Some early adult hip disorders can now be treated with “keyhole” surgery. The most common of these is hip impingement, which may be associated with a tear of the labrum. Thorough investigation is required to diagnose the nature of the problem and determine if surgery is the best course of treatment.
The surgery is normally performed as a day case procedure (going home the same day of the operation). The operation requires a general anaesthetic following which traction is applied to the hip to allow access into the hip joint. Using between 2 and 4 small incisions a camera (arthroscope) is inserted into the hip joint together with instruments to treat the abnormality in the hip. Depending on the extent of the surgery required the procedure takes between one and two hours.
When you have recovered from the anaesthetic you will be encouraged to walk and go home the same day with crutches. It is normal to have a lot of swelling around the hip which quickly subsides. You will need to take painkillers when you go home and will have out-patient physiotherapy following the surgery. Mr. Loughead will review you two weeks following the surgery to inspect the dressings and check on your recovery.
Type of Hip Replacement
There are a broad range of hip replacement types which use different metals e.g. stainless steel, titanium, and which use either a conventional metal on plastic or newer materials. Mr. Loughead will discuss the most appropriate choice of hip replacement with you. All of the hip replacements Mr. Loughead uses have a proven track record.
There are advantages and disadvantages of different approaches to the hip which may for example preserve different muscles around the hip, or may have different risks associated with them. Mr. Loughead routinely performs hip replacement surgery through two different approaches tailored to the individual patient, he can discuss which approach is most suitable for you.
Hip Resurfacing (The Birmingham Hip)
As a result of concerns which have been raised about the impact of metal ions within the hip and the bloodstream, Mr. Loughead no longer performs hip resurfacing. Recent outcomes for contemporary hip replacement surgery suggest it performs equally as well as hip resurfacing, and avoids these potential risks. Many of Mr. Loughead’s patients have returned to physical jobs e.g. builder / roofer, or sports e.g. tennis / martial arts after conventional hip replacement.
Hip Replacement (arthroplasty) is the most common treatment for osteoarthritis of the hip. It normally results in excellent pain relief and can enable return to many sport and leisure activities for patients with significant hip arthritis. All patients come into hospital on the morning of surgery and most patients stay in for 1-2 days. When you go home you will be on crutches and will have practised walking up and down stairs. It takes six weeks from surgery before patients are able to drive a car or return to a sedentary job (longer for a manual job). Mr. Loughead sees his patients at 6 weeks following surgery to check on their recovery, and sometimes sooner than this to inspect the dressings.
Hip Arthritis (previous surgery undertaken in childhood)
Revision Hip Replacement
After some time a hip replacement may wear out and require revision (re-do) surgery. This can be undertaken more than once if necessary, although this entails a bigger operation than a first time hip replacement, and recovery time is longer.
A number of knee disorders can be readily treated with “keyhole” surgery. These include loose bodies within the knee, cartilage (meniscal) tears, and in some selected cases patients with early arthritis can benefit from knee arthroscopy. This involves a camera being passed into the knee joint together with specialised instruments through small incisions around the knee approximately 1cm in width. Patients can normally go home the same day following this procedure. Mr. Loughead will review you two weeks following their surgery to inspect the dressings and check on your recovery. Physiotherapy may be required, return to work and driving a car can be normally be anticipated around ten days following surgery.
Arthritis of the knee is the most common form of arthritis and once again can result in significant pain and disability. Knee replacement surgery can provide excellent pain relief and return to function. This involves removing the arthritic joint surfaces and replacing them with metal (Cobalt Chrome) and plastic (High density polyethylene) ones.
The operation takes around an hour to perform with the patient admitted on the morning of surgery. Most patients stay in hospital for 2 days and receive intense input from physiotherapy whilst in hospital. It takes six weeks from surgery before patients are able to drive a car or return to a sedentary job (longer for a manual job). Mr. Loughead sees his patients at 6 weeks following surgery to check on their recovery, and sometimes sooner than this to inspect the dressings.
Although patients are quick to get going after knee replacement surgery they continue to improve for a long time after surgery (at least a year).
Partial (Unicondylar) Knee Replacement
In the early stages of knee arthritis often only one side of the knee has become worn out. Therefore it can be possible to simply replace the affected part of the knee rather than the whole knee. This is a smaller operation than a total knee replacement and has a quicker recovery time.
Revision Knee Replacement
From time to time a knee replacement may reach the end of its lifespan and have to be replaced, if it is causing pain or feeling unstable. The length of time a knee replacement lasts varies considerably although for most patients it will last at least 10 to 15 years. The operation involves removing the old knee replacement and inserting a new one which has stems to gain extra hold in the bone. The operation takes longer and recovery time is slower following revision surgery.