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Lucy Ballinger, April 24, 2011 1:00AM

AMANDA Keller is just one of many people under 50 having hip surgery.

Amanda Keller

She is active, young and glamorous – so Amanda Keller is not someone who would immediately come to mind when you think of hip replacements.

But the 49-year-old mother-of-two has just undergone surgery because of osteoarthritis in her hip.

The team captain on Talkin’ ‘Bout Your Generation only discovered she suffered from the condition three years ago, when she was in pain while on a walk with her father. Tests showed she suffered from osteoarthritis. Then last September things became worse.

“I had an awful pain in my hip,’’ Keller says. “I thought it was a pinched nerve, but when the X-rays came back my doctor told me the cartilage was gone. I was down to bone on bone. I couldn’t believe it had come to this so quickly after hearing I had arthritis. I thought, ‘I’m just 49, arthritis is an old person’s disease’.”

>> What caused it?

Although her mother had suffered from rheumatoid arthritis, Keller’s osteoarthritis was caused by a genetic hip abnormality she had when she was born. The slight misalignment of her hip joint meant she was unknowingly compensating for it when she walked, creating friction in the joint.

Eventually, the pain became so intense Keller booked to have an anterior hip replacement. She had the operation on March 18.

“The pain had become so isolating, it hurt to walk,” Keller says. “My youngest son, who is seven, wanted to sit on my lap but I couldn’t let him because of the pain.”

The TV star, who also co-hosts WSFM’s breakfast radio show, is one of a growing number of younger people having hip replacements.

The average age of hip operation patients has plummeted during the past decade. Rheumatologist Professor David Hunter, from the University of Sydney, says: “Over the last 15 years the mean age of when people have hip operations has come down by about 10 years.”

The average age is now mid to late 60s. Official figures aren’t available, largely due to the different types of hip operations available and the fact men have them on average five years younger than women do.

>> Why the younger age?

Professor Hunter says the primary factor for the decreasing mean age is technology. Previously, surgeons were concerned about carrying out hip replacements on younger patients because the replacement would only last for a short time and the patient would need further surgery. Advances mean the operation can now be carried out on younger people, with greater success.

“Replacements last as long as 30 years, and with life expectancy at around 80, if a 50 year old has their hip replaced it will last for their lifetime. So they’re tending to do that in younger people.

“Once you’ve done the initial surgery, to go back and have a revision is a big operation. That is why historically it wasn’t done on young people.”

>> The numbers game

Figures from the Australian Institute of Health and Welfare show the number of hip replacements carried out increased by 40 per cent between 2000-01 and 2007-08.

In 2009, there were 33,943 hip replacements reported to the National Joint Replacement Registry. This was an increase of 3.4 per cent on the number in 2008.

The number of hip replacements has increased because of the rising number of people suffering from osteoarthritis, which is a type of arthritis. Arthritis can be genetic or caused by injury or obesity. Currently, three million Australians have arthritis: 1.6 million of them have osteoarthritis.

Arthritis Australia believes the number of sufferers will keep growing due to increasing obesity and the ageing population. By 2050, an estimated seven million Australians will be affected.

Anterior Hip Procedure images

>> Technological marvels

Keller had a relatively new type of operation called an anterior hip replacement. Her surgeon operated through the front of her leg, rather than the side or back, which meant he didn’t have to cut any muscles.

“I’m a medical miracle,” Keller says. “I have a scar the length of my middle finger on my leg, although the whole thing was bruised from hip to thigh.

“It’s been incredible. Rather than going up the side of my leg and cutting through the major muscles, they went through the front and pulled through the muscles to operate. It’s almost like pinhole surgery.”

Because she had the anterior procedure, rather than a traditional hip replacement, Keller was out of hospital a day after the operation.

“The doctor said my rehab is just to walk,” Keller says. “This operation had much less impact on my life than the traditional way would have had.”

Anterior v Posterior images

But anterior replacements are only just becoming available in Australia and aren’t suitable for all patients, so many are still having traditional surgery.

Professor Hunter says there are a lot of instructions given to someone who has their hip replaced with traditional surgery: “It takes up to 12 months to get back to pre-surgery function in the hip. Patients initially can’t take the hip through an extreme range of motions.

“After the operation, a patient must start with simple strengthening exercises to regain function, then make concerted effort to rebuild the muscles.”

Anterior Hip Replacement index

There are many different types of replacement, including ceramic and metal bearings, and metal and plastic joints. Hip replacement patients are given the choice of the type of hip they would like, including one for people who are very active and want something that will take the impact of extreme sports.

Keller opted for what she calls the “walking shoe” of hip replacements: “I can play tennis and go for light jogs. I have this giant metal hip, a titanium and ceramic thing, that’s part of my body.”

>> Road to recovery

Professor Hunter says that historically people have thought of osteoarthritis as an old person’s disease, but two-thirds of people who have osteoarthritis are aged under 60: “Over the next 10 years the number of people who have osteoarthritis will double.”

Keller says: “You talk to people and everyone has a story. They aren’t just little old ladies but young people, too.

“My doctor tells me my hip will last me for the rest of my life. He said to me, ‘You’re too young to be living in pain like this’. Just a week after the operation I could walk the kids down to the beach: I haven’t been able to do that for months. It’s been incredible.”

 

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