Hip Replacement

To alleviate chronic hip pain it may be beneficial to undergo surgery to allow the patient to live a full and carefree life – providing the ability to do whatever they want without the constant threat of pain getting in the way. Professor Ali Ghoz offers a number of different treatments depending on individual needs and will go through the details on a patient-by-patient basis before any procedure.

Some of the advantages of the minimally invasive X-ray guided hip surgery:

No muscle cutting

Decreased pain after surgery

Shorter rehabilitation period

Shorter hospital stay

Lower risk of dislocation

Better positioning of implants

Reduced risk of limping

Faster return to daily activities

Smaller skin scar

Why have surgery?

There is no one ‘right time’ to have hip surgery – it depends on the individual and how the pain is affecting their lives. Professor Ali Ghoz always advises patients to take their time and really think about when it is right for them. If the pain is interfering with a patient’s daily routine then it might be time to do something about it.

Opting for hip surgery is a way to eliminate hip pain and the bespoke treatments carried out by Professor Ali Ghoz enable patients to rediscover an active life.

What are the options?

Before the decision to go ahead with surgery is made Professor Ali Ghoz will go through non-surgical options – such as pain relief medication and exercises – with the patient but if it is thought that it is the right time for hip surgery then there are a number of replacement treatments available depending on the individual need of the patient.

Whether it is hip replacement or hip resurfacing replacement there are a few options when it comes to the type of bearing used in the ball and socket joint. These implants should last a lifetime (depending on the age of the patient).

Traditional Bearings

Traditional hip bearings are comprised of a metal head moving on a polyethylene – or plastic – liner. Studies have shown that these liners take around 30 years to wear out so are ideal for an active life.

Metal on Metal Bearings

Metal on metal bearings have been developed with younger patients in mind. Their strength and durability give them the ability to last even longer so have more chance of lasting a lifetime.

Ceramic Bearings

Ceramic bearings have extremely low wear rates and are again ideal for the younger patient. With all these options surgical technique is critical and Professor Ali Ghoz has the skill and expertise to perform a minimally invasive procedure to suit the individual patients’ needs.

Approaches to Hip Replacement

When pain becomes too much to bear and is limiting an individual’s ability to maintain the life they want to lead, a total hip replacement is a highly successful option. It is never too late to replace a hip joint and with the improvements in surgical and anaesthetic techniques recovery times are now faster – with less pain – making for an easier recovery.

There are two approaches to total hip replacement surgery and Professor Ali Ghoz is comfortable performing them both using minimally invasive techniques that are individually customised to cater for the needs of each patient.

Anterior Approach
The minimally invasive direct anterior approach (sometimes referred to as DAA or AMIS) promises quicker recovery due to the fact that it uses intramuscular planes allowing exposure of the hip joint without detaching muscle from the bone.

Posterior Approach
The more common posterior approach to hip surgery requires splitting muscle and detachment of rotator muscles to perform the procedure from the back. There is therefore a slightly longer recovery time to be expected.

Studies have shown that after 12 months patients are able to function equally well with either approach used. Professor Ali Ghoz favours the anterior approach from a recovery perspective but believes the most important factor is to ensure a safe and full recovery to provide the individual patient’s pain solution.

Before Surgery – What You Need to Know

After Professor Ali Ghoz has discussed the options with a patient and decided on surgery as the way to go they will need to attend a pre-admission clinic where a nurse will go over the procedure and post-operative details. Routine blood tests and an ECG will then be performed.

Patients are given an antiseptic soap at the clinic that needs to be used for the two days prior to the surgery. This reduces the risk of skin infection after surgery.

The Surgery – What You Need to Know

Professor Ali Ghoz’s minimally invasive procedures are carried out under a combined spinal anaesthetic and a light general sedation. This is entirely safe and is proven to reduce any possible complications during joint replacement surgery.

A urinary catheter is used as the morphine given for pain relief invariably results in patients finding it difficult to pass urine for 12-18 hours. Removing the catheter is a very straightforward process and not painful at all.

Pain relief after the surgery is down to the individual patients’ needs in accordance to the anaesthetist’s direction.

Recovery – What You Need to Know

Preventing thrombosis is the priority after hip replacement surgery and mobilisation and exercise are vital. To aid this, every patient is fitted with a calf compressor that promotes blood flow and prevents clots.

The sooner a patient gets out of bed and walks the less the risk of thrombosis so Professor Ali Ghoz encourages his patients to walk twice a day whilst in the hospital. The more exercise the better but patients are warned not to overdo things.

Although there may be some discomfort the key to a successful recovery after replacement surgery – even the minimally invasive techniques offered by Professor Ali Ghoz – is mobilisation. Physiotherapists will be able to show patients exercises to help recovery and ensure that hip replacement surgery is just the start of a new way of life.

Professor Ali Ghoz

Specialist Hip Surgery