01 June 2017
Around 70,000 hip replacement operations are carried out in the England and Wales each year. Half of those are for the over 70’s, but now the number of younger patients opting for this type of surgery is growing*.
“With a new generation of hip implants and techniques we are seeing an increase in the numbers of younger people who need surgery but don’t want to wait or to live with pain,” said Jon Conroy, consultant orthopaedic surgeon who offers a specialist young adult hip clinic at Spire Leeds Hospital.
Doctors once suggested that patients delay surgery for as long as possible because implants only lasted about 10 years. Now advancements in medical technology means that implants made of ceramic or titanium can last much longer enabling younger patients to undergo hip replacement surgery at a younger age so they can maintain their active lifestyles. Minimally invasive methods and spinal block surgery also means less scarring and a potentially shorter recovery time than traditional surgery.
That’s the case with Hannah Blackburn, 40, a business development director for a private diagnostics company who lives in Leeds. It started last summer when Hannah noticed her leg would give way when walking. The pain in her left hip and leg worsened until she was in constant pain which started to impact her active lifestyle.
Hannah said, “The pain felt like a red hot poker running from my hip to my ankle. I do a lot of gym work and like to keep fit and it affected the amount of exercise I could do. It was so painful at night that I had to get up and walk around and work became challenging as it involves a lot of travelling.”
Hannah was referred to Mr Conroy at Spire Leeds Hospital, and an X-ray showed her hip had worn away to bone on bone.
Mr Conroy said, “Chronic hip pain can have a devastating effect on quality of life. Hannah had a condition called hip dysplasia that predisposes to early arthritis. In this group of younger patients potential complications need to be discussed fully as the demands on a hip replacement are far greater than in the elderly population. We now have more confidence about the wear rate of these new prosthetics which allows us to be less restrictive on an age basis as people are now keeping active longer than ever before.”
Hannah was treated with physiotherapy and two steroid injections before considering surgery. Her pain worsened and after discussing it with Mr Conroy she decided to go ahead with surgery in early February 2017.
Mr Conroy described procedure, “Hannah had a minimally invasive hip replacement operation through an opening of just five centimetres minimising trauma to muscles through an innovative retractor system. She chose a spinal block as opposed to general anaesthetic that allowed her to be awake throughout surgery whilst being pain free. It helped her recover more quickly with minimal pain and she was able to mobilise putting full weight on the hip the same day as surgery.”
The fact that the scar was only 5cms long and is concealed within the bikini line was important to Hannah for cosmetic reasons. She researched carefully and specifically requested Mr Conroy use a certain piece of equipment which would leave her with a smaller scar.
Mr Conroy, who also has a degree in mechanical engineering, added, “The operation involved a unique retractor to protect the skin edges and allow a very small incision. The ball portion of the joint was removed and replaced with a short stem implant with a ceramic ball and modern polyethylene socket. Her implant was an uncemented stem with ceramic bearing surface. This type of implant is ideal for young patients with good bone quality and increased demands on lifestyle. The implant could potentially last for 20 to 25 years.”
Hannah said, “I’d never had any type of surgery before, not even major dental surgery so having an operation was quite a big thing for me. However, the nursing staff was superb. They helped me to relax and I listened to music through my ipod throughout the surgery and felt quite calm. I knew I was in good hands.”
She is delighted with the results. Seven weeks after surgery she is making a steady recovery with weekly hydrotherapy and physiotherapy and following strict ‘doctor’s orders’ about what she can and cannot do. She plans to head back to work in her London office next week and is looking forward to getting back to normality.
“I had almost resigned myself to living with the pain. I would have had the surgery done sooner if I had known that was not the case. My parents and friends looked after me really well during my recovery but I’m now able to do things for myself and I cannot wait to get back to the gym once I get the go ahead. I’m really looking forward to getting my freedom and independence back.”
* Source: Royal College of Surgeons based on Hospital Episodes Statistics (HES) data for England. It showed that in 2004-5 patients under 60 underwent 10,145 hip replacements rising to 17,883 in 2014-15. The number of hip replacement operations for people under 60 has risen 76% in the last decade.