CONSULTANT’S PERSPECTIVE
Total hip replacement is used to treat end-stage arthritis of the hip when the patient’s symptoms can’t be controlled by any other means.
Most patients have the procedure awake under spinal anaesthetic, which is usually safer and continues to provide pain relief for several hours after surgery. Although there are many approaches to performing this surgery, my preferred method is to use a posterior approach which preserves the major muscles around the hip and helps reduce the risk of patients limping after surgery.
Total hip replacement has a high success rate, but, as with any major surgery, it does carry some risks including infection, blood clots and dislocation of the artificial ball from the socket. We minimise these risks using medication and ‘rapid safe mobilisation’ – getting patients up and walking under supervision – as soon as possible.
Recovery time varies, but at St Joseph’s we find that rapid mobilisation and a programme of physiotherapy helps patients to make a quick, functional recovery.
In most cases a hip replacement will last around 20 years, and some people even forget they have had their hip replaced. Mr Swenson is a fantastic case of a successful hip replacement, however, his symptoms were slightly unusual because he had pain in his knee, rather than in his hip or groin.
Mr Swenson had been experiencing pain in his right knee which left him unable to walk any distance and made it difficult for him to complete simple tasks such as putting on his shoes and socks and getting in and out of his car.
He made repeated visits to his GP and had a series of scans and X-rays on his knee, but nobody had been able to correctly identify the problem.
My examination revealed an extremely stiff right hip, but I couldn’t see anything wrong with his knee. I ordered X-rays that morning which confirmed severe osteoarthritis of his hip. He didn’t want to carry on with the pain and I recommended a total hip replacement.
The bones around his hip were strong so I performed the replacement without cement, which I have to use for patients with weaker bones.
Operating without cement allows the bone to grow naturally into the porous titanium replacement which gives a long-lasting result.
Mr Swenson recovered very well using our enhanced recovery plan combined with extensive physiotherapy at our Clinical Physiotherapy Centre. I’ve seen him for two check-ups since his operation and he’s walking well without aids.
He experienced very little pain after his operation and is delighted with the result.