Mr Mark Ashworth FRCS (Orth)
Consultant Orthopaedic Surgeon
HIP AND KNEE PAIN
Total Hip Replacement
Whilst this is usually performed for arthritis, there are many other reasons why a hip replacement may be needed:-
Dysplasia is a condition where the hip is shallow This causes overload of the shallow wall of the socket and damage to the femoral head. This can be diagnosed on x-ray, MRI or at prior arthroscopy (wave sign on the acetabular rim cartilage or groove sign on the femoral head - these are not well visualised by MRI scanning). Mr Ashworth has considerable experience of managing the symptoms of dysplasia including arthrscopically and when to perform hip replacement.
Avascular necrosis (AVN) is a condition where the blood supply to the femoral head is damaged resulting in death of the hip (analogous to a stroke) and this can lead to collapse of the hip with arthritis. AVN may be painful and unresponsive to other treatment meaning hip replacement becomes necessary.
Following other hip surgery, when the results have not been successful.
The operation is performed under a spinal or general anaesthetic and takes an average of 80 minutes.
This surgery is occasionally performed as a day-case. Mr Ashworth and his colleagues have been performing day case hip replacement surgery on a carefully selected group of patients for over 2 years. This group rehabilitate much quicker than the inpatient group and generally return to work and normal activities several weeks ahead of the in-patient group.
Thrombosis, Embolism, Stroke, Heart attack, Death
Infection, Dislocation, Wearing out or loosening,
Leg length discrepancy, Fracture, Limping/weakness
Numbness around the skin incision
Rarely, numbness & weakness of the foot/ankle (usually temporary, occasionally permanent loss occurs)
Ongoing pain- most settle, but occasionally further treatment is needed such as physiotherapy, cortisone injection, arthroscopic surgery and very rarely re-operation.
Mr Ashworth audits the infection rate of all hip and knee replacement operations in conjunction with the Torbay Hospital Microbiology department.
In the UK, around 0.5–1% of patients receiving total hip replacement subsequently develop deep prosthetic joint infection (PJI), a potentially serious and devastating complication.2 ,3
Mr Ashworth's deep infection rate for both hip and knee replacement operations has consistently been below 0.4%. The last primary hip replacement performed by Mr Ashworth which developed PJI was in 2009 and was successfully treated.
Mr Ashworth has not had a dislocation of a primary hip replacement in the last 17 years.
Patient related outcome scores (PROMS)-
PROMS are one method of assessing how a patient feels about the results of their surgery. Mr Ashworth has collected PROMS in Mount Stuart Hospital since 2013, his results have consistently improved since then, the figure above represents the most recent 12 months.
Hip and Knee Replacement pre-operative videos-
The link below details the process at Torbay Hospital. The process at Mount Stuart is similar but not identical. The videos are useful in relation to what to expect before during and after your operation and after discharge.