Aren’t I too young for a hip replacement?

Every week, at least one patient in my clinic will utter the immortal words “but aren’t I too young for hip replacement? I’m only in my 40s”.

On the inside, I’m typically suppressing a wry smile, because I find myself in exactly the same boat. My own hip is also a bit clapped-out.

It’s time to debunk some myths about hip replacement surgery  (a form of arthroplasty).

1. “They are only for ‘old’ people”.

Whilst my nieces and nephews might consider me to be from the Jurassic period, there are plenty of people out there who are less than sixty and are undergoing this kind of surgery.

Even teenagers sometimes need new hips.

A quick nose around in the National Joint Register shows that in 2016 (it takes them a wee while to gather in the data), in the NHS alone, over 58,000 hip arthroplasties were carried out. That’s a lot metal work setting of airport detectors. The rate of us ‘youngsters’ getting new joints is continuing to rise.

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2. “I’ve been told by my GP that I must wait until I’m much older because they only last ten years, and so it’s better to wait ‘till I’m at least 70”.

Poppycock.

Most cemented hip replacements will last a good twenty years, and the cementless type often used for younger, more active people, are believed to last even longer (watch this space – we’re still counting).

As a rough guide, if you’re over 75 years of age when you get a new hip, that same hip prosthesis will probably follow you to the funeral parlour, and if you’re under 55 years of age, you could expect to get a revision surgery (if you decide to live that long, of course).

Age doesn’t determine the need for a hip replacement – symptoms do. If you’ve got pain and rubbish function, and you’ve done a heap of rehab and still aren’t getting better, it may be the right choice for you. Even if you’re not an octogenarian.

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3. “I’ve been told to wait it out because science is improving really quickly, and there might be a chance that some kind of new treatment will restore my hip back to how it was”.

Yep, we’ve all heard that old chestnut before, but the trouble is, the ‘flashy new treatment’ never seems to arrive in time. Once your hip has become a square peg in a round hole, and feels like the enemy, no amount of fashionable, wonder-cell-lipo-space-dust-awesomeness-juice is going to magic your hip back to its teenage years…Sorry.

Aren’t I too young for a hip replacement?

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4. “I’ve been told that if I have a new hip, my sporting days are over and that will be end of my tennis, boot camp and skiing”.

This may have been true 30 years ago, but it simply isn’t the case anymore. Whilst the primary aim of getting a new hip is to (obviously) end pain and improve day to day movement and function, we know that most arthroplasty patients far surpass the ability to simply walk to the local paper shop for a copy of ‘TV Quick’.

I’ve worked with hundreds of hip arthroplasty patients who ski, play squash, participate in triathlons (and even run the odd marathon when their surgeon isn’t looking).

Do your rehab well, and you’ll very likely be amongst one of those people.

Hip replacement is arguably the most successful of all orthopaedic procedures.

If your desire is to get back to an active lifestyle (because there’s still life in the old dog), then it’s entirely possible to still be very sporty (although we can’t promise you’ll be appearing on centre court, just because you have some expensive titanium on board).

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5. “It will take ages to recover – I’m not sure that I can take months off work”.

It takes less time than you think to get back to your regular routine after hip surgery.

Patients are often home from hospital within 72 hours of being on the operating table, and ‘enhanced recovery’ techniques mean that a physio literally gets you up out of bed and walking in just 3 hours, post-surgery.

Whilst it’s a good idea to take enough time off to recover, the days of needing a mandated six weeks off work and needing to sit on ‘special chairs’ and raised plastic toilet seats for months and months, are well and truly over.

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It’s important to say:

Hip replacement surgery, as with all types of surgery, comes with the potential risk of complications, and as a physician, it’s my job to generally keep people away from the operating theatre.

Nevertheless, for some of us, having tried all pretty much everything else, it’s the appropriate thing to do.

It’s time to end ageism in the hip arthroplasty world.

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We want to raise awareness about sport injury management and prevention, for patients and clinicians alike.

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About the Author:

css@sportdoclondon.co.uk'
Dr Cath Spencer-Smith is a Consultant Physician in Sport and Exercise Medicine and Director of Sportdoc London. Cath is passionate about the diagnosis and management of all musculoskeletal conditions, and has expertise in getting to the bottom of persistent problems, such as hip and groin pain. She works with Olympians, through to the occasional exerciser.

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