With 4.46m in the UK currently on the waiting list for routine treatments like hip or knee operations, there are currently many people at home having to withstand hip or knee pain until they’re offered a date for surgery. Others might be postponing surgery because they have misconceptions about the scale and the severity of the operation.
The prospect of a hip or knee replacement can often seem daunting – but it doesn’t have to be. Most people’s idea of what a joint replacement entails is actually far more drastic than the reality; and advances in medical technology and technique mean it’s now a far less complex procedure than it used to be.
Mr Sujith Konan is a consultant orthopaedic surgeon at St John & St Elizabeth Hospital, where his high-volume clinical practice focuses on all aspects of hip and knee surgery. Here, he explains why hip and knee replacement is nothing to be worried about, how St John & St Elizabeth Hospital eliminates waiting times and outlines the specifics of the procedure and recovery times.
It’s a much less drastic operation than people think.
It’s basic human nature to be scared of having a part of your body replaced, but most of these procedures are very delicate, planned surgeries where we replace surfaces and articulations (which is the joint). The success rate is extremely high and furthermore, there is only a 1% chance of anything going wrong during a hip or knee replacement, and anything that does go wrong can be managed and rectified.
What I’ve noticed is that when people are scared, it’s the result of a lack of information and understanding about the procedure – and, even more importantly, a failure to grasp the magnitude of the positive change it can bring to their lives. Once people hear about the impact a joint replacement can have – often from friends or family – their fear disappears quite quickly!
A joint replacement will completely change your quality of life – for the better.
I would say that a hip replacement completely changes your quality of life and makes you feel like a different person almost 99% of the time, and in the case of a knee replacement it’s more approximately 95% of the time.
For someone who is living with hip or knee pain that is making it hard to enjoy their life, I tell them it’s a game changer; for these people they often have a completely restored quality of life as a result of total pain relief.
A hip or knee replacement only requires a short stay in hospital.
In today’s world, with the technology and the techniques we have, a hip replacement is usually a very straightforward, streamlined and well-rehearsed process.
Before patients come in for their surgery, they are pre-assessed to ensure they are medically fit for surgery. This is often guided by the anaesthetic team who ensure the patient’s heart, chest and so on are fit to undertake the procedure. This precedes the procedure so that if there are any issues we have enough time to make necessary adjustments.
After the pre-assessment, patients will come in for the operation, and at this point there are two pathways they usually follow:
Day-case pathway. This means that the patient will go home on the same day that their procedure takes place. Medically fit patients who have reasonable social support will often take the day-case pathway, and this will always be communicated to them well in advance.
Inpatient pathway. This means the patient will stay in hospital for one or two nights after their procedure, either because they don’t have the necessary support at home, or because they have a medical condition that requires us to observe them for a bit longer after the procedure.
We have new safety measures in place in light of COVID.
After a patient is told by a consultant that they will have surgery, a referral form is sent to Admissions and signed off by theatres. The patient is called and offered an appointment, which is then booked into the system and the patient is emailed with some questions about their medical history. At this point, the admissions team schedule a COVID test to be carried out 3-7 days in advance of their surgery, and it is made clear that the patient must isolate for the time between the test and their operation.
If they are unable to attend a COVID test at the hospital then one is sent out for them, but otherwise patients are required to travel into hospital in their own transport rather than on public transport – both for the COVID test and their surgery. Under the current circumstances, pre-assessments are carried out over the phone a day prior to the operation.
We support patients with physiotherapy after their procedure.
After the patient wakes up after the operation, the patient is seen by a physiotherapist, who will start walking them and making them do exercises on the joints so they get moving straight away.
There are two types of recovery that we talk about, one being the ‘immediate recovery’ which refers to when patients can go home, followed by the delayed recovery that refers to specific, higher intensity activities. For many, ‘immediate recovery’ will be on the same day, and they’ll be walking, drinking, eating and doing simple exercises focused on the joint that has been replaced. The wound usually takes up to two weeks to heal, and the patient will be taking oral pain medication – nothing too strong – while the pain from the procedure settles down.
We support all of our patients in their individual aims, first by giving them a set of exercises to do during the two weeks after they leave hospital. After two weeks they return to the hospital for a surgeon to check their wound has healed correctly, and start some outpatient physiotherapy where they step up their exercises and activities. The outpatient physiotherapy continues until they have reached their personal recovery goals; for example, long walks , gym, exercises and sports.
Our orthopaedic department has a team-based approach, with quick results.
We have a team of hip and knee specialists working together on similar principles, which offers the opportunity to discuss and pass on cases based on expertise. The Hospital has been in place for a long time and has dealt with a high volume of joint replacements – both simple and complex – so they are highly capable of dealing with all sorts of needs and demands.
However, the key attraction for a place like St John & St Elizabeth Hospital is that the time between seeing a specialist and taking the decision to proceed to surgery to having the surgery itself is quick and streamlined for a medically optimised person. An excellent team provides planned care tailored to individual patient needs
Don’t let COVID put you off having a joint replaced.
Proceeding with joint replacement surgery during COVID should be discussed with your Orthopaedic surgeon. In my opinion, we have very well established pathways to manage joint replacement patients during the COVID pandemic and we know from experience that hip and knee replacements can be undertaken safely by adhering to our guidelines. There is absolutely no need to struggle with painful hips and knees that significantly affect your quality of life and sleep.
If you have a health concern you’d like to get seen to sooner rather than later contact our team by heading to our contact page, calling us on +44 (0)20 7806 4000 or emailing us at firstname.lastname@example.org.