THE baby-boomer generation has set trends since its noisy, attention-seeking arrival and continues to do so, particularly in its attempts to stay young forever.
The medical world is doing its best to keep up with boomer demands and is succeeding spectacularly in the field of total hip replacements.
The operations are increasingly helping people, aged between 60 and 80, and even older, with hip problems to keep walking, hiking and climbing. At a similar age, their parents probably had stooped backs, needed walking sticks, or were in wheelchairs.
The procedure replaces an arthritic or damaged hip joint with a prosthetic one akin to a ball and socket. The goal is to relieve pain and improve the motion in a hip.
"It is likely the number of hip replacements will increase by 300% to 400% over the next 10 to 15 years," says a Johannesburg orthopaedic surgeon, who asked not to be named.
He has replaced about 3,500 hips in the past couple of decades. In the US, it is estimated that 340,000 hip replacements are performed a year, enabling the majority of patients to walk pain-free again.
The average age of people who now have a replacement is 75, whereas a decade ago it was 65, says the surgeon.
"But people are living longer and remaining healthier," he adds.
Johannesburg artist Frances Kendall, 69, has had both her hips replaced in the past four years because arthritis was restricting her active outdoor life.
"I walked every day and when the level of pain began to inhibit my activities, I consulted an orthopaedic surgeon," Kendall says. "I left an 18-month gap between the hip replacements."
She recovered quickly from what the medical fraternity describes as one of the most effective surgeries today. Still, her friends were astonished when she climbed a volcano in Bali last year.
"It was a three-hour hike and the only discomfort was losing a toenail due to pressure from my boots on the way down," she says.
There are several surgical approaches surgeons can use. The typical hip replacement procedure uses one of two approaches performed through small incisions located on the buttock or the upper thigh. One is called a posterior-lateral approach and the other is the anterior-lateral approach.
"The posterior approach through the buttock muscle is still the most popular approach done today," says the surgeon.
Kendall’s total hip replacement was carried out using minimally invasive surgery, through an anterior-lateral approach. This largely spares the muscles and also limits neurovascular complications.
...
THE anterior approach, sometimes called the "true anterior approach" to distinguish it from the anterior-lateral approach, uses one small incision on the front of the upper thigh, near the groin.
In anterior minimally invasive surgery, the surgeon works through an opening between the muscles, which means neither they nor the tendons are cut. Advocates of this say there is less pain and blood loss, shorter hospital stays, and a faster return to mobility.
This appealed to Johannesburg businessman Neil Surgey, who needed to get back to a normal lifestyle as soon as possible. He did research and consulted two surgeons before opting for the anterior approach.
"I have a condition called FAI, or hip impingement, which means the ball of the femur does not fit properly into the socket of the hip joint," Surgey says.
After his operation, he was away from his office for less than a month and made a full recovery after six months. He needs to have his other hip replaced and will go the same anterior route.
"I want my two twentysomething sons to be examined in case they have the same congenital condition I have. If so, they can have arthroscopic surgery to repair any damage to the cartilage and, hopefully, avoid a full hip replacement," Surgey says.
Both he and Kendall were surprised to learn that New York City surgeons are performing an outpatient hip-replacement procedure. The Wall Street Journal described last month how a patient admitted for surgery in the morning was walking on crutches by midafternoon. He was discharged by 6pm.
The surgeon used the anterior approach which, it is estimated, is used by 25% of American orthopaedic surgeons doing total hip replacements. The surgeons are increasingly using a special operating table to help them to manipulate a patient’s body to improve access to the surgical site.
If you have the stomach for it, you can watch one of these operations, as I did for an hour, on YouTube, accessed through The Latest Procedure — an American multimedia project encouraging patients to become smarter health-care consumers by providing integrated and interactive content.
But whichever procedure is used, the recovery period levels out after about six weeks, says a Johannesburg orthopaedic surgeon. Most patients recover fully from a hip replacement after about three to six months, regardless of the surgical approach.
What matters is the correct placement of the prostheses, and that they be given adequate opportunity to let the bone grow on to them. This determines how long they will last — an important consideration for younger people.
The surgeon compares it to a crown being fitted to a tooth. Some settle down for life, others occasionally come off.
He also suggests that hip replacements be approached from a holistic perspective.
Most men go home to a wife who will cook and care for them. Many women do not, which is why "they tend to stay longer in hospital. It makes sense."
...
THE surgeon says many people who have the outpatient hip replacement in the US move out of the hospital and straight into an hotel over the road. This can be likened to going from an acute high-care situation to a step-down facility. They are still not able fully to care for themselves.
"Physiotherapists and doctors can visit them there, the surroundings are more convivial than that of a hospital, the food is better, and the room rates more reasonable," says the surgeon.
Surgey went home to his organised, caring wife, Sheila. Kendall went to stay with a close friend after each of her hip replacements "because I knew I would have total care and delicious food, something my busy husband could not provide".
Her perspective is underlined by her description of the day he took her home.
"On the way there, we went to Pick n Pay to do the shopping. I clutched the trolley. I managed."
An increasing number of people are having hip replacements, which can be carried out using minimally invasive surgery. Picture:ISTOCK
THE baby-boomer generation has set trends since its noisy, attention-seeking arrival and continues to do so, particularly in its attempts to stay young forever.
The medical world is doing its best to keep up with boomer demands and is succeeding spectacularly in the field of total hip replacements.
The operations are increasingly helping people, aged between 60 and 80, and even older, with hip problems to keep walking, hiking and climbing. At a similar age, their parents probably had stooped backs, needed walking sticks, or were in wheelchairs.
The procedure replaces an arthritic or damaged hip joint with a prosthetic one akin to a ball and socket. The goal is to relieve pain and improve the motion in a hip.
"It is likely the number of hip replacements will increase by 300% to 400% over the next 10 to 15 years," says a Johannesburg orthopaedic surgeon, who asked not to be named.
He has replaced about 3,500 hips in the past couple of decades. In the US, it is estimated that 340,000 hip replacements are performed a year, enabling the majority of patients to walk pain-free again.
The average age of people who now have a replacement is 75, whereas a decade ago it was 65, says the surgeon.
"But people are living longer and remaining healthier," he adds.
Johannesburg artist Frances Kendall, 69, has had both her hips replaced in the past four years because arthritis was restricting her active outdoor life.
"I walked every day and when the level of pain began to inhibit my activities, I consulted an orthopaedic surgeon," Kendall says. "I left an 18-month gap between the hip replacements."
She recovered quickly from what the medical fraternity describes as one of the most effective surgeries today. Still, her friends were astonished when she climbed a volcano in Bali last year.
"It was a three-hour hike and the only discomfort was losing a toenail due to pressure from my boots on the way down," she says.
There are several surgical approaches surgeons can use. The typical hip replacement procedure uses one of two approaches performed through small incisions located on the buttock or the upper thigh. One is called a posterior-lateral approach and the other is the anterior-lateral approach.
"The posterior approach through the buttock muscle is still the most popular approach done today," says the surgeon.
Kendall’s total hip replacement was carried out using minimally invasive surgery, through an anterior-lateral approach. This largely spares the muscles and also limits neurovascular complications.
...
THE anterior approach, sometimes called the "true anterior approach" to distinguish it from the anterior-lateral approach, uses one small incision on the front of the upper thigh, near the groin.
In anterior minimally invasive surgery, the surgeon works through an opening between the muscles, which means neither they nor the tendons are cut. Advocates of this say there is less pain and blood loss, shorter hospital stays, and a faster return to mobility.
This appealed to Johannesburg businessman Neil Surgey, who needed to get back to a normal lifestyle as soon as possible. He did research and consulted two surgeons before opting for the anterior approach.
"I have a condition called FAI, or hip impingement, which means the ball of the femur does not fit properly into the socket of the hip joint," Surgey says.
After his operation, he was away from his office for less than a month and made a full recovery after six months. He needs to have his other hip replaced and will go the same anterior route.
"I want my two twentysomething sons to be examined in case they have the same congenital condition I have. If so, they can have arthroscopic surgery to repair any damage to the cartilage and, hopefully, avoid a full hip replacement," Surgey says.
Both he and Kendall were surprised to learn that New York City surgeons are performing an outpatient hip-replacement procedure. The Wall Street Journal described last month how a patient admitted for surgery in the morning was walking on crutches by midafternoon. He was discharged by 6pm.
The surgeon used the anterior approach which, it is estimated, is used by 25% of American orthopaedic surgeons doing total hip replacements. The surgeons are increasingly using a special operating table to help them to manipulate a patient’s body to improve access to the surgical site.
If you have the stomach for it, you can watch one of these operations, as I did for an hour, on YouTube, accessed through The Latest Procedure — an American multimedia project encouraging patients to become smarter health-care consumers by providing integrated and interactive content.
But whichever procedure is used, the recovery period levels out after about six weeks, says a Johannesburg orthopaedic surgeon. Most patients recover fully from a hip replacement after about three to six months, regardless of the surgical approach.
What matters is the correct placement of the prostheses, and that they be given adequate opportunity to let the bone grow on to them. This determines how long they will last — an important consideration for younger people.
The surgeon compares it to a crown being fitted to a tooth. Some settle down for life, others occasionally come off.
He also suggests that hip replacements be approached from a holistic perspective.
Most men go home to a wife who will cook and care for them. Many women do not, which is why "they tend to stay longer in hospital. It makes sense."
...
THE surgeon says many people who have the outpatient hip replacement in the US move out of the hospital and straight into an hotel over the road. This can be likened to going from an acute high-care situation to a step-down facility. They are still not able fully to care for themselves.
"Physiotherapists and doctors can visit them there, the surroundings are more convivial than that of a hospital, the food is better, and the room rates more reasonable," says the surgeon.
Surgey went home to his organised, caring wife, Sheila. Kendall went to stay with a close friend after each of her hip replacements "because I knew I would have total care and delicious food, something my busy husband could not provide".
Her perspective is underlined by her description of the day he took her home.
"On the way there, we went to Pick n Pay to do the shopping. I clutched the trolley. I managed."
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