It’s Not Hip to Have Osteoarthritis Young
Over 100,000 hip and knee replacement surgeries are performed in Canada each year, according to a report by the Canadian Institute for Health Information. Most people receiving them are older than 65 and living with osteoarthritis. In fact, 69% of hip replacement recipients and 99% of knee replacement recipients were diagnosed with this type of arthritis prior to undergoing surgery.
Contrary to popular belief, osteoarthritis is not a natural consequence of aging. It’s a degenerative joint condition characterized by the breakdown of cartilage and is becoming so common that an estimated 12 million Canadians will have it by 2040. And it’s not only affecting older adults.
Kohle Merry was diagnosed with osteoarthritis in 2019 at the age of 27. Three years later, he underwent total hip replacement surgery.
“It is a myth that only older adults get this operation and condition because they have worn and torn the joint down to almost nothing,” Merry said. “Anyone can get osteoarthritis.”
Mind-Body Barriers
Before his diagnosis, Merry was a marathon runner and athlete. He struggled to come to terms with his new reality, which, prior to surgery, involved managing chronic pain and constantly doing a cost-benefit analysis before participating in activities.
“I would have flare-ups after vacuuming, often experiencing pain for days,” Merry said. “I was always thinking of the fallout of certain movements.”
But the impact of osteoarthritis and suddenly navigating life in pain was about more than the physical.
“As an avid exerciser, I struggled to come to terms with being someone with a disability,” Merry said. “It was a lot to process at such a young age…thinking about the impact on my future.”
Merry had to reconceptualize who he was, which came with mental challenges.
“You can only bite down on the mouthguard for so long,” he said. “I had to figure out a path forward for a lifetime of managing this condition as well as the impact on my community and career.”
Surgery to Set the Clock Back
Before his total hip replacement, Merry did physiotherapy and underwent another less invasive surgical procedure called hip arthroscopy to clean out the joint and assess damage. He couldn’t put weight on one leg for six weeks and did months of daily rehabilitation. The full function never returned, but the chronic pain did.
He then decided to have a complete hip replacement and feels fortunate to have received the procedure in a relatively short amount of time. Though he acknowledges the reality of needing a revision in the future, Merry is grateful he can be active today.
“I’m 90-95% of what I was before the osteoarthritis diagnosis,” he said. “I sometimes get nagging pain after a hike or long walk, but the pain with every step is gone.”
He now does less high-impact sports and focuses more on muscle-building, low-impact exercises.
“Thanks to the surgery, I can still feel like an active individual; it’s just different.”
Unknowns & Unanswered Questions
When it comes to osteoarthritis, Merry has always wondered why he developed this condition – especially given his age.
“I’ve never received an affirmative statement of cause,” he said, adding that some surgeons think it was avascular necrosis (AVN), which is a condition that happens when blood flow to a bone is disrupted and causes the bone to die.
“It’s frustrating. The cause is not always as obvious as you hope.”
Merry was, however, diagnosed with femoroacetabular impingement (FAI), which is a collection of bony abnormalities in the hip joint that cause abnormal contact during movement. This is a common source of hip pain in many young and middle-aged adults.
Researchers at Arthritis Research Canada are studying causes of hip pain, particularly FAI, to better understand why it occurs, and to determine whether physical activities may interact with the condition to further damage the hip joint and cause osteoarthritis of the hips.
If the study reveals that hip impingement and certain physical activities are risk factors for osteoarthritis, healthcare professionals can focus on preventing the disease and the need for costly hip replacement surgeries.
Participation in Research
Merry is now a member of Arthritis Research Canada’s Arthritis Patient Advisory Board and shares his experience to help find answers for others living with arthritis. As an engineer with a PhD in rehabilitation sciences, he brings a unique perspective.
“In my PhD research, I worked with people who experienced ankle injuries, and I truly understand the value of having the patient perspective in research,” he said. “Research is not just about taking steps to progress science, but considering what is impactful to the patient.”
For him, participating in research as a patient partner is a way to give back to the arthritis community.
“People think young people don’t have arthritis, so I thought I had a good viewpoint to share.”
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