Minimally invasive hip replacement with Hugh Apthorp

Compare my Care speaks to Mr Hugh Apthorp, Consultant Hip Surgeon specialising in minimally invasive hip replacement. Mr Apthorp is one of the top 3 in the country for the volume of hip replacments he performs (Source: National Joint Registry), and for the last 20 years has championed better outcomes and a faster recovery for hip replacement patients - for the NHS and in his private practice.

What outcomes can be achieved in hip replacement surgery today?

Hugh: Hip replacement surgery along with cardiac and cataract surgery have the highest success rates in medicine today. Indeed, success rates - improvements in pain, function and quality of life after surgery - can exceed base levels of a 95% in the right hands. Since the 1960s, when breakthroughs in hip prostheses and surgical approaches occurred, incremental achievements have meant that for the vast majority of patients, their main regret was not having a hip replacement sooner.

What significant advances have occurred over the last 20 years to improve outcomes even further?

Hugh: There have been a number of advances in hip replacement surgery. The two areas I’ve dedicated my practice to in the last 17 years are: minimally invasive hip replacement and rapid recovery protocols. In the right hands, techniques and protocols like these have led to an already small number of failures and complications halving.

A minimally invasive incision forces a surgeon to be meticulous about blood loss and tissue damage to prevent pain, infection and a protracted recovery.

How is minimally invasive surgery improving success rates?

Hugh: The main goal of minimally invasive hip replacement is to safely carry out surgery minimising tissue trauma, blood loss and pain. It’s this bruising and trauma that typically results in more pain and stiffness, and hinder your recovery. Less trauma to the muscles allows a faster return to normal activities with less pain and tissue damage around the hip joint in order to improve outcomes.

Can the benefits of a minimally invasive approach be more than cosmetic?

Hugh: So, it’s not just a question of making a smaller incision for cosmetic reasons but rather, carefully doing the surgery in a way that avoids damage to the important muscles of the hip. This is where experience and expertise counts.

A better outcome is achieved by meticulous surgery, using specialist instruments and muscle sparing techniques. This type of surgery requires a specialist team with the experience to ensure consistently good results; opening tissue just enough with no over-cuts once inside, and avoiding muscle tissue. A small incision forces a surgeon to be meticulous about blood loss and tissue damage to prevent pain, infection and a slow recovery.

What are the benefits of minimally invasive hip replacement in the hands of a skilled surgeon?

Hugh: Due to less tissue and muscle damage, minimising blood loss, and early mobilisation (walking), recovery times are significantly improved. A good recovery following minimally invasive hip replacement is when by day two patients are climbing stairs, and within two weeks, driving if comfortable and in control. At six weeks my patients can look forward to 95% of their recovery and improvement - and a further 5% within a year of surgery. Standard practice would typically see longer timeframes.

Mr Hugh Apthorp focuses exclusively on hip surgery and is one of the country’s most experienced hip replacement surgeons. He performed 1176 primary and revision hip replacement procedures in the three years to 31 March 2021 (source: National Joint Registry). These volumes are 8.5 times the national average which correlates with his considerably higher than average success rates - alongside one of the lowest revision (failure) rates in the UK.