How to choose a surgeon for a hip replacement

Choosing a surgeon is both a personal decision but also a very technical one. Your choice of surgeon will determine everything from the cost of the surgery to the quality of the outcome of the operation. So, it’s critical to make a good choice.

The Checklist

A quick overview. When choosing a surgeon for your hip replacement it is important you consider and get as much information about the following:

• How many hip replacements they perform a year
• The results they achieve and experience of their patients
• The surgeon’s team, medical and support staff
• Rapid Recovery Programmes
• Their specialist approach to a hip replacement

Armed with that knowledge you have the best possible chance of a fast recovery and a very positive long term outcome from your operation.

A surgeon’s experience

Like most things in life, a good rule of thumb is, ‘the more you do of something, the better you get at it’. The same is true for a surgeon and their team. Everything that contributes to a good outcome for your patient - how accurately the new joint is placed into position, how little trauma you cause to the surrounding muscle/ tissue, how long the surgery takes to minimise risk of infection - is all determined by the skill of the surgeon. And that skill comes from practice.

So, I would always recommend a patient selects a surgeon performing over 100 - even 150 - hip replacement operations a year. This guarantees they have the right level of experience to give their patients the best possible chance of a good outcome.

It also ties in with the second criteria I’d look for in a hip replacement surgeon - what the medical establishment calls outcomes.

Hip replacement results, outcomes and evidence

'Outcomes' are measures of how successful our operations are. Whenever a surgeon performs a hip replacement, that operation is entered into the National Joint Registry (NJR). This allows independent assessment of their long-term outcomes. Patient reported outcome measures (PROMS) data is also collected to assess the quality of the experience from the patient giving an insight into the Surgeon and the process. Information such as how quickly they returned to normal activity, how much pain they experienced, and quality of life improvement is captured in PROMS data.

Surgeon outcomes are the best way to judge the capability of a surgeon and what you can expect after surgery at key milestones.

You can view surgeon outcomes on the Compare my Care platform. I would only be treated by a Surgeon achieving great outcomes for their patient.

The surgeon’s wider team

Your experience of a hip replacement isn’t just down to the Surgeon’s skill, it is also down to the team supporting that Surgeon. The Anaesthetist, the physiotherapist, nursing team and Practice Manager/PA who organises your treatment pathway and ensures everything runs smoothly.

Surgeons who have busy private practices, treating a lot of patients tend to have an experienced specialised team, with each person knowledgeable of their unique role in achieving better outcomes and a faster recovery for patients.

Senior surgeons have teams around them. That improves patient care.

The team set up is perhaps the hardest aspect of a Surgeon’s practice to judge without in-depth insider knowledge of the Surgeons in your locality. Typically, the best way to do so is by speaking to friends or reading reviews of the Surgeon on platforms such as Doctify. All Surgeons on Compare My Care will have team setups similar to what is described above due to the nature of their high-volume practices.

Rapid Recovery Programmes

In the early 2000’s when length of hospital stay for hip replacement surgery was often over a week, I initiated a new system for the NHS in the South of England. This essentially meant getting all the people who worked with me together to help patients recover more quickly: Anaesthetist, Physiotherapists, Pharmacists, Occupational Therapists, Ward Staff – everyone involved in the patients care and we looked at how we could optimise every element of their care. As a result patients were able to leave hospital within 2 days of their surgery with the many benefits that follow, especially lower hospital acquired infection rates.

Patients were able to leave hospital in 2 days rather than a week.

The surgeon’s surgical approach to a hip replacement

From robotic surgery to keyhole (minimally invasive) surgery, Surgeons tend to have slightly different approaches to carrying out a hip replacement. Whilst all have merit, some approaches might be better suited to particular patients. Therefore, understanding your Surgeon’s preferred approach, how long they have been using it and why it is right for you should help you understand what is involved and reassure you.

For example, my own approach – a muscle sparing, minimally invasive hip replacement allows for smaller incisions, minimal blood loss and faster recovery from surgery. However, it means I work through a smaller incision in the hip through which I perform the replacement. This takes time and experience to perfect. I have performed over 2000 hip replacements using this Direct Superior Interval (Anterior) Approach with one of the lowest revision (failure) rates in the UK.

To book a consultation with Mr Apthorp, or speak to one of our team, you can call 020 8064 0875.

To find out more about the approaches to do a hip replacement operation and their pros and cons, read my other articles in the 'More Insight' column.