BRAD BUETTNER has always prided himself on his physical fitness. For years the 49-year-old from Huntington Beach competed in triathlons, cycling races, water skiing tournaments and horse jumping. Granted, after he got married and had children, he slowed the pace a bit, but he always made time for sports. "I have just always enjoyed being active and fit."
So the news that he needed a hip replacement hit hard.
"I didn't tell anybody for a while, because I was just so ashamed," said Buettner, who is a fit 6 foot 2 and 185 pounds. "I thought hip replacements were for older people or those who had let themselves go."
Increasingly not. Although age, obesity and arthritis are still leading reasons why people need new knees and hips, a growing number of the younger and fitter are finding they need new joints as well.
"We are seeing an increasing patient base of younger adults whose extremely active lifestyles put high demands on their joints," said Dr. Joseph C. McCarthy, a clinical professor of orthopedic surgery at New England Baptist Hospital in Boston and past president of the American Assn. of Hip and Knee Surgeons. These active baby boomers may forestall heart disease, stroke and the other plagues of the unfit, but in the process, their joints will take a pounding.
And while early joint replacement can extend an active lifestyle, it also raises the disturbing possibility that the artificial joint itself will eventually need to be replaced.
Today, surgeons perform 1 of 3 knee and hip replacements (34%) on patients younger than 60, up from 1 in 4 (25%) in 1993. The biggest growth has occurred in patients between the ages of 50 and 59; in 1993, 11% of all joint replacements were in this age group; by 2003, it was nearly 20%, according to the American Academy of Orthopaedic Surgeons, or AAOS.
The numbers of replacements have increased in the younger-than-50 group as well, though its percentage has remained stable.
"Running and other demanding sports don't cause arthritis, but they're accelerators," says Lawrence D. Dorr, an orthopedic surgeon and medical director of the Arthritis Institute at Centinela Hospital in Inglewood who performed Buettner's surgery. "Most arthritis happens because, starting from early childhood, the joint wasn't normal."
Buettner, apparently, was one of those people whose hips developed in a way that makes them more prone to arthritis. For people like him, it's not a question of if, but when. Buettner's activity level just brought it on sooner.
