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Hip Replacement (Evidence based)

Hip ReplacementOpinion and Philosophy on Hip Replacement

Mr Taylor believes the gold standard hip replacement is a ceramic on polyethylene "ball and socket" but now uses more ceramic on ceramic bearings as the longer term results are being published. The implant for the femur he decides on an individual basis depending on the quality of the bone and its shape/anatomy. Templating of X rays is useful before the operation to optimise the fit for each individual hip.

Procedures:

Bilateral Hip Replacement.* : Hip Replacement in the young adult : Limited Incision.

* Bilateral Hip Replacement - Mr Taylor has a personal experience of over 180 bilateral total hip replacements carried out as a single operation. The advantages are if that both hips are bad that the other hip does not hold back recovery from the first replacement and the hospital stay is on average only 1 day longer than the single operation. Hydrotherapy is particularly valuable in the rehabilitation period.

The age argument: " Am I too young and if I wait will I be able to avoid having it done again" or "Am I too old" ?

This is a common question and totally understandable because nobody wants any more operations than is necessary. Mr Taylor's opinion is that no operation can be guaranteed to last a lifetime and quality of life when you are young enough to enjoy all the benefits is crucial. For example: if you need a hip replacement at 55 and it lasts 15 years but you struggle on to 58 you may need another operation at 70 rather than 73. All the patient has is 3 more years of increasing disability when they are younger and fitter. This would seem to question the argument of waiting.

Age is today rarely a reason not to have an operation to relieve pain and replacements ar now commonplace in the 80's and 90's.

Cemented v Uncemented Hip Replacement

Over the age of 65 no Hip Replacement outperforms a cemented replacement (National Joint Registry). Uncemented Hip Replacement has gained popularity in attempts to improve survival rates as more younger patients are undergoing surgery.

The Uncemented replacement is attached to the bone initially by a "press fit" which is initially a mechanical fixation. The surface is covered with a coating which allows the bone to grow onto the surface creating a biological fixation. Mr Taylor favours Hydroxyapatite as the surface coating.

Mr Taylor makes his definitive selection at operation depending on age, bone quality (osteoporosis) and bone shape/anatomy but will discuss the options with you. The clinical outcomes in relation to function and range of movement are equivalent.