A hip replacement procedure where patients leave 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 protects the muscle surrounding the joint, allowing 90 percent of patients to be able to get up and walk the same day of surgery, without crutches.
And although it is currently mainly available privately in the UK, several expert surgeons told The Mail on Sunday that they hope the operation will 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 orthopedic surgeon at private clinic Oveli Healthcare.
‘And what this very intelligent technique has achieved is to take a procedure that already works well and transform it in terms of safety and speed.
‘The average time for a double hip arthroplasty using the standard operation is 90 minutes; Now we can do it in a third of that time. “By reducing waiting list times and saving the NHS millions, this will help thousands of people.”
Just under 100,000 people in the UK had hip replacement surgery last year. Recovery from the operation usually takes a few months and the average waiting time is 128 days, compared to 87 days before Covid.
A new hip operation where patients leave hospital just 24 hours after the procedure could halve waiting lists in the UK (file photo)
The new technique, called the “Rapid Recovery” or Rottinger Approach, promises to get patients out of the hospital as quickly 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, in Rapid Recovery surgery doctors make an angled incision from the side of the body.
Cutting just 5-6cm of skin and a thin layer of tissue, they then separate the two muscles underneath with retractors to reveal the hip joint, all in less than a minute.
The joint is removed and replaced with a titanium shell that is inserted 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 back of the hip,” says Dr Wilson. “It takes about 20 minutes to get to the hip and the muscles need to be separated and stitched later, making the recovery time slower.”
The speed of the rapid recovery procedure also reduces the chance of infection, explains Dr. Wilson, since there is not enough time for the body to recolonize skin bacteria, the leading cause of surgical infections.
The developer of the procedure, German surgeon Dr. Kristian Kley, says he has had only three infections in more than 7,000 procedures in the past 15 years. In the UK, the average infection rate for double hip replacement is around two or three in every hundred.
The procedure is currently offered at London’s Cromwell Hospital, where surgeons say 80 percent of patients are walking within two hours and 95 percent are out the door the next day. “Because people get on their feet so quickly, the risk of blood clots is greatly reduced,” says Dr. Wilson.
The technique that allows 90 percent of patients to get up and walk on the same day of surgery, without the need for crutches (file photo)
‘Often after a double hip arthroplasty, patients are told they cannot drive for six weeks; We say they can do it after fifteen days.
“It is a much faster and safer recovery, and we aim to make the procedure available to as many people as possible, as soon as possible.”
The operation costs around £17,000 privately. But Dr Wilson and Dr Kley say they are running courses to teach the procedure to NHS surgeons, plus a visiting and fellowship program at Dr Kley’s clinic in Germany.
And Dr Arj Imbuldeniya, an NHS consultant orthopedic knee and hip surgeon, hopes to offer the surgery at London’s Chelsea and Westminster Hospital early next year.
“While there are other successful techniques for hip replacement surgery with next-day recovery, Rottinger’s method takes less than half the time and data suggests it is safe,” he says.
‘I wanted to help our long NHS hip replacement waiting lists by increasing the number of hip replacement cases I could safely perform in a single day from three current cases to up to six.
“It is a safe and cost-effective solution for our poor patients who are currently waiting a long time for surgery on the NHS.”