I know, the idea shocked me as well!

Recently I declared 2020 to be the Year of the Hip. Today I’d like to tell you why.

Through the mists of time

Back when I was a very VERY new physiotherapist I was extremely fortunate. One of my patients was getting a hip replacement!

While incredibly common now (over 35,000 per year on the NHS) they had only just started to be possible back then.

And, best of all, I was invited to WATCH the procedure, performed by none other than the developer of the prosthetic hip himself, Sir John Charnley (he was Prof. Charnley at that time!).

And then my job was to get that patient up and mobile asap so that Prof. Charnley could add another success to his tally!

So that’s 4 decades of post hip replacement rehabilitation experience!

And I know just how hard that rehab process can be to get a good result. Which is why, quite frankly, when there was a choice of hip replacement or MRT for close family members – I chose MRT every time. In fact, it’s half the reason I got the technology in the first place! (The other half was my shoulder but we’ll save that for another day).

Recommendations

And then the phone range. The lovely Isabel from Hospital Ceram called, they had a new hip surgeon from Holland. Would we like to meet him regarding a collaboration?

To be honest if it was anyone other than Isabel asking . . . . . but we said yes.

So, one quiet Friday evening in December, Dr Joris Van der Lugt, his anaesthetist Dr Peter Van Aggelen and their colleagues came to visit us.

Hip Hip Hooray

Dr Van Der Lugt took the time to explain his particular specialism – anterior hip replacement.

And when he says specialism – he’s done over 2,000 in the last decade!!!

What’s an anterior hip replacement and why do I care?

The traditional method of doing a hip replacement, particularly here in Spain (nope, I don’t know why either!) is the posterior approach. This is the original or traditional method and the one I saw performed by Prof. Charnley all those decades ago.

Essentially the difference is where the surgeon makes the incision and the route he takes through your body to get to the hip joint. (this website provides a good technical summary)

In a posterior approach, the incision is made through the back of the hip while you’re on your side.

In an anterior approach, the replacement is done through the front while you lay on your back.

But it’s the route through the body that is the BIG difference – going in from the back , the posterior approach, means having to detach some really big, really important muscles (glutes / external rotators etc). This means the operation takes a long time as they have to be carefully unstick and then, just as carefully, put back together.

And that means a long time that you’re under general anaesthetic. Which is pretty damn risky, especially as we all move away from being fit young 35 year olds!

And that route and all those change to muscles causes a LOT of distress to the surrounding tissues which means more healing.  And more rehab. And more pain.

From the front

But the anterior approach?

Well it takes about 30 minutes!!! I’ll say that again, 30 minutes!! That’s so fast that you can do it with a regional anaesthetic.

And no muscles are hurt during this procedure.

Because you go between not through.

So you wake up with all your muscles in the same place as they were before. Only a little stretched (like a yoga class?!?!).

So what does that mean for you?

That means that that HUGE risk of a problem under general anaesthetic? Often the riskiest part of any procedure (particularly if you’re over 50). Almost gone.

And those months of rehab? Walking on two crutches, having to relearn a proper gait pattern, referred pain into the lower back, knees and shoulder. Gone. You’re back up and walking the SAME DAY!!!

This blows my mind. That’s 2 of the biggest reasons why I am so vehemently, loudly and proudly anti-surgery GONE. Poof. Vaporised.

I’m still in shock. In fact, that’s why it’s taken me so long to tell you about it.

I’ve been genuinely conflicted.

I am as anti-surgery as you can get. Because of the risks. Because most people aren’t patient enough to do the rehab to get a good result.

And now . . . . .

Why isn’t everyone doing it then?

Because it’s harder.

Which means that (especially when the surgeon is learning!) there is a higher risk of error.

But Dr Van Der Lugt has done more than 2,000. And his “day job” in Holland? Teaching other surgeons how to do it.

One last reason

So there’s one last reason why I’m wary of surgeons – because they love to operate.

It’s the age old stereotype isn’t it? If all you have is a hammer then every problem is a nail.

Except that Dr Ven der Lugt and Dr Van Aggelen are so proud of their success rate that they don’t.

They only want to operate if it’s the right procedure for the right person. Otherwise, you get referred back to . . .  well . . . .me!

I don’t have a leg to stand on any more do I?

So now what?

Well Dr Van der Lugt has offered to prove his point to me. He’s agreed to offer free consultations for the patients I refer him.

So if you are considering hip surgery call Emmie now to arrange your free consultation with Dr Van der Lugt.

I’m off to lie in a dark room and wonder what the world is coming to!