Arthritis Awareness: What Even Younger Adults Need to Know About Diagnosis, Hip or Knee Replacement

About one in five U.S. adults (21.2 percent) or about 53.2 million people have doctor-diagnosed arthritis, according the most recent data reported by the U.S. Centers for Disease Control and Prevention (CDC).

Adults aged 45 years or older represent 88 percent of all U.S. adults with arthritis, according to the CDC study released late last year, Prevalence of Diagnosed Arthritis — United States, 2019–2021. The remaining 12 percent are in their 20s, 30s or 40s. And it’s a growing demographic.

Orthopedic surgeons are increasingly seeing young adults with advanced arthritis that often require hip and knee replacements. Osteoarthritis is the most common type of the disease, and is sometimes referred to as the “wear and tear arthritis.” It develops when the smooth cushion between bones (cartilage) breaks down and joints get painful, swollen and hard to move. Traumatic injury can hasten arthritis in younger adults. And there’s a risk factor that’s still very much part of extensive research: Genetics.

Alexander Gaukhman, M.D., orthopedic surgeon with Baptist Health Orthopedic Care at Boca Raton Regional Hospital.

Alexander Gaukhman, M.D., an orthopedic surgeon with Baptist Health Orthopedic Care in Boca Raton, a part of Baptist Health, explains that he’s seeing many more active patients in their 30s and 40s who have end-stage arthritis in their hip or knee, an indication that they are candidates for replacement surgery.

Baptist Health orthopedic surgeons take advantage of the latest advances in joint replacements, using the latest 3D reconstruction software for pre-operative planning and for guidance during surgery. More precision minimizes complications, pain and the need for a knee or hip replacement later in life.

“For patients who are in their 30s and 40s, we will not hesitate to do hip or knee replacement on them if that's what they need,” explains Dr. Gaukhman. “And 20 years ago, that would've been laughable. That would've been – ‘No way, see me in 15 years.’ Patients are active and they want to remain active. They don't want to wait 10 or 15 years and suffer in pain. The trend definitely is surgery in younger patients for advanced arthritis. That is becoming much more commonplace and accepted.”

The CDC report found that arthritis prevalence was highest among adults reporting no leisure time physical activity (31 percent), compared to those who are insufficiently active (27 percent) or who meet physical activity recommendations (19 percent).

Arthritis and It’s Link to Obesity, Genetics and Other Risk Factors

Arthritis symptoms can be a barrier to physical activity, and inactivity among people with arthritis is associated with conditions such as cardiovascular disease, diabetes, obesity, and functional limitations. However, regular physical activity can be an important way to reduce pain, improve function, and manage symptoms for people with arthritis and other chronic conditions.

In its study, the CDC reported that about one half of adults aged 65 years or older with COPD, dementia, stroke, heart disease, diabetes, or cancer also had a diagnosis of arthritis. But there's no real correlation between osteoarthritis to any particular comorbidity or underlying health issue, said Dr. Gaukhman. Although obesity is known to accelerate arthritic conditions.

“We do know that obesity increases the risk of arthritis, overloading the joints,” said Dr. Gaukhman. “And typically, obesity is associated with other underlying comorbidities. You can make the link that patients who have obesity or have metabolic syndrome – that may include high blood pressure, cholesterol issues, obesity, or diabetes -- have a high risk of developing osteoarthritis. But that's probably a minority of patients.”

The majority of patients, he adds, are “healthy patients that have developed basically arthritis from a genetic standpoint, or maybe a small percentage of them from a traumatic standpoint.” And there are smaller percentage of patients that have autoimmune diseases such as rheumatoid arthritis.

“There are various factors that increase the risk of arthritis: Age, genetics and trauma are definitely up there -- whether it's when you're a young adult, an adolescent or a child,” said Dr. Gaukhman. “And there are certain diseases that predispose you to having arthritic disease in your hips or your knees earlier in life. And we're basically discovering some of those factors that increase the risk of it.”

‘Bad Genetics’ and End-Stage Arthritis at a Young Age

But some patients just have “bad genetics” and develop end-stage arthritis in their hip or knee at a young age, he adds. “They have wearing of that cartilage. It's like a bad tire that essentially just wears out really easy. And waiting 10 or 15 years until they hit a certain age for replacement surgery really creates a lot of misery for them, and interferes in their quality of life.”

What if a you’re a middle-aged or younger adult who is active and starts noticing some aches and pains? Should they see an orthopedic specialist?

“Knowledge is power,” responds Dr. Gaukhman. “Having information and having somebody counsel you regarding potential intervention is key. Especially if the person is overweight or they have unhealthy dietary habits and they have very low exercise tolerance. Seeking medical counseling earlier is definitely better.” .

And prevention is key, he adds, when it comes to arthritis – as with so many other health issues.

“Exercise is a great way to improve your general health, whether it’s cardio, weightlifting or playing sports,” says Dr. Gaukhman. “However, there are some exercises that are higher impact, such as a running and tennis, that may affect the joints more. We urge our patients to engage in low-impact activities like swimming or riding a stationary bike. Low-impact exercise is always encouraged to minimize the amount of impact to the hips, knees and ankles.”