Hip arthritis doesn’t just affect older adults

Liam Gallagher recently revealed that he is suffering from arthritis, leaving him with excruciating pain and the realisation that he will probably need hip replacement surgery. Most people associate arthritis with old age, but Gallagher is just 49. So how unusual is it to develop such severe arthritis before old age? Well, it depends on the type of arthritis.

While there are a number of different types of arthritis, osteoarthritis is the most common. Osteoarthritis is common in older people, but it is possible for it to develop in younger people.

A number of factors have been associated with the development of osteoarthritis, including ageing, being overweight, having an injury (such as having a torn anterior cruciate ligament in the knee – a common affliction among footballers) and genetic susceptibility. In Gallagher’s case, it may be linked to Hashimoto’s disease – a thyroid condition he was diagnosed with a few years ago. Hashimoto’s disease is associated with arthritis.

Unlike rheumatoid arthritis – which is an autoimmune disease that can occur in younger adults – osteoarthritis develops when the shock-absorbing cartilage that covers the end of the bone wears away. Osteoarthritis is often referred to as a “disease of the cartilage”. In fact, the absence of cartilage is how doctors confirm the presence of osteoarthritis. However, it is actually a condition that affects the whole structure of the joint, including changes to the bone and soft tissues, such as ligaments.

The origins of the pain that people with osteoarthritis experience have been difficult to pin down and this is one of the reasons it can be hard to manage. Pain is thought to occur for a number of reasons, including changes to the bone that result in the outgrowth of bony spurs known as “osteophytes”, and inflammation of the tissue that lines the inside of the joint, called the “synovial membrane”.

Unfortunately, there is no cure for osteoarthritis. Unlike rheumatoid arthritis, where treatment has been revolutionised over the last several decades, with new drugs that target and dampen down the immune response, similar developments for the treatment of osteoarthritis have yet to emerge.

For most people with osteoarthritis, keeping the joint functional while managing chronic pain is their biggest challenge. Lifestyle changes early on when the condition is diagnosed, such as losing weight and exercising to strengthen the supporting muscles, can help to maintain the joint for longer. However, the condition is progressive, and for many people joint replacement is their last resort.

Advances in modern medicine means that hip or knee replacement surgery is increasingly routine – often delivering a pain free, functioning joint. The replacement joint is made of metal (usually titanium) on plastic. And while it will eventually wear out, for many people, their artificial joint is still going strong after 15 or even 20 years.

While most of us may think that it would be a no-brainer to have the surgery, some people are put off by the fact that it is an invasive procedure, with months of recovery and physiotherapy required to gain full use of the joint. Deciding whether or not to have a joint replaced can therefore be difficult – as it seems to be for Gallagher. In an interview with Mojo magazine, the former Oasis frontman said: “I think I’d rather just be in pain. Which is ridiculous, obviously. I know that.”

Other considerations include the age at which you have a joint replaced. At 49 years of age, Gallagher is young for this type of surgery. And the younger the person, the more likely their replacement joint will wear out during their lifetime and a second surgery will be needed.

On the plus side, joint replacement surgery can be life changing, leaving the person pain free and restoring joint function and mobility. While applicable to everyone who suffers from arthritis, it is particularly relevant to younger patients like Gallagher, as it can allow them to continue to work and maintain an active life style.

Anne Crilly is a lecturer in immunology at the University of the West of Scotland. This article first appeared on The Conversation.