Successful hip replacement: what it feels like

How do we judge whether hip replacement is successful?

Hugh: Hip replacement is one of the most successful operations we can do in medicine. It takes patients who can hardly walk and within a few weeks they can be walking normally and they can often, for most patients, be walking normally for the rest of their life. And I judge success from hip replacement as when a patient forgets they've had an operation, they just get back to a normal life and never have to think about their hip and that is success.

If you love skiing and you can't ski because of your hip, and then you can ski again, that is how I judge success. Not whether you can walk to the shops because people need to do far more things these days and it's not my job to limit people, its my job to open up people's horizons again.

What objective measures of hip replacement are available?

Hugh: Obviously, you can judge success in terms of, what can people do, but there are now much more objective ways of judging success, external ways, and this success can be measured in a number of ways. One is, 'how long do hip replacements last?', and two is, 'how well do they work?' and we judge that using something called PROMs data, Patient Reported Outcome Measures and its a very helpful thing to help patients understand how successful surgery has been.

PROMs data is data collected independently by the government, through questionnaires sent to patients and asking practical questions about the things that affect them most, the things that judge whether they've had a successful operation or not.

And the wonderful thing about hip replacement surgery, is that if it's done properly, 98% of people will report good or excellent results

And the wonderful thing about hip replacement surgery, is that if it's done properly, 98% of people will report good or excellent results from their PROMs data and that's really important and really encouraging for the future, for patients coming to surgery.

What should a patient ask their surgeon?

Hugh: Consultants are all made aware of their outcome data and I think it's really helpful that people can be open and transparent and patients should be asking consultants 'what is your outcome data?', 'what are your revision rates?', 'What are your PROMs outcomes', because this data is freely available, we're all happy to discuss it, we're all happy to tell you how we can help you and what results we get.

How important is anaesthesia in successful recovery from hip replacement?

Hugh: The anaesthetic part of your surgery is vitally important. The anaesthetist has a huge role to play, both in how I can do the surgery and how you're going to get on later.

We use an anaesthetic technique where we numb your legs called a spinal anaesthetic, it's a very small injection into your back that numbs your leg. Because the operation takes about an hour, people like to be unaware of the surgery, so we tend to give you some sedation, so you don't actually remember anything about the surgery. You're completely comfortable, it's like time travel. You drift off to sleep before the operation starts, you wake up in recovery, and you're completely unaware.

You haven't had to have a horrible general anaesthetic that can make you sick and can effect your blood pressure. So within a few hours, because the anaesthetic is so good and the spinal anaesthetic wears off, we can get you up and around for a walk. People usually feel comfortable, they don't feel sick so they can have some food and we can start their journey to recovery straight after the operation.

Mr Hugh Apthorp performed 1176 hip replacement surgeries in the three years to March 2021 - more than 8 times the national average. Higher volumes of surgeries undertaken correlate with better outcomes and faster recoveries. Volumes of joint replacement surgeries performed are recorded by the National Joint Registry.