HIP REPLACEMENTS: MUCH LESS TRAUMATIC THESE DAYS
Hip replacement surgery has become routine in many parts of the world, with hundreds of thousands of operations of this type done in in the UK. Success does still depend on the skill of the surgeon and the quality of aftercare but, generally, hip replacement surgery has become a much smaller operation than it used to be.
“When I first started as an orthopaedic surgeon it was common for a patient to be in hospital for two weeks. They had drains and catheters in place for days after surgery, injectable morphine for pain relief and a significant proportion would need a blood transfusion because of the amount of blood lost during the operation.
Today, the incision used is much smaller and recovery time has reduced. Someone having a hip replacement here at Medcare today would be in hospital for no more than four nights and we rarely need to use injectable painkillers at all.”
The prosthetic hip joints used today are also very durable.
“Traditional metal-on-plastic hip replacements start wearing out in 10-15 years. The hip prostheses that I use today are now able to last many decades, so revision hip replacements that are required due to prosthesis failure should really reduce over the next few years.”
BETTER MATERIALS, BETTER FITTED
“My favoured hip prosthesis has a ceramic-on-ceramic bearing and wears out very slowly at around one hundredth of the rate of the best metal-on-plastic replacement hip. For this reason, ceramic hips are particularly good for younger patients.
The early ceramic hips were attached to the skeleton with cement and the ceramic materials were nowhere near as good as they are today. We are just getting the 10-year data on modern ceramic-on-ceramic hip replacements attached to the skeleton with contemporary techniques. I seldom use cement; if the prosthesis is fitted well, it is better for it to bond to the bone naturally. The data is showing outstanding results; virtually none of the ceramic-on-ceramic hips done in the last 10 years have failed, apart from a very few cases of infection or dislocation, which were not connected to the type of prosthesis.”
CAN HIP TECHNOLOGY STILL IMPROVE?
The trend towards medical innovation is strong and it is likely that new materials and techniques will be developed. However, as Dr Paul points out, not all developments in hip replacement technology have been beneficial.
“Just because something is new does not mean it is better. It is important for hip replacements to be done by surgeons who are skilled in the surgical techniques but who are also very clued up with the data. We need at least 10 years’ data or more before we are convinced that a new material is as good as what we currently have, and the best surgeons are able to choose the right prosthesis for the right patient, and then fit it well.”
Medcare IS A CENTRE OF HIP EXPERTISE
Medcare is without doubt the UAE’s premier private hospital for hip hip disorders. Most other hospitals have one surgeon with some experience in this area, if they are lucky.
THE ADVANTAGE OF EXCELLENT FACILITIES
Dr Paul Macnamara thinks that the combination of such surgical expertise and the facilities offered by Medcare make this a leading centre for hip surgery in the UAE
“The theatre facilities are good, the nursing is good, surgeons and patients always have what they need and everyone works together in great teams. The physiotherapy and hydrotherapy available also helps patients during recovery and rehabilitation.”