At 26, happily married and with a busy career as a dog-groomer, Sophie Cater should be enjoying life to the full.
Instead, she struggles to get out of bed in the morning, cannot put her own socks on and is in pain virtually round-the-clock – all because of a hip replacement she had in 2023, after developing arthritis.
‘I thought it would give me back my mobility and end my pain, but it’s made it worse; I am less mobile and in more pain than before,’ says Sophie.
A year on from her operation, she relies on a daily cocktail of potent painkillers – gabapentin, amitriptyline and dihydrocodeine – to get through the day and can only walk with crutches.
Sophie Cater thought her hip replacement would be a ‘golden ticket’ to a pain-free life, like so many older patients who’d had it done. Instead, a year on, she still relies on crutches and a daily cocktail of painkillers
She’s also had to redesign her dog-grooming parlour, as she cannot stand for long periods, and even neighbours in their 70s who have had hip replacements themselves are puzzled as to why she still ‘hobbles around’.
‘It’s upsetting – I feel as if they’re saying I’m making it up or milking it, but I was in agony,’ says Sophie, from Warwickshire.
‘If I’d known there was a risk of feeling worse after the surgery, then I’d never have had it done.’
Around 100,000 people (mostly aged between 60 and 80) undergo hip replacement surgery every year on the NHS.
Approximately 90 per cent of new hips last longer than ten years and 80 per cent more than 20 years.
But every year around 5,000 people need revision surgery to fix new hips that have gone wrong – often as a result of the joint dislocating, an infection in the joint, components coming loose or inflammation caused by debris left after the procedure.
And studies show if revision surgery is needed, artificial joints tend to last nowhere near as long as those that ‘take’ first time.
‘If I have a patient whose hip is failing because of infection, this may need to be urgently revised as there is a risk of sepsis,’ says Caesar Wek, a consultant orthopaedic and trauma surgeon based in Dorset, who specialises in hip replacements.
Caesar Wek, a consultant orthopaedic and trauma surgeon, says: ‘Although hip replacements are thought of as something older people have, we are doing them on younger and younger people with osteoarthritis and hip pain.’
Sophie’s hip replacement followed years of pain – initially said to be just ‘growing pains’.
It was only when she was 13 and experienced excruciating pain in her right hip that she was diagnosed with slipped upper femoral epiphysis – where the bone at the top of the thigh fractures, causing the ball at the top of the bone to fall out of place. Doctors said it was something she was born with.
Sophie recalls: ‘I missed a lot of school and when I did attend other kids bullied me – it took a massive toll on me physically and mentally.
‘I had surgery to correct the problem, but was later diagnosed with hip dysplasia’ – where the socket for the femoral ‘ball’ (the round bit at the top of the thigh bone) is too shallow. She had surgery for that, too.
Sophie’s pain and mobility improved to the point where she could enjoy a social life – meeting her future husband, James, and setting up her dog-grooming service. All was well until several years ago when Sophie developed pain in her upper leg.
She was just 21 but it took another two years of badgering doctors about her symptoms before she was finally sent for an arthroscopy – where a surgeon inserts a fibre-optic probe into the joint – and she was diagnosed with osteoarthritis of the hip, a condition normally associated with older age.
Despite being in her early 20s, Sophie was told she would one day need a hip replacement.
Doctors assured her it was one of the UK’s most performed operations, that it was normally highly successful and that it would improve her quality of life.
‘I’d seen countless people have hip replacements – usually older than me – who raved about them changing their lives, so I was actually looking forward to it for the improvement,’ says Sophie.
‘I knew it would be something I’d need one day and saw it as a golden ticket to feeling totally well and improving my life.’
Then, during a routine appointment with her consultant last year, she was told her arthritis had progressed significantly.
‘It was made pretty clear that a hip replacement was now the best thing I could do,’ she says.
‘My consultant said he’d done many successful ones and there was a very high chance I’d be pain-free afterwards.’
Mr Wek told Good Health: ‘Although hip replacements are thought of as something older people have, we are doing them on younger and younger people with osteoarthritis and hip pain.’
Increasing rates of obesity and a more sedentary lifestyle are factors, too. Another cause in younger patients is hip impingement, which may damage the hip joint over the long term and cause hip arthritis, says Mr Wek.
Hip impingement occurs when a bump on the ball of the hip bone sits right against the socket of the hip, or the socket of the hip ‘pinches’ against it. Either can damage surrounding cartilage and cause stiffness and pain that can lead to osteoarthritis – even in young adults.
The defect – known informally as ‘young hip’ and often affecting people in their 20s and 30s – can be present from birth, but is also seen in those who take part in sports that involve a lot of twisting of the hip, or squatting.
Before the surgery Sophie says she ‘was genuinely looking forward to life afterwards and being out of pain’.
But, she says: ‘When I came to afterwards, the excruciating pain returned. I knew it would hurt at first so I wasn’t worried at that stage.’
But when six weeks passed and she had still not improved, alarm bells rang.
‘The pain was worse than before the surgery,’ she says. ‘I knew something had gone wrong.’
Her consultant assured her it was part of the healing process. Yet Sophie’s pain continued to worsen, as did her mobility.
‘I joined Facebook groups of people who’d had hip replacements and they were all extolling the virtues, posting photos of themselves running and jogging and being pain-free,’ says Sophie.
‘Yet I was in agony. I couldn’t even put my socks on [James has to do it for her] and I was walking with crutches.’
Around 100,000 people (mostly aged between 60 and 80) undergo hip replacement surgery every year on the NHS
Sophie concedes that hers was not a straightforward case, having had surgery before.
But she insists she was told her hip replacement operation was a common procedure.
However, she later discovered that when surgeons began the procedure, they noticed her pelvis tilted backwards – probably as a result of the earlier surgery.
‘This made fitting the new hip more complex,’ says Sophie.
‘Doctors insist this surgery should have worked and that my only hope now is steroid injections [to try to dampen down the pain and inflammation]. I wish I’d never had it done.’
Mr Wek says the success of hip replacements in young people depends on the reason for doing it in the first place.
‘The bigger the problem, the less successful it can be,’ he says.
But it is key to stay active, in order to maintain hip muscle strength, and keep your weight low, says Mr Wek. ‘if you look after your hip this way, it will look after you.’
At her most recent appointment, Sophie was informed she now also has a condition called iliopsoas tendonitis – or ‘snapping hip syndrome’ – where tendons in the hip joint slide out of position and cause a ‘crack’ or ‘snap’ sound, as well as pain.
This may also need surgery at some point. And she has bursitis – inflammation of the bursa (the fluid-filled sacs that cushion the hip joint).
‘For now,’ says Sophie, ‘All I have is pain management.’