BMI St Edmunds: Making giant strides in hip replacements

Sam Parsons, consultant hip and knee joint replacement surgeon at BMI Bury St Edmunds Hospital.

Sam Parsons, consultant hip and knee joint replacement surgeon at BMI Bury St Edmunds Hospital. - Credit: Archant

Consultant hip and knee joint replacement surgeon at BMI Bury St Edmunds Hospital Mr Sam Parsons looks at the history of hip replacement operations and describes some of the major advances since the pioneering days of the 1970s.

Hip replacements have transformed the lives of millions since becoming a regular procedure in the 1970s, but things have really improved and advanced since those early days.

Early patients were often left on bed rest for days at a time, walking with crutches for months, and told to limit their activities afterwards. It was also a case of ‘one size fits all’ when it came to choice of joints available.

Nowadays we can reflect on the many changes and enormous improvements that have been made as the operation becomes more and more common.

In the past the operation was normally performed on older patients whose needs and expectations were often fairly limited. However, expectations are now much greater, people are living longer and leading much more active lives. They don’t want to ‘become old’ simply because they have had a hip replacement.

Advances in anaesthetics have helped shorten length of stay, make the operation less painful and, importantly, enabled the rehabilitation and physiotherapy to start on the day of surgery.

In almost all cases the patient is out of bed on the day of the operation while hospital stays have dropped to an average of three nights – in the past it could sometimes run into weeks. The improvements have also meant that hip replacements can be carried out on much younger people who, in most cases, then go on to resume an active and healthy lifestyle.

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We see an increasingly large number of young and fit patients who have demands that far exceed the limits of conventional joint replacements.

These younger and fitter patients do represent a challenge as past solutions, such as resurfacing, have sadly not lived up to their promise.

However, the use of ceramic implants have moved on immensely and now produce excellent results.

Very early models did suffer from problems in the form of fracture but, with modern delta ceramics, this is virtually unheard of now.

There are also ceramisized metals such as Oxinium which are producing excellent results in the younger, higher-demand, patients.

The use of newer polyethylene cups, using highly cross-linked polyethylene, offers a significant advantage at minimal risk. These cups/sockets wear significantly slower than conventional polyethylene and will last longer, so delaying the need for revision, and hopefully ensuring that more people of all ages can have a hip replacement that lasts a lifetime.

Another improvement means hip wounds can now be closed without visible stitches, doing away with the need for dressings which can get smelly and contribute to a risk of infection.

This combination of implant and bearing surface choice, along with new methods of fixation, mean we can tailor the surgery, anaesthesia and implant to suit the individual patient.

Have you got a health concern? Do you need an expert opinion? Contact the team at BMI St Edmunds by emailing stedmunds@bmihealthcare.co.uk

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