Enhanced recovery after hip replacement

James Gibbs and Philip Stott

Having a hip replacement is a major operation and traditionally patients would spend a long time recovering. But James Gibbs and Philip Stott, the hip specialists at Spring Orthopaedics, get people back on their feet within hours of having their new hip fitted.

Since the 1960’s millions of people have been given a new lease of life thanks to a hip replacement. The procedure is usually carried out because the joint has arthritis, making it stiff and painful to move. The hip replacement operation involves replacing the “ball” at the end of the thigh bone with an artificial one, and lining the “socket” of the pelvis with an artificial cup so that the joint can once again move smoothly and painlessly.

Over the years a great many technical developments have been made, but nonetheless, it is still a major operation, usually needing several days in hospital. But the Enhanced recovery programme that the Spring Hip Service follows means that patients are often well enough to go home within 48hrs of their operation. Surgeon James Gibbs explains how they achieve this: “There is a great deal of evidence to show that the sooner people get up on their feet after an operation the quicker they will recover both physically and emotionally.

“Although it may seem rather brutal to get someone out of bed almost as soon as they have come round, it really isn’t. Our patients have a team of people looking after them – their consultant surgeon and anaesthetist, a physiotherapist and specialist nurses who work together to make sure the patient is secure and comfortable with every aspect of their care. Our patients are given a special type of anaesthetic into the spine which is a lower dose than usual. This means they are less likely to feel sick or light-headed when they wake up. We also administer a painkilling injection into the hip during the operation to reduce post-operative pain. All of this means they can get up and walk within hours of surgery.

The benefits of the enhanced recovery programme go far beyond a shorter stay in hospital. Patients who get up on their feet quickly find they need less painkillers in the days following the operation and are also less likely to get post-operative complications.

Spring hip surgeon Philip Stott said: “Most of my patients are able to follow an enhanced recovery programme whatever their age. In fact, in some ways, it’s the older people who really benefit as they are more prone to getting complications. Lying in bed for a long time after an anaesthetic can make you vulnerable to deep vein thrombosis or even pneumonia, so getting up and about is the best thing to do.”

But a speedy recovery is not all down to the health professionals - patients also need to take some responsibility for their health prior to coming into hospital. “Keeping as active as possible, eating healthily and losing weight if necessary, cutting back on alcohol and giving up smoking before your operation will all help towards a faster recovery,” said James Gibbs. “It might sound like a lot of hard work but it will be well worth it when you are back at home, managing well with your new hip within a couple of days or so.”