A hip replacement! I’m only 35!
Young people can get arthritis of their hip from certain sports, and find it painful to move and function normally. Naturally, they want to carry on enjoying life and engaging in physical pursuits. Fortunately, modern hip replacements allow them to remain active, according to orthopaedic surgeon Dr Jason Brockwell.
“Most hip problems cause pain in the groin, thigh or buttock. A firm diagnosis can usually be made based on their sports involvement, injury history, physical examination, and appropriately positioned X-rays,” Dr Brockwell said. “Unfortunately, the diagnosis is sometimes missed, and people may be told they have a ‘groin strain’ or a ‘sports’ hernia.”
People who regularly play lots of sport can suffer from a condition called ‘FAI’ – femoro-acetabular impingement – where the hip bones are the wrong shape, causing them to crush the cartilage and damage the joint. “We think the majority of ‘misshapen’ bones are caused by playing lots of sport as a pre-teen, when the bones are nearing the end of their growth.” says Brockwell.
If one carries on playing sport with misshapen bones, the hip joint will be damaged. Pain often settles with physiotherapy and a change of activities, but, if not, the shape of the bone may need to be corrected by arthroscopic surgery. This is usually very successful if the problem is caught in time.
However, sometimes young people develop arthritis of their hips.
“People who develop arthritis in their 30s – usually because of FAI, are shocked when they hear that they need a hip replacement. They are concerned that they will not be able to continue their active lifestyle, or take their children hiking or skiing,” Dr Brockwell said. “A special kind of hip replacement procedure, Birmingham Hip Resurfacing, will allow people to return to almost any sport or activity,” Dr Brockwell said.
Hong Kong’s first Birmingham Hip Resurfacing was performed by Dr Brockwell in 2003 at Matilda International Hospital, and he has performed about 300 since.
“To get the best results, it is necessary to use an implant that works well, and to put it in the right place!” said Dr Brockwell. “Optimal positioning can be confirmed with a simple intra-operative X-ray.”
The longest reported series of Birmingham Hip Resurfacings shows them working well at up to 16 years.
Are there any sport activities that are particularly ‘bad for the hip’?
“Any sport that involves bending and twisting the hip, repeatedly, and forcefully, for example, lunging in squash or kicking in martial arts or soccer, is bad. Cycling and running are OK, but not hurdling. Yoga is OK as long as one doesn’t attempt to force the hip where it doesn’t want to go. Swimming front crawl, backstroke and butterfly is safe, but breaststroke is not so good. The ‘eggbeater’ kick used in water polo can be devastating to the hip joint,” Dr Brockwell said.
Surgery of the hip is one of many orthpaedic procedures available at MIH. To find out more about MIH’s Centres of Excellence specialties, please visit www.matilda.org.