Total Hip Replacements

As part of his ongoing CPD, Mark took part in a webinar last week on “rapid recovery from Total Hip replacements”…

As Osteopaths and Physiotherapists we are often the first people to diagnose or highlight the potential presence of an arthritic hip in a patient.  Quite often the presentation is of knee or back pain, but actually a restricted hip is the main issue resulting in overuse or change of use of these other areas.     A typical OA hip will have pain in the groin and a tendency to bend forward over that hip as it becomes harder to straighten.   Activities such as putting on socks and doing up laces become difficult.

I certainly try to soften the news that I suspect an OA hip with positive information on how exercises help some, but if a replacement is required how successful they are.   This webinar certainly backed up the positive outcomes.

Mr Hugh Apthorp who works at London Bridge Hospital undertakes the most Total Hip replacements (THR)  in the country.    He told us that THR’s are regarded as the most successful surgical interaction alongside cataracts and cardiac stents.

He regards the operation as a “soft tissue procedure” as minimising the damage to the strong muscles around the hip will allow a rapid return to mobility.  Alongside careful anaesthesia, ensuring minimal post-surgical side effects, he can have patients up and walking within an hour of the surgery.   He showed us numerous videos of patients walking and climbing stairs all within 24 hours of surgery.

THR can now be regarded as “for life” as they do not wear out.   Whereas in the past people would be encouraged to wait as long as possible, Mr Apthorp encourages patients to have surgery when they have had enough of the pain and disruption to their life.   It must always be the patient’s decision but outcomes are better when muscle strength remains pre-surgery and age is a factor in regaining lost strength.    After an initial period of avoiding impact exercises, he expects patients to be back to full activities after 3-4 months, including running etc.

The key element is that although it is quite a heavy blow to be diagnosed with an arthritic hip, THR is a very successful procedure and has a high potential to allow a return to full activity with the loss of various other pain and discomfort that was present pre surgery.

The only downside is that, unfortunately, privately a THR at the London Bridge Hospital costs £17,000.00.   However, more locally I believe the rate is around £11,000.00 and it is covered by most insurance companies.

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