My Weekly

Dr Sarah Jarvis

MyWeekly’s favourite gp from tv and radio writes for you

- DR SARAH JARVIS

The good news is we’re living longer than ever. The bad news is our joints haven’t kept up. Thewear and tear of ageing, along with increasing strain from being overweight, mean more of us than ever are suffering.

The most common reason for hip pain is osteoarthr­itis. Our joints don’t stay the same in adulthood – in fact, our bodies are constantly repairing minorwear and tear. Unfortunat­ely, as time goes on, the repair can fail to keep up with thewear – especially if you put pressure on your joints.

The joints that take the most strain are vulnerable towearing out – hips, knees and lower spine, aswell as the small joints of your hands. Being overweight is a risk factor, as are trauma (including major accidents) and contact sports. Women are more likely to suffer osteoarthr­itis than men, and it can run in families.

Fortunatel­y, doctors (or more specifical­ly orthopaedi­c surgeons) are on the case. While there’smuch that can be done to protect joints, sometimes surgery is the only option, and outcomes are better than ever.

A review from Nuffield Health showed 75% increase in the number of men and a 70% rise inwomen under 55 having hip replacemen­t compared to 10 years ago. Knee replacemen­ts among younger people have also gone up, but to a lesser degree – 40% for men and 20% forwomen. There are lots of reasons for this shift. Firstly, surgeons used to recommend putting off surgery because the average replacemen­t hipwas likely to wear out within a decade. Repeat Replacemen­t is more

FOLLOWING HIP REPLACEMEN­T, YOU’LL USUALLY BE OFF CRUTCHES IN 4-6WEEKS AND DOING LIGHTWORK BY 6WEEKS

complicate­d and often less successful, so theywanted the new one to last a lifetime if possible. Today, advances in both the artificial joints and replacemen­t techniques mean that, with care, a new hip can last up to 20 years.

Secondly, 60 is the new 50, but there are downsides to constant media pressure to stay young. People in their 50s and 60s still feel in the prime of life andwant to stay active. That means they see a joint replacemen­t more as a new lease of life than as a sign of being decrepit – only 1 in 4 people having a hip replacemen­t says the surgery makes them feel old.

Even if surgery is necessary, it doesn’t always mean replacing thewhole joint. There are other options. Hip resurfacin­g may be an option, where the surface of the ball and socket that make up your hip joint are covered with metal covers. It’s not suitable for everyone as you need strong bones.

While hip replacemen­t is major surgery and takes a while to recover from, the pain caused by your arthritis should be gone straight away.

Not everyone needs a replacemen­t joint. It’s usually only offered if you have pain at rest, which can’t be controlled with painkiller­s and lifestyle. Exercise is key to reducing progressio­n of symptoms. Aerobic exercise – the kind that makes you out of breath – helps strengthen muscles around your joints. Clearly you don’t want to damage your joints more, so lowimpact exercise likewalkin­g, swimming or cycling are perfect to maximise strengthen­ing and flexibilit­y.

Anti-inflammato­ries can be effective, but often have side effects like inflammati­on of the stomach lining and kidney damage.

Strong painkiller­s can cause side effects such as constipati­on, so you may need to take medicine to counteract this. Next week: Healthy lungs for life

GETTING UP AND MOVING ABOUT WILL CUT THE RISK OF COMPLICATI­ONS LIKE A CLOT ON THE LEG AFTER HIP REPLACEMEN­T

AEROBIC EXERCISE HELPS TO STRENGTHEN THE MUSCLES AROUND YOUR JOINTS’’

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Is hip replacemen­t surgery necessary?
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