Why more and more women are needing hip replacements in their 40s: It?s not just Darcey Bussell. Fitness fanatics can pay a painful price for their diligence
Tasmin McCulloch, 42, from Essex, was told by a surgeon two years ago that she has the hips of a 70-year-old Lucy Kelly, 46, from Surrey, needs her right hip replaced after years of running which has destroyed the cartilage around the joint Hip replacements are becoming more common for younger patients Having a hip replacement is something that happens to old ladies after a fall – not healthy women in their 40s and 50s.
But recent news suggests that’s no longer the case. Earlier this month, ballerina-turned-Strictly Come Dancing judge Darcey Bussell, 46, revealed she has already had her hip resurfaced and will soon need a full replacement, after decades of ballet have taken their toll.
In 2013, 66,000 replacements were carried out – and the number is increasing. But while most are given to people aged 60 to 80, operations on younger patients are becoming more common, according to leading orthopaedic surgeon, Mr Tim Waters of Spire Bushey Hospital.
Tasmin McCulloch, 42, from Essex, was told by a surgeon two years ago that she has the hips of a 70-year-old The reason is twofold. First, medical technology means today’s replacement joints – made from a combination of stainless steel, titanium, plastic and ceramic – are smaller and last much longer than first-generation models of the Sixties, so can be offered at a younger age. Technology is advancing all the time and replacement joints could soon last a lifetime.
‘People see joint replacement as a last resort,’ says Mr Waters. ‘In the past we’d put them off for as long as possible because they only lasted up to ten years and second and third replacements (called revisions) were tricky. But that’s no longer the case. The technology used when revising them is getting better all the time. There’s no reason not to have one in middle age.’
The second reason is we’re pushing our bodies to the limit and wearing our joints out far sooner. ‘More of us are living longer, we’re more active for longer and we’re fatter than we should be,’ explains Mr Simon Moyes, a consultant orthopedic surgeon.
‘This extra weight bearing puts strain on the joints, particularly knees and hips. As a result I’m seeing more orthopedic problems. More people are asking for joint replacements in their 50s and 40s and more hospitals are prepared to offer them.’
But it seems, we’re on a hiding to nothing – because exercising to slim can also damage joints. Mr Moyes says he’s seeing increasing numbers of people suffering overuse injuries as a result of workouts.
‘These are much more than just weekend warriors, they’re putting their bodies through tough training regimes – classes, weights, triathlons and more – as a lifestyle choice,’ he says.
‘Most of the population aren’t active enough, so being really fit is obviously a good thing. But overuse injuries can be a side-effect.’
Lucy Kelly, 46, from Surrey, was initially diagnosed with just wear and tear of the hip joints, caused by running
Lucy Kelly, 46, is one such patient. When she complained of hip pain and stiffness, doctors diagnosed wear and tear, caused by her passion for running.
Now a hip replacement is on the cards. ‘I was sporty at school but exercise took a back seat when I had my four children – Oscar, 19, Harvey, 17, and twin daughters, Niamh and Mia, 15,’ says the beautician from Caterham in Surrey. ‘By the time my girls were settled at school I was 36, a size 12 to 14 and out of shape.
‘So I threw myself into exercise. At first I did Step aerobics and Body Pump classes. Then I took up running. After six months I was doing 10 km on the treadmill in about 40 minutes, which is fast. I ran four or five times a week. It never occurred to me I might be overdoing it.’
About 18 months ago, after eight years of running, Lucy started to get pains in her right hip. ‘When I walked it would jar,’ she says. ‘It felt like bone was rubbing against bone. If I’d been sitting for a while, I’d find I was too stiff to stand up. It soon became so bad I’d bend down to load the washing machine then not be able to straighten up again.’
Darcey Bussell, 46, revealed she has already had her hip resurfaced and will soon need a full replacement An osteopath thought Lucy may have torn some cartilage in her hip and advised her to see her GP.
‘My GP did blood tests for rheumatoid arthritis, which came back clear. But he could see my mobility was reduced so referred me to an orthopaedic consultant, who ordered X-rays and an MRI scan. When the scans came back there was no sign of a tear or other acute injury. What they did show was a worrying level of wear. There was significant loss of cartilage on both hips, particularly my right one.’
Lucy’s consultant diagnosed osteoarthritis (OA), a degenerative condition affecting the cartilage around the joints. She said it was likely to have been caused by running and told her to stop straight away. By doing her best to stay fit, Lucy had actually been damaging her body.
According to Arthritis Research UK, one third of British people over the age of 45 have sought treatment for osteoarthritis, with women more commonly affected than men. Sometimes I just get stuck, as if my hips have forgotten how to move. I was once in the park with our dog and I thought I wouldn’t be able to get home. I worry about getting stranded on my own somewhere one day Just under a quarter of those affected have OA in the hip. It’s a condition that can be genetic, but it is also a result of wear and tear, through sport or being overweight.
‘I rely heavily on paracetamol, which I take most days, and always feel stiff after I’ve been sitting for a while. I have to do a funny straight-legged walk to get going again,’ says Lucy.
‘Sometimes I just get stuck, as if my hips have forgotten how to move. I was once in the park with our dog and I thought I wouldn’t be able to get home. I worry about getting stranded on my own somewhere one day. I hate feeling so physically compromised at such a young age.’ Lucy was referred to a surgeon at Epsom Hospital, Mr Stafford, who told her she would need her right hip replaced. ‘It was a shock to learn I’d worn the joint out so much I actually needed a new one,’ she says. ‘I’d expected some physio exercises, not a major operation.’
In the meantime, he suggested steroid injections to delay surgery by relieving the pain and improving mobility in Lucy’s right hip. These are given under a general anaesthetic, right into the hip joint.
The trouble is doctors can’t tell how long the effects will last – everyone responds differently,’ she says. ‘I was told it might work for two years, or two weeks. And due to the fact they require a general anaesthetic, you can’t keep having them indefinitely.
‘I’ve just had my first injection and I have to go back to the surgeon in two months’ time to assess its effects. I have to fill out a pain diary so he can gauge if the steroids are working. At the moment it’s too soon to tell. I’m hoping I get a couple of years’ relief, at least. I accept I’ll need a hip replacement while I’m still in my 40s, but it’s far from ideal due to my work and family commitments. I’d need at least six weeks off work.’
Tasmin lives with hip pain for years before she could persuade her GP to refer her for hip X-rays. The damage was so extensive that the doctor performing them was shocked at the amount there was for someone her age
Like Lucy, Tasmin McCulloch, 42, is set to become a 40-something with new hips. Two years ago the dressmaker from Essex was told by a surgeon she had the hips of a 70-year-old and a replacement was inevitable.
‘I had no idea the damage was that bad,’ she says. ‘I came out of the consultation and burst into tears.’ Tasmin’s problems started when she attended aerobics classes, aged 18.
‘I was in a class, doing star jumps, and something suddenly “went” in my right hip,’ she remembers. ‘I collapsed on the floor. I couldn’t bear weight and was in a lot of pain.
‘The pain eased off but it was an intermittent problem from then on. Gradually I gave up the tap dancing, badminton and judo I’d enjoyed since childhood, as the hip pain and stiffness took hold.
Lucy was told that she would need her right hip replaced, which she found shocking as she is just 46 ‘Aged 29 I had my son Ewan, now 12, and three years later my daughter, Alina, who is nine. The problem got worse after childbirth.
‘Osteoarthritis runs in my family, so I was sure that’s what it was,’ she says. But when Tasmin suggested this to doctors, she was dismissed as far too young. Without a diagnosis, she just tried to endure the pain. By 2009 Tasmin was desperate and begged her GP to send her for X-rays. ‘Sure enough, they showed considerable cartilage damage to my right hip and some to my left. The doctor finally agreed it was OA and was shocked at how much damage there was for someone of my age.’ Two years ago, in increasing pain, Tasmin was referred to a hip surgeon in Colchester. ‘He recommended a replacement on the right side and warned me not to leave it too long.’
‘I have spoken to people who’ve had joint replacements and not looked back,’ she says. ‘So I’ve asked for a referral back to the hip surgeon. It’s a big decision, but last week I was contemplating calling an ambulance as the pain was so intense I couldn’t move. So I think it’s probably time.’
I’ve asked for a referral back to the hip surgeon. It’s a big decision, but last week I was contemplating calling an ambulance as the pain was so intense I couldn’t move. So I think it’s probably time Sandy Hamilton-Power, 53, would almost certainly agree. Sandy, who runs a law firm in Chichester with husband Ben, had her right hip replaced in February 2010 and the left last October, and has never felt fitter.
She only discovered she had a problem after surgery for an unrelated condition seven years ago.
‘The day after surgery I couldn’t get out of bed. The pain in my right hip was intense and I couldn’t bear any weight on that side. Doctors realised I had a congenital hip disorder that had been significantly worsened by the position the medical team had placed me in for the operation.
‘It turned out I’d been born with normal-shaped hip sockets but the ball part of both joints was shaped like a rugby ball so didn’t fit properly.
‘Over the years this had worn away at the socket. It was a shock because I’d never suffered hip pain before then. But looking back I’d had limited movement. I loved ballet as a child but could never do certain wide-legged moves, including the splits.’
Over the next two years both Sandy’s hip joints deteriorated and her right hip caused her constant pain. So despite only being in her 40s, she agreed to a full hip replacement.
‘I suppose it was a shock to find myself a candidate for that sort of surgery at such a young age,’ says Sandy. ‘But by that time I just wanted my life back.’ She found a private specialist and had her right hip replaced in February 2010.
‘I had the operation in the afternoon and by the morning I was attempting a few steps with the aid of a Zimmer frame. I was allowed home after four nights, once I could get in and out of bed by myself, and I was able to do some work after six weeks.’
Sandy was told to wait until her left hip started hurting before having the second replacement. ‘About nine months ago it started to get tighter and tighter and by last summer the pain in my groin was too much to bear,’ she says.
‘There didn’t seem any point delaying the next operation. The left hip was replaced three months ago and this time my rehab has been quicker.
‘I can’t understand why anyone who needs a replacement would put it off. Having two new hips has made me feel younger not older.’