Annually, over 90,000 people in the UK require a hip replacement.
The procedure has previously had a reputation for being a painful, major surgical operation with a long recovery period. In consequence, many people are anxious about the prospect of hip replacement, and the impact that it may have on their daily life.
However, is this still correct in 2019?
Professor Richard Field, Consultant Orthopaedic Surgeon at The Lister Hospital – part of HCA Healthcare UK – believes the landscape has changed, with many of the stereotypical concerns no longer correct. With this in mind, we’ve asked Professor Field to share his perspective on the key things all prospective patients should know:
(1) WHO IS THE TYPICAL HIP REPLACEMENT PATIENT?
“In the UK, the average patient age is 67. My oldest patient was 101 and did well for five years after her operation. My youngest patient was in her teens, and if we hadn’t replaced her hips, her life would have been quite awful. Around one in eight have hips that are slightly misshapen. In such cases, prolonged vigorous exercise can make the hip deteriorate prematurely. Andy Murray is an extreme example of this.”
(2) HOW LONG IS A HIP REPLACEMENT OPERATION?
“This is dependent on the complexity of the case, the severity of damage, and whether bone cement is used to fix the components. The actual surgery usually takes 60-90 minutes. However, the theatre journey is considerably, because of time needed for the anaesthetic, pre-operative checks, and the time a patient spends in the recovery area following surgery to regain full consciousness. Overall, the theatre journey is between 3 and 4 hours.”
(3) WHAT IS THE BEST TECHNIQUE FOR HIP REPLACEMENT?
“I use the anterior hip technique – an approach which was first described in 1870 for draining TB from infected hip joints. It is beneficial for patients as it avoids cutting any muscles, causes less pain, and allows patients to mobilise more quickly.
At present, the UK is lagging behind the USA, Australia and many European countries as relatively few UK surgeons have learnt how to do anterior hip replacement. I was fortunate to be in contact with many of the world’s leading hip surgeons in the early 2000’s and, through them, realised that it would be a good idea to learn the technique. I have been using the anterior approach for over ten years and have undertaken nearly two thousand cases to date.”
(4) WHAT IS THE TYPICAL HOSPITAL STAY FOLLOWING A HIP REPLACEMENT?
“Twenty years ago, it was normal for patients to spend ten days in hospital post-surgery. Nationally, we are now down to just under five days, but in the USA many surgeons are running programmes with 90% of their patients returning home on the day of their operation. Using the anterior approach is an important contributor to this reduction – most of my patients leave hospital after one or two nights. It also means that the patients are better able to look after themselves and are less dependent on carers. Most importantly, it gets them away from the hospital environment where they are most vulnerable to antibiotic resistant bugs.”
(5) WHAT IS THE AVERAGE RECOVERY TIME FOLLOWING A HIP REPLACEMENT?
“There are many stages to recovery after hip replacement. Firstly, patients must be able to go up and down stairs before they can be discharged from hospital. Many anterior hip patients tell us that they were walking without aids within a few days. My aim is for patients to understand that it takes time for their tissues to heal and, if we have not used cement to secure the implants, it takes time for the bone to attach securely.
I tell patients that they should be walking normally by 5-6 weeks, walking long distances, without a limp, by 3 months and be unable to remember what their bad hip felt like by 6 months. Driving takes anything from 10 days to 5 weeks; depending on which hip is replaced and whether the car is automatic or manual.”