Why Are Specialist Hip Surgeons Now Busier Than Ever?
There are several reasons for a surgeon to operate on the joint positioned between the pelvis and the femur. Among the older population, falls are common and will frequently lead to a fracture of the pelvis, which must then be repaired in order to restore mobility and to alleviate the patient’s pain. However, pain and loss of mobility are not always the result of external trauma. Sometimes, the role of hip surgery specialists is to rectify the damage resulting from internal trauma.
For example, certain tumours can act to break down bone tissue and, if allowed to proceed unchecked, osteoporosis following menopause can have a similar effect. Both conditions can give rise to spontaneous fractures. However, the most common reason for internal damage to this joint is the condition known as osteoarthritis. In a healthy joint, the acetabular cup and the head of the femur have a protective layer of cartilage that enables friction-free articulation. Intervention by a specialist hip surgeon in patients with osteoarthritis may eventually become necessary when, as the disease progresses, one or both of these layers become too badly worn, resulting in increased friction, painful restricted movement, and potential damage to any exposed bone surfaces.
In the early stages, while a patient’s movement is not too badly impaired, it is possible for a GP to manage his or her pain with suitable medication. However, the condition is a progressive one. In time, medication becomes ineffective and, at this point, a specialist hip surgeon will normally recommend that the patient undergoes a joint replacement. Given the tough materials from which the components of a modern prosthetic joint are now prepared, and the improvements in surgical techniques, arthroplasty is considered by most in the profession to be the most successful orthopaedic procedure of all time.
While once, osteoarthritis was a condition encountered almost exclusively in those aged 65 and over, all over the world, specialist hip surgeons have been reporting a change in this pattern. Many of the patients they are now required to treat are only in their fifth decade and a few of those displaying the characteristic symptoms are even younger.
Opinions differ regarding the explanation for this statistical shift, but many of these younger patients are overweight or clinically obese. This has prompted researchers to conclude that the extra weight, combined with muscles weakened by a sedentary lifestyle, has led to increased pressure on the joints. Whatever the explanation, hip surgeons and orthopaedic specialists are now performing more joint replacements than ever, while the average age of those undergoing these procedures has been decreasing.
In normal use, the lifespan of a prosthesis should be a minimum of ten years, but with a little care, that figure can often be doubled. Because people are living longer today, it is common practice for an orthopaedic surgeon to postpone arthroplasty for as long as possible, in order to maximise its benefit and to minimise the chance that the prosthetic joint may itself require replacement.
To limit trauma, many surgeons who are hip specialists now choose to employ a minimally invasive procedure when performing arthroplasty. The process still involves the removal of damaged bone and soft tissue, followed by the attachment of a prosthesis, but it entails significantly less tissue damage. However, the traditional approach requires a 25- to 30-cm incision to fully exposes the joint and while the same prosthetic components are used in the minimally invasive technique, only a single incision of around half the size or two smaller ones in the buttock and groin area respectively are required.
Clearly, this procedure is more demanding, so specialist hip surgeons require extensive experience to develop the necessary skills. It’s also worth noting that this option is not suitable for everyone. It is generally reserved for those younger patients, who are thinner, are in good general health, and who appear sufficiently motivated to stick to the post-op rehabilitation programme. By contrast, when replacing this joint, an orthopaedic surgeon will be more likely to treat a patient with health problems, a significant deformity of the affected joint, or a subject who is particularly muscular, by means of the more traditional approach.
Further advances in orthopaedics are inevitable. This highlights the need for hospitals, hip surgeons, and allied specialists to remain abreast of all the new developments.