A Tennessee Titans Team Physician Sees Rising Trend of Adults Choosing Regenerative Alternatives Before Knee Replacement

Orthopedic Surgeon, Dr. Ethan Kellum outlines alternative treatments, as total knee replacement procedures are projected to grow 85% by 2030

FRANKLIN, TN, UNITED STATES, May 13, 2026 /EINPresswire.com/ -- Total knee arthroplasty procedures in the United States are projected to grow 85% to 1.26 million annually by 2030, according to peer-reviewed research published by Sloan, Premkumar, and Sheth in the Journal of Bone and Joint Surgery (2018). And for the first time in U.S. medical history, patients younger than 65 are projected to represent as much as 62% of all knee replacements by 2030, according to research presented at the American Academy of Orthopaedic Surgeons 2023 annual meeting.

The trend has surfaced a question that orthopedic surgeons increasingly hear from active patients in their 50s and 60s: Is there a way to keep my natural knee?

Dr. Ethan Kellum, MD, fellowship-trained orthopedic surgeon, sports medicine specialist, and a team physician for the NFL's Tennessee Titans, has built his Franklin, Tennessee practice around answering precisely that question. His approach, what he calls "surgery-sparing protocols", relies on regenerative orthopedic treatments including platelet-rich plasma (PRP), bone marrow concentrate (BMC), and alpha-2-macroglobulin (A2M) injections to address joint pain and arthritis at the root, rather than replacing the joint outright.

"I want to be the alternative ... what patients are looking not to have," Dr. Kellum says. "For the right patient, regenerative orthopedics can delay or even eliminate the need for replacement surgery. But that's the most important phrase in that sentence: the right patient. These treatments aren't a cure-all, and not every active adult is a candidate. The honest evaluation is the whole job."

The Wider Trend: Active Patients, Not Elderly Patients, Now Drive Demand

Historically, knee replacement was understood as a procedure for elderly patients. The data shows a clear and accelerating shift. Peer-reviewed projections published by Kurtz and colleagues in Clinical Orthopaedics and Related Research, based on Nationwide Inpatient Sample data, indicate that the 45-to-54 age category is the fastest-growing knee replacement cohort, with procedures projected to grow seventeen-fold between 2006 and 2030.

The reason matters. Active adults: former athletes, weekend warriors, and patients who refuse to slow down... are arriving in orthopedic offices earlier in life, more frequently, and with higher expectations for return-to-activity outcomes from any treatment they choose.

"When a 58-year-old patient tells me they don't want to give up tennis, or pickleball, or hiking with their grandchildren...that's a different clinical conversation than the one that defined this specialty thirty years ago," Dr. Kellum says. "Replacement surgery has its place. It works. But it isn't always the first answer, and it isn't always the right answer at the first sign of arthritis."

Who Is a Candidate for Regenerative Alternatives And Who Isn't

Dr. Kellum, who completed his sports medicine and arthroscopy fellowship at New England Baptist Hospital and Boston Children's Hospital and previously served as assistant team physician for the Boston Celtics, Harvard, and Tufts athletics during his fellowship training, emphasizes that regenerative treatments work for some patients and not others.

Candidates who generally see the strongest results, in his clinical experience, share specific characteristics: earlier-stage osteoarthritis rather than end-stage joint collapse; mechanical alignment that has not significantly deteriorated; sufficient remaining cartilage for the regenerative response; absence of advanced inflammatory disease; and a willingness to commit to the rehabilitation protocol that follows treatment.

Patients who do not benefit from regenerative alternatives include those with end-stage osteoarthritis where the joint has structurally failed, those with significant bone-on-bone deformity, and patients whose pain or dysfunction stems from causes a regenerative injection cannot address.

"The most important thing I do in a first consultation is tell some patients that I am not the answer for them, that surgery is genuinely the right path," Dr. Kellum says. "That honesty is the entire premise. The regenerative orthopedics field has a credibility problem because too many providers say yes to every patient who walks in. I won't do that, and patients shouldn't accept it."

The Cost of Getting It Wrong

Knee replacement, while effective for the right candidate, it carries documented long-term tradeoffs. Revision knee arthroplasty is projected to grow 149% by 2040, according to peer-reviewed analysis published by Shichman and colleagues in Arthroplasty Today (2023) — a reflection of the fact that more replacements at younger ages produce more eventual revisions.

"Every replacement has a finite lifespan," Dr. Kellum notes. "If a patient gets a knee replacement at 55 and lives to 85, statistically they will likely need a revision. Revisions are more complex, more expensive, and often less successful than the original procedure. That math is why we owe active patients an honest conversation about whether replacement is necessary right now, or whether a regenerative approach can buy them a decade — or more — of their natural joint."

About Dr. Ethan Kellum and Regenerative Solutions Sports & Orthopedics

Dr. Ethan Kellum is a fellowship-trained orthopedic surgeon and sports medicine specialist based in Franklin, Tennessee. He serves as team physician for the NFL's Tennessee Titans and USA Basketball, and previously served as assistant team physician for the Boston Celtics, Harvard, and Tufts athletics during his fellowship training at New England Baptist Hospital and Boston Children's Hospital. He earned his medical degree from the University of Tennessee Health Science Center College of Medicine and completed his orthopedic surgery residency at the Medical College of Georgia. Dr. Kellum is a member of Alpha Omega Alpha, one of the United States' oldest national medical honor societies, and the author of multiple peer-reviewed publications in orthopedic surgery. His Franklin practice, Regenerative Solutions Sports & Orthopedics, focuses on non-surgical and regenerative orthopedic treatments for patients seeking to preserve their natural joints.

For media inquiries, interview requests, or expert commentary, please contact: Christine Haas Christine Haas Mediapress@christinehaas.com (512) 751-1592

For more information, visit drethankellum.com.

###

Christine Haas
Christine Haas Media
+1 512-751-1592
email us here
Visit us on social media:
LinkedIn
Instagram
Facebook
YouTube

Legal Disclaimer:

EIN Presswire provides this news content "as is" without warranty of any kind. We do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author above.