Hip Joint
This is one of the largest ball and socket joint in the body. It is a major weight bearing joint, connecting the lower limb to the trunk (pelvis and spine). It is a very stable joint with good movement range. The joint cartilage is a special smooth structure lining both the ball and socket of the joint and is essential for weight bearing function with frictionless and pain free movement range.
Hip osteoarthritis
This refers to wear of the hip joint cartilage. Pain and stiffness can restrict a patient’s day to day and fitness activities. In early stages non-operative treatment such as exercises, pain killers and maintaining a healthy weight all serve to improve hip function. As arthritis worsens, these treatment measures might not be so beneficial. At this point, hip replacement can be considered after thorough evaluation and discussion with a surgeon regarding alternate options, recovery, expected outcome, long-term results and any possible complications.
Hip replacement
Hip Replacement surgery is one of the most successful surgical procedures in helping to improve quality of life. Thanks to scientific advancement there have been significant improvements in materials, prostheses design, fixation techniques, patient care – all of which have contributed to the success and durability of hip replacement. Most patients are able to gradually return to their fitness activities. Hip replacements are now considered even for young patients with advanced arthritis.
Clinical studies have shown excellent long-term results. The latest UK National Joint Registry report suggests more than 90 percent of hip replacements survive 19 years post-surgery. Nowadays, revision hip replacement results are also good in terms of pain relief and improvement in function but are generally not as good as primary hip replacement. Their results are also improving due to research, technology and surgical expertise.
Enhanced recovery …
Minimally invasive hip replacement is a technique carried out through a smaller incision and with minimal soft tissue injury and blood loss which should enable faster recovery. Equally important aspects of surgery are how well the patient’s hip anatomy is restored using prostheses, with excellent long-term results and sound fixation of the prostheses. Optimal patient preparation before surgery, minimally invasive replacement done well under safe anaesthetic techniques providing good pain control, early mobilisation, and positive and supportive care from the nursing staff and physiotherapists are all cornerstones of enhanced recovery hip replacement. This has improved patient satisfaction, minimised complications and reduced length of hospital stay. Day case total hip replacement is a recent success of the enhanced recovery programme. Selected patients of mine go home on the same day of operation.
Computer-assisted or robotic hip replacement
This is an evolving innovation trying to improve results further by restoring patients’ hip anatomy as accurately as possible. This allows for better planning and execution of hip replacement, minimising variation from the plan and reducing risk such as leg length discrepancy. I am pleased to offer it to my patients where it is both needed and possible. Long-term studies will be needed to prove efficacy, but current results are encouraging. Research using artificial intelligence in patient care, and the planning and performing of operations has begun and may have a role in the future.
It’s human nature to push boundaries, and this has resulted in improved surgical outcomes, increased longevity of hip replacement and minimising of complications. The journey continues.
Mr Senthil Kumar Velayudham is a hip specialist based at Tunbridge Wells NHS Hospital. His private practice is based at Nuffield Health, Tunbridge Wells and Horder Centre, Crowborough. He is committed to training the next generation of hip surgeons. National Joint registry data shows he is one of the very high-volume surgeons in UK and that his patient satisfaction scores are one of the best after total hip replacement with very low revision rates. His other interests in hip surgery are resurfacing hip replacement, complex hip replacement, revision hip replacement and hip arthroscopy for hip impingement.
Ph: 01892 537040
