Hip Specialists Increasingly Important in Major Cities such as Pretoria

Dec 10, 2018 | Articles

Hip Specialists Increasingly Important in Major Cities such as Pretoria

The sad truth is that recent generations of South Africans, especially those living in urban areas, lack the physical fitness and strength of previous generations. With the exception of the few who make a point of working out at a local gym, cycling to work, jogging, and/or ensuring to maintain a healthy, balanced diet, most are fast displaying the inevitable consequences of a lifestyle characterised by too little physical activity and a diet based on quantity rather than quality. Although not obvious to the layman, hip specialists in Pretoria and major cities in most countries, perceive these trends as explaining the rising demand for their services, as well as the fact that those in need of such services now tend to be younger than in the past.

Wear and tear, of course, is to be expected and tends to be more evident amongst those jobs that are more physically demanding, such as labourers and removal specialists who must regularly lift heavy loads that result in excessive pressure on their joints. Nevertheless, this is normally a fairly slow process which, barring accidents, would not normally give rise to serious pain or impaired mobility until sometime during the sixth decade of life. Today, however, hip specialists in Pretoria and elsewhere report that they are encountering these symptoms in a growing number of subjects still in their 50s and sometimes even younger.

A traumatic injury will often make it necessary to replace a damaged joint with a prosthetic one, perhaps at the time of the trauma or even many years later. However, the most common reason for a surgeon to consider performing a partial or total joint replacement is as a means to overcome the damage caused by the condition known as osteoarthritis. The condition affects the layer of cartilage that is normally present on the articulating surfaces of the bones, facilitating a smooth and silent gliding action while protecting the underlying bone from frictional damage. Osteoarthritis progressively erodes the protective cartilage exposing bone and prompting the need for attention by hip specialists, such as those at the Life Wilgers Hospital in Pretoria.

So why is the demand for this type of procedure on the increase, both locally and throughout the developed world, and why is the average age of those who require it now significantly lower than was the case in years past? The explanation appears to be tied to the lifestyle changes mentioned earlier. The more sedentary lifestyle in conjunction with a tendency to consume convenience foods loaded with too much sugar and starch has seen a rise in the number of South Africans who are overweight or obese. The resulting, additional strain on the knee and hip joints is thought to explain the increased workload for specialists in Pretoria and most major cities

It has taken more than a century to develop the surgical techniques and suitable materials employed today for the insertion of a functional artificial joint. The earliest attempt on record took place way back in 1891 when a doctor by the name of Themistocles Gluck successfully replaced the head of a femur with one fashioned from ivory. Unfortunately, the material, chosen for its biomechanical properties, proved to be insufficiently tough for the task. However, there might be no hip specialists practising in Pretoria or anywhere else today if it was not for the fact that Gluck’s failure at least served to confirm the feasibility of implanting an artificial joint, encouraging others to research the use of alternative materials.

The first true success came in 1940 with the use of a femoral prosthesis made from a patented metal alloy known as Vitallium™, consisting mainly of cobalt, chromium, and molybdenum. It was performed, not by hip specialists in Pretoria, but by Dr Austin Moore at Columbia Hospital in South Carolina. Moore also designed the implant which was around 30 centimetres in length and secured to the femoral shaft by means of bolts. An improved version, known appropriately as the Austin Moore prosthesis, is still in use today, although the attachment is now achieved, not with bolts, but by insertion into the medullary canal of the femur resulting in a more permanent bond, as it is gradually encased by growing bone.

The techniques and materials have continued to evolve apace, and among those closest to the cutting edge of arthroplastic surgery are the shoulder, knee, and hip specialists providing their services from the state-of-the-art facilities at Life Wilgers Hospital in Pretoria.