“The doctor looked at my x-ray and said, ‘That doesn’t look good at all!’.” Then the result: “You have osteoarthritis.”
The moment at the doctor still upsets 31-year-old Ilana Bollag to this day: “The diagnosis was a mega shock. I never expected that!”
Review: Ilana Bollag goes to the doctor with severe pain in her right hip. She was 29 years old at the time, sporty and an active person. Dancing, jogging, hiking a lot. She suspects the cause of her symptoms is something banal – perhaps a muscle strain.
But the clarifications then reveal: She suffers from advanced hip arthrosis. The doctor’s comment: “You are a young woman trapped in an old woman’s body!” A bitter truth: A lot of the bone and cartilage tissue in her hip joint has been destroyed.
Limping, pain, limitations
The Zurich orthopedist Daniel Wüst, who now looks after Ilana, cannot sugarcoat her situation: “The damage to the right hip joint is extensive and has serious consequences for everyday life.”
Ilana Bollag limps and sometimes uses crutches. Tying your shoes is difficult, running for the bus is impossible. The consequences she struggles with are typical of severe cases:
- Limited mobility
- Strong pain
- Impaired everyday life
Her quality of life suffered greatly – worst of all in the first, acute phase: “Just going to the toilet was difficult. I was extremely bedridden because everything hurt so much.”
Your bad luck: a circulatory disorder
The cause of Ilana’s hip problems was completely new to her. The disaster is caused by a circulatory disorder in the joint bone, a so-called femoral head necrosis.
The disorder rarely affects women. It causes bone tissue to die and leads to osteoarthritis with cartilage loss.
She didn’t do anything wrong. The disease simply arose.
Orthopedic surgeon Wüst can at least offer some consolation: “Mrs. Bollag did nothing wrong. It is simply a disease that has arisen.”
In other words: tough luck!
Osteoarthritis also affects younger people
As a young patient, Ilana Bollag belongs to a minority. This was another reason why she found it difficult to come to terms with her fate.
The 31-year-old has now met other young people with similar problems and says: “The fact that other young people are affected has helped me to accept the disease.”
A scientific survey confirms: she is not alone. The German study with 22,000 participants comes to the following results:
- In the age group between 18 and 44 years, around 5 percent suffer from osteoarthritis symptoms.
- In the group of 45 to 64 year olds, almost 20 percent are affected.
- Of those over 65, around 40 percent have noticeable symptoms.
The study is based on self-reports. X-ray images can show findings that look bad but do not cause any problems in everyday life.
Hope from the nose
Osteoarthritis is still incurable today. There is still no standard treatment that could permanently resolve the destruction process. However, science today understands more about the mechanisms of joint breakdown than before. This promotes research into new, promising therapeutic approaches.
Our dream is to prevent the use of a prosthesis.
In Basel, the first osteoarthritis patients are being treated with cultured cartilage from the nose as part of studies. Bioengineer Ivan Martin is thinking about the future: “Our dream is to prevent or at least delay the use of a prosthesis.”
Initial results are encouraging – but for those affected like Ilana Bollag, it’s just a dream of the future.
Artificial joint: Tried and tested, but not perfect
The first artificial joints were developed in the 1960s – an enormous advance. Since then, prostheses have saved countless people suffering from osteoarthritis from a life full of torment and obstacles.
But experience shows: artificial joints don’t last forever. Even modern materials wear out. Abrasion particles can lead to bone loss in the area of the prosthesis. However, if an artificial joint no longer sits firmly in the bone, the prosthesis must be replaced in whole or in part.
Bone loss is a particular problem for younger patients
Such interventions are not uncommon: around 40 percent of hip prostheses have to be replaced within 25 years.
“Bone loss is a particular problem for younger patients,” emphasizes orthopedist Claudio Dora. Anyone who has an operation at a young age almost immediately has to expect another operation due to the long life expectancy.
Artificial joint as a last resort
Ilana Bollag has a hard time thinking about an artificial hip joint. “Every procedure is also a risk, and the prosthesis is a foreign body.”
The prospect of having to replace your first prosthesis through a replacement operation at some point is not very encouraging.
Since her diagnosis, Ilana Bollag has tried everything she can to improve her suffering without surgery. The young woman wants to avoid the artificial joint for as long as possible.
Painkillers and cortisone injections
Daniel Wüst supports his patient in her posture. Surgery must be the last resort: “Non-surgical measures should be exhausted at any age, and with a young patient you might try it a little longer.”
The doctor prescribed her painkillers. He injected hyaluronic acid and cortisone directly into the joint, also to reduce inflammation. He also prescribed physiotherapy.
Physiotherapy for better gait
As her illness progressed, Ilana Bollag got used to postures and bad postures. Physiotherapist Fabienne Theler wants to break her habit again. Because there is a risk of consequential damage. The challenge: “Ilana’s brain has forgotten how to control the muscles correctly.”
With a lot of discipline, Ilana Bollag successfully fights against her incorrect movement patterns. Her gait has improved – despite severe osteoarthritis.
Expensive treatment with your own blood
The osteoarthritis patient paid for two so-called platelet-rich plasma treatments out of her own pocket.
“PRP” is a therapy using your own blood. Blood plasma with platelets is obtained from this and injected into the diseased hip joint. This is said to promote the regeneration of damaged tissue such as cartilage and also combat inflammation in the joint.
Usually only early stages are treated with such injections. But Ilana Bollag felt an improvement after the injections. However, it is not certain whether the autologous blood method will work in the long term.
Anesthesiologist Edzard Ellerkmann admits: “We have no proof that PRP has a lasting effect over years.” Therefore, the cost of 150 francs per syringe is not covered by health insurance.
In the end, the artificial joint
Almost two years after her diagnosis, Ilana Bollag tried everything to avoid an operation. But her osteoarthritis cannot be treated to this day.
Weighing up the advantages and disadvantages now speaks in favor of an artificial joint, says orthopedist Daniel Wüst: “If the quality of life remains severely limited, an artificial joint is also justified for boys.”
Ilana herself sees it that way too. She finally decided on a prosthesis – knowing that her history of osteoarthritis would continue even if she had an operation. “I’ve tried everything, but it’s not enough,” is how she sums it up.
At the end of January, the young osteoarthritis patient may already have a new joint. And with the hope that the old quality of life will find its way back to her.