Thousands to benefit from new hip replacement operation which allows patients to walk just hours after the procedure is completed

• Most patients undergoing a hip replacement spend up to five days in hospital
• A new technique could see 80 per cent of patients sent home within 24 hours
• The high-tech keyhole surgery avoids cutting through muscles and tendons
• As a result, recovery times are sped up and the operation is far less painful  

People who have had a hip replacement operation could be walking out of hospital within hours thanks to new minimally invasive surgery being introduced to the NHS.

Currently, many of the 95,000 Britons undergoing hip replacements every year will spend up to five days in hospital, unable to walk. But thanks to the new technique, 80 per cent of patients will be sent home within 24 hours.

The high-tech approach avoids cutting through tough muscles and tendons, making the procedure far less painful and speeding up recovery times.

The new procedure is minimally invasive allowing the patient walk within hours of the operation, unlike the earlier technique which required muscles to be cut apart

Patients undergoing the radical new procedure can be released home the following day

Paul Robertson, 51, a business consultant from Leicestershire, was the first patient to have the operation on the NHS at Leicester General Hospital in April. A couple of hours after the procedure, the father-of-three was walking up stairs with the help of crutches, and returned home the next morning.

He says: ‘I expected to be in agony afterwards but instead the pain was minimal.’

The hip joint is made up of a ball attached to the end of the thigh bone – also known as the femur – and a socket, which is part of the pelvis. Hip replacements involve swapping the damaged ball and socket for new, artificial parts.

This is most commonly needed in patients aged between 60 and 80 who develop arthritis in the joint.

This happens when the cartilage – the smooth elastic tissue which cushions the joint – wears away. The bones either side then rub the joint, creating friction that causes agonising pain and affects movement. In a traditional hip replacement, the surgeon makes a large cut of roughly 20cm through the thigh muscle and dislocates the hip to make room to insert the new joint. But the new method, called SuperPath, is far less invasive, requiring an incision of just 5cm.

Rather than cutting through the muscle, it is simply moved aside. No dislocation is needed either because the surgeon uses intricate movements and tools to reach the damaged socket.

‘The approach causes very little damage to the tissue around the hip,’ says Ashwin Kulkarni, consultant orthopaedic surgeon at University Hospitals of Leicester NHS Trust. ‘This means there’s less blood loss and pain, and recovery is much quicker.

‘Patients are able to get back their full hip function very quickly.’

Another advantage is that it reduces the risk of patients dislocating their hip in the months after surgery, which can occur with normal hip replacements. ‘Because we don’t dislocate the hip, it makes the joint stronger afterwards,’ Mr Kulkarni says.

The operation, which takes an hour, is normally carried out under general anaesthetic. With the patient positioned on their side, the surgeon makes the 5cm incision over the buttock. The hip muscles are moved to either side to expose the joint. While the incision is smaller than in normal hip operations, the surgeon can still see clearly inside. The joint is surrounded by a stiff layer of tissue called the hip capsule which is cut through with a hot scalpel to expose the ball. The surgeon then uses a drill to create a hollow vertical space inside the thigh bone.

The old, diseased ball, which is attached to the end of the thigh bone, is cut off and removed.

Then, after reshaping the old socket, a new titanium socket with a cushioned plastic or ceramic liner is fitted in place. Finally, a titanium-alloy stem – the stick of the new artificial joint – is used to fill the hollow gap inside the thigh bone.

The new artificial ball is attached to this piece of metal and put in position inside the pelvic socket.

With the new joint assembled, the muscles are moved back in place and the cut stitched up.

Mr Robertson, a keen sportsman, had the procedure in April to treat agonising arthritis. ‘I couldn’t play tennis, and even getting up from a chair hurt,’ he says.

He was back at work and driving three weeks after the operation, and back on the golf course within four. ‘What amazed me most was the speed of the procedure, and the little time it took to recover.

‘I was up and walking relatively quickly and wasn’t dwelling on using my leg. Now I’m playing tennis again without any pain. It’s really changed my life, and it’s wonderful that it’s on the NHS.’

SuperPath – possible in up to 80 per cent of patients needing a replacement hip – is also being trialled by the NHS at Hereford County Hospital.

 

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