21 March 2018
It was in the 1960s when hip replacement operations were first carried out in the UK. It was considered pioneering surgery and patients would spend around two weeks in hospital as they started their recovery.
Nowadays most patients are encouraged to walk with the aid of a frame within 24 hours of leaving the operating table and most will be back home within three days of surgery.
Mr Panagiotis Gikas, a Consultant Orthopaedic Surgeon at Spire Bushey Hospital, looks at the changes on surgical procedures and at how patients can now look forward to a much quicker recovery and greater movement in their new joints.
What do you consider to be the latest and most effective approach to hip replacements?
In my opinion, the anterior surgical approach for hip replacements offers the best post-operative course for patients and allows for the quickest rehabilitation. This is a relatively new technique but is being increasingly utilised by orthopaedic surgeons.
How does the anterior approach differ from previous procedures?
The anterior approach involves accessing the hip joint from the front of the hip, avoiding the need to cut through the muscles around the hip. This means that post-operatively patients are able to get up and start walking much quicker than in the other approaches to the hip which go in from the side or back.
The anterior approach uses a specialised table which moves the leg to help optimise the position of the hip joint for surgery. Implants may be custom templated before surgery to ensure the optimum fit with minimal bone loss.
Using the anterior approach, patients may be able to go home as soon as day one post-op, as compared to day three to seven post-op with the traditional approaches to hip replacement.
Is it suitable for patients of all ages?
This technique is suitable for all adult patients who need hip replacement, however, patients must be assessed on a case by case basis regardless of this.
Is the age of people having hip replacements getting lower and if so, is that a good thing?
In my experience this is a yes, however, it is important to understand that it is quality of life rather than age which is what determines when a patient needs hip replacement surgery. Allowing patients to suffer in silence due to their age is not the correct option. Moreover, joint problems can have knock on effects on other parts of a patient’s health – stopping activity can result in unhealthy lifestyles with development of obesity, heart disease, diabetes and other major illnesses – in this sense, getting hip replacements at a younger age – and using new hips to continue activity is a good
The downside of younger patients getting joint replacements is that over time they will get worn out and will require some form of revision surgery to either replace part or all of the old joint replacement.
How much movement can people of reasonable fitness expect from their new joint – how near to a healthy natural joint can a replacement get?
Reasonably fit patients, with few other health issues, can expect a good range of movement following joint replacement. The key to this is early mobilisation and exercise post-operatively; patients should be aiming to get moving as soon as possible post-operatively and maintain this level of activity to get the best from a joint replacement. Patients undergoing anterior approach hip replacement may be able to get up and walking as soon as the same day as surgery, due to the fact that the muscles that control the hip are left intact during surgery.
With time, a joint replacement should feel much the same as a natural joint.
The most important message for patients today is to follow a healthy lifestyle, follow a balanced diet, get plenty of exercise and not to suffer in silence if they are getting joint issues.
Mr Panos Gikas now performs anterior hip replacements at Spire Bushey Hospital. For more information or to book a consultation call 020 8901 5505.