A hip replacement procedure that sees patients walk out of hospital just 24 hours after surgery could halve waiting lists in the UK.
The technique, which involves doctors reaching the joint through an incision of just 5cm, has a remarkably low infection rate.
It also spares the muscle surrounding the joint, allowing 90 per cent of patients to be up and walking on the same day as surgery – without crutches.
And while it’s currently primarily available privately in the UK, a number of expert surgeons have told The Mail on Sunday that they expect the operation to become the gold standard procedure for the National Health Service within the next ten years.
‘Hip replacements are the most common operation in orthopaedics,’ says Professor Adrian Wilson, consultant orthopaedic surgeon at private clinic Oveli Healthcare.
‘And what this very clever technique has done is taken a procedure that already works well and transformed it in terms of safety and speed.
‘The average time for a double hip replacement through the standard operation is 90 minutes – we can now do them in a third of that time. By cutting waiting list times and saving the NHS millions, this will help thousands.’
Just under 100,000 people in the UK received hip replacement surgery last year. The operation usually takes a few months to recover from, and the average wait time is 128 days – up from 87 days before Covid.
A new hip operation which sees patients leave hospital in just 24 hours after the procedure could halve waiting lists in the UK (file photo)
The new technique, named the ‘Rapid Recovery’, or Rottinger Approach, promises to have patients out of the hospital as soon as possible and with far fewer complications.
Unlike the most common hip replacement procedure in the UK, during which surgeons operate from the back of the hip, the Rapid Recovery surgery sees doctors make an angled incision from the side of the body.
Cutting just 5-6 cm of skin and a thin layer of tissue, they then move the two muscles beneath apart with retractors to reveal the hip joint – all in less than a minute.
The joint is removed and replaced with a titanium shell that goes into the socket, a plastic insert and a ceramic head to act as the new joint before the retractors are removed and the incision and tissue sewn up.
‘The main approach in the UK is through the posterior, or back of the hip,’ says Dr Wilson. ‘It takes about 20 minutes just to reach the hip and requires the muscles to be detached and sewn up later, making for a slower recovery time.’
The speed of the Rapid Recovery procedure also reduces the chance of infection, Dr Wilson explains, as there’s not enough time for the body to recolonise bacteria on the skin – the primary cause of surgical infections.
The developer of the procedure, German surgeon Dr Kristian Kley, says he’s had just three infections in more than 7,000 procedures over the past 15 years. In the UK, the average rate of infection for double hip replacement is around two or three in every hundred.
The procedure is currently offered at the Cromwell Hospital in London, where surgeons say 80 per cent of patients are walking within two hours – and 95 per cent walk out the door the next day. ‘Because people are on their feet so quickly, the risk of blood clots is massively reduced,’ says Dr Wilson.
The technique allowing 90 per cent of patients to be up and walking on the same day as surgery – without crutches (file photo)
‘Patients are often told after a double hip replacement that they can’t drive for six weeks – we say that they can after a fortnight.
It’s a much quicker recovery and much safer – and we intend to make the procedure available for as many people as possible, as soon as possible.’
The operation costs around £17,000 privately. But Dr Wilson and Dr Kley say they’re running courses to teach the procedure to NHS surgeons, as well as running a visitation and fellowship programme at Dr Kley’s clinic in Germany.
And NHS consultant knee and hip orthopaedic surgeon Dr Arj Imbuldeniya hopes to offer the surgery at Chelsea and Westminster Hospital in London by early next year.
‘While other successful techniques for hip replacement surgery with a next-day recovery exist, the Rottinger Approach takes less than half the time and data suggests it’s safe,’ he says.
‘I wanted to help our long NHS hip replacement waiting lists by increasing the number of hip replacement cases I could do safely in a single day from three cases currently to up to six.
‘It’s a safe and cost-effective solution for our poor patients who currently wait a very long time for surgery on the NHS.’
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