After a very bad motorbike accident in which my son broke his hip, my son has been doing heavy farm work, but recently he has a lot of pain and stiffness in the joint in the morning. His doctor says he will need a hip replacement as there is arthritis showing on X-rays of the joint. He is only 28. Can exercise or diet stop him from having the operation?

After breaking his neck of femur (hip bone) your son’ s leg may have reset at a slightly different angle to before. This, combined with the heavy work he is doing, may have placed abnormal stresses on the hip joint, and resulted in premature arthritis of the joint.

With rest, the joint stiffens as microscopic adhesions form in the joint. With movement in the morning, these are broken down, causing pain for a while until the joint starts moving freely again.

Unfortunately, this problem will slowly worsen with time and the only effective long-term treatment is a hip replacement operation. Anti-inflammatory medications and physiotherapy exercises may help in the short term, but there is no diet that will be of any benefit.

The operation is very successful, and young people who need such an operation usually recover rapidly. There is no reason why the steel hip replacement should not be successful in carrying your son around and allowing him to do heavy work and play sport.

The timing of the operation depends on your son. When the discomfort of the hip worries him enough to want an operation, then he should sec an orthopaedic specialist to have it arranged.

Can you recommend some exercises for an elderly woman with osteoarthritis?

It is most important for patients of all ages to keep their arthritic joints as mobile as possible, and exercises specifically designed for the individual are therefore a vital part of any treatment program.

Exercises for arthritis should be performed regularly, every day. You may experience some pain as you put your joints through their paces, but if this pain lasts for more than 30 minutes after the exercise, you are probably doing too much and should ease off. Doing your exercises after heating the affected joints in a bowl of warm water or after a hot bath can often ease the discomfort and give a better range of movement.

The aim of any exercises in arthritis is to move the joint through its full range of movement (eg. bending a knee as much as possible and then straightening it as much as possible) several times. Once this is readily achieved it may be possible to add some light weights to make it harder to use the joint. This will strengthen the muscles around it. Always start with an easy exercise and slowly build up to harder ones.

Booklets containing exercise programs are also available from the Arthritis Foundation (listed in your capital city phone book). The best person to teach you the appropriate exercises is a physiotherapist. Physios can also give heat, interferential and other treatments to arthritic patients to help their arthritis further.