patients are told it is

The three questions you must ask before agreeing to a knee replacement

Cortisone, hyaluronic acid, PRP and bone marrow concentrate: what the evidence says about each

The French study showing an 82% chance of avoiding knee replacement for up to 20 years with the right regenerative approach

Why running does not cause arthritis, and what actually does increase your risk

The most common mistakes endurance athletes make that accelerate knee damage

Why strength training is the single most important thing you can do to protect your joints at any age

Why getting in early, before things deteriorate, changes everything