if you have OA and are active, then the pain increases intolerably for years and years with more opiates needed just to wait until you are 50 or old enough to be 'deemed' ok for surgery by then your body is so out of shape, you are downtrodden and don't want to exercise after 10+ years.  Surgery should be given by need related to pain not age.  You can be in a wheelchair on pain meds when older, not with a one year old waiting for them to be 18 and never knowing their parent not in excruciating pain.