While hip replacement surgery is now a routine operation, the procedure is constantly being revised and updated, with new advancements as technology advances.
Andrew Carrothers, consultant orthopaedic and military surgeon, uses Symbios custom implants or MAKO robotic arm-assisted surgery to provide the best possible outcomes for patients. In this blog we explore the benefit of Symbios custom implants and MAKO.
Patient satisfaction levels following joint replacement
If you are experiencing severe pain due to arthritis or injury you may have been offered hip replacement surgery. Around 1,191,000 total hip replacements are performed in the UK each year but, sadly, patient satisfaction after surgery is not guaranteed. In 2-3% of patients who have a hip replacement, there is no improvement or symptoms may even worsen. This may be due to complications or other pre-existing problems such as spinal conditions.
The risk of leg length discrepancy
Some patients experience a discrepancy in the length of their leg after a total hip replacement. Most commonly the leg that has been operated on becomes longer than the other leg – up to 17mm longer in some cases, although in the majority (97%) of patients the discrepancy is below 10mm. Some patients experience minor symptoms as a result of leg length discrepancy and these tend to decrease over time. In others, however, it can cause lower back pain, sciatica, instability and problems with gait. A discrepancy in leg length may increase the risk of developing other osteoarthritis in the lower limb or the hip implant loosening and may lead to the need for further surgery.
Custom made implants for better performance
Using custom made implants helps to prevent lower leg discrepancy and reduces the risk of complications. Carrothers Orthopaedics uses Symbios implants that are fully customised to the individual patient anatomy (‘patient specific implant’) or MAKO robotic arm assisted surgery which ensures that surgical implantation is designed for the patient’s unique anatomy (‘patient specific implantation’).
Symbios custom made hip implants
Symbios, based in Switzerland, has consistently achieved excellent results in the National Joint Registry as the best performing cementless stem implant. All prosthetic implants will wear out over time and need to be replaced. However, 94.5% of patients receiving the Symbios custom made implant experience good performance levels 25 years after surgery. Throughout the world Symbios is regarded as the gold standard of custom made hip implants, offsetting problems with leg length discrepancy and offering better performance, faster recovery times and increased hip replacement longevity.
MAKO robotic arm assisted surgery
In some cases, Carrothers Orthopaedics recommends MAKO robotic arm-assisted technology for total hip replacements as it creates a personalised ‘patient specific implantation’ using standardised prostheses and deliver pinpoint accuracy during surgery.
How MAKO works
MAKO technology uses a CT scan to create a 3D model of the patient’s hip prior to surgery (we also use it for knee replacements). Using this model, the surgeon uses the MAKO software to produce a personalised standard implant surgical plan, which is the closest match to the patient’s natural joint and optimised to fit with their anatomy. In short, MAKO helps the surgeon to devise a pre-operative plan which identifies the ideal positioning and orientation of the implant. During surgery the MAKO robotic arm actively controlled by the surgeon, which has a burr or saw/reamer attachment, will only allow cutting bone to the planned boundary. It moves with fluidity and control and the surgeon can see a real-time feed in three different dimensions on a screen.
The benefit of MAKO is that only those parts of the joint that are diseased are removed and healthy areas of the bone and tissues remain untouched. By preserving as much healthy bone and tissue as possible, not only are recovery times shortened but if revision surgery to replace a worn-out implant is ever needed the risk of complications is likely to be lower.
If you are due to undergo a hip replacement, talk to us about the different options available to you and how we could support you to improve the outcomes of your surgery. Andrew Carrothers currently has 455 five-star reviews on the I Want Great Care website in relation to his NHS and Private hip, knee and ankle surgeries.
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Please be reassured that despite the ongoing UK Covid-19 pandemic, orthopaedic treatments are now again being routinely offered to patients. Having the vaccine does not mean that your treatment won’t go ahead. However, in some circumstances, such as for planned surgery, it is advisable to delay it by a couple of weeks to ensure your body responds in the optimum way to the vaccine. If in doubt, please talk to your orthopaedic consultant or contact us for more guidance to help get your orthopaedic treatment back on track.
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