Andrew Carrothers Features in Acclaimed TV Series Performing Pioneering Treatment
Founder of Carrothers Orthopaedics, Andrew Carrothers showcased his extraordinary surgical skills in the new BBC series of Surgeons: At The Edge of Life. He was performing a combination of operations for cancer patients to help restore mobility.
The highly acclaimed BBC series, which features the pioneering work of some of the UK’s top surgeons, described Andrew as:
“pushing at the boundaries of medical science with a complex operation that he has devised called the Harrington Plus”.
It explained how he was frustrated by the limited options for patients whose hip bones and pelvis have been badly weakened by advanced cancer and set out to create a surgical approach to the problem.
What is the Harrington Plus Procedure?
The Harrington method is an established surgical procedure for reconstructing the pelvis due to damage caused by cancer that has metastasised (spread). It strengthens the patient’s own failing pelvis before a total hip replacement is carried out.
The original procedure entailed passing metal rods from the ileum to the ischium and pubis to create a scaffold onto which a hip replacement could be attached. Unfortunately, in extreme cases, particularly when much of the acetabulum (hip cup) is missing, it becomes more limited. Various attempts have been made to modify the original technique over the years. Originator Harrington suggested adding two further groups of threaded pins which were cemented together with a support ring. Further modifications were later made by Grimer and Tillman. Other surgical options are limited in this setting but the use of a tumour cone is also recognised.
Harrington Plus, which was pioneered by Andrew Carrothers four years ago, was developed for the treatment of the most severe cases of hemipelvic metastatic disease. It involves the use of a suprapectineal plate to provide additional support to the pelvis. In effect, the plate acts as a buttress to the medial wall of the pelvis and acetabulum. With the addition of the Harrington rods and steel mesh as needed, the total hip replacement can be performed.
What are the benefits of the Harrington Plus procedure?
The Harrington Plus method is biomechanically strong. When used in conjunction with total hip replacement surgery, it means the joint is immediately able to bear the patient’s weight, allowing a return to function of the damaged hip.
To date, this operation has been performed on fewer than 20 patients so it is impossible to give an accurate picture of longer term outcomes in a broad cross-section of patients. The risks including bleeding are high, nevertheless, among those for whom it has been performed, it has been shown to produce good results and to allow weight bearing through the cancer destroyed joint.
Who can undergo the procedure?
Surgical reconstruction is generally offered to patients with a good prognosis who have suffered significant loss of function in the pelvis and hips due to metastatic cancer.
Why is it needed?
Bone is the third most common place that cancer cells can spread in the body, after the lungs and liver. Fractures caused by metastatic cancer present a significant surgical challenge, particularly those involving the pelvis. Yet, advancements in the care of cancer patients mean that more patients are surviving longer and the prognosis is improving all the time.
For these patients, particularly those who are active and independent, a robust and reliable method of pelvic reconstruction is vital to maintain quality of life.
What does the BBC programme show?
In the BBC programme, Andrew operates on 76 year-old Peter who has fractured his hip as a result of prostate cancer that has spread to his bones. The cancer in Peter’s pelvis proves to be even more extensive, resulting in significant blood loss, and the emergency team struggles to stabilise the patient as Andrew continues with the technically complex Harrington Plus total hip replacement.
Carrothers Orthopaedics Consultations – Cambridge
Carrothers Orthopaedics is currently open and scheduling clinic appointments, as well as surgery. The safety of patients and staff remains our number one priority at all times. We are happy to discuss fully the risks and benefits of any proposed orthopaedic surgery, in the context of the ongoing UK Covid-19 pandemic.
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For your convenience, we offer appointments at both Nuffield Hospital Cambridge and Spire Cambridge Lea Hospital.