Walking post THR

Thanks for the advice Graham. I think I'll start inside and see how I feel. And leave the bed upstairs! I am in the UK, my operation should be in the first week in May (to be confirmed). I will check your website. Thanks again, Jeremy

Graham, I have a related question - a dilemma actually - and was wondering if, in your experience of information gathering, the following issue was considered by others:

My boss who last year had exactly the same op that I'll be having next month had the luxury of choosing between rather well known surgsurgeins (unlike me he had it done privately, under insurance). His analysis placed my surgeon in the 'good-ish' category while the surgeon he selected was graded as 'excellent'. All this based on his own research and

rather unscientific - but somewhat comprehensive - methodology. I know all very intriguing!

The long and short of it all is that he has advised me to postpone my op until such time when one of the 'excellent' surgeons becomes available to perform my op under the NHS.

My question: statistically, have the outcomes of hip ops performed by 'excellent' surgeons been better than those performed by 'good-ish' surgeons? I believe it will always be possible to create categories of competencies of hip surgeons?

Do I cancel the op and wait for the 'excellent' guy to become available (no guarantees!) or do I go with my appointed surgeon?

OOOOOOOOOh that's a hard one - really I have no idea.

My surgeon came highly recommended, in fact a friend had her hip replaced by him in the same hospital that I had, and she walked from the hospital holding her walking sticks in her hands - not using them, whereas I had the misfortune to have mistakes made in my replacement where my acetabular insert was put in crooked, and then not discovered for 4 weeks.

I think luck plays an important part, no two patients are the same, no two operations are the same.

Following my second surgery by the same surgeon, my recovery was fairly similar, but different in certain aspects.  After the first operation I could lay on my operated side and not on the unoperated one.  After the second operation it was exactly the opposite.

First time I had no 'waterworks' problems, second time I had to have a catheter fitted in the middle of the night due to excrutiating pain.

I don't think anyone, least of all me, can advise you on this one. It's a personal choice, and the outcome may well affect you for a long time.  Would I trust the surgeon I had to do my other hip if I ever need it - possibly (!), I am sure he wouldn't make the same silly mistake on me twice in a row.

In many ways I am better off than many people who cannot bear weight on their new hips.  I was up and walking in no time, and the muscle and nerve displacement seems to have been minimal.  Judging from others on this forum, I know that the Physiotherapy I received was absolutely first class.

Graham - 🚀💃

Excellent Graham, thanks. I think I'll stick to my surgeon and see what happens! Meantime, I hope you continue to have a good recovery. Jeremy

Jeremy, I think you'll find that a lot of surgeons work for both the NHS & private. I'm fortunate in that I have medical insurance & have been able to choose my surgeon but there will always be good & bad experiences on both, everyone is different & has their own opinion. Where are you having it done?

Hi Fernlady - National Orthopedic Hospital, Stanmore. According an Occupational Therapist friend, it is a very good hospital. Very large, lots of surgeons. As you say some would be very good others not so. Wish there was a definitive way of classifying these surgeons based on post op success. If you take the Premier League (football / soccer) parallel you'll be able to list at the end of any period say, the highest to lowest goal scorers. Same concept, isn't it? In these days of serious data and information processing capability you would have thought the 'surgeons list' would have been possible. Maybe one day! All the best, Jeremy

Jeremy,

You are very lucky in getting in there - I am trying to get referred there for my problems.

Hi Jeremy, only just seen this. I had my hip replaced at Stanmore. Fabulous place. Who is your surgeon? Not sure if you are allowed to say so possibly private message me. I am coming up to 13+ months. 

Catrin

You have to be very persistent (and have a supportive GP). I live very close to it so eventually after four years and numerous referrals elsewhere I finally made it there. It's so good. How's it going back at work?

catrin

Hi there Jeremy. Something very similar to what you're looking for exists already. Don't know if anyone's told you about the National Joint Registry? It's a brilliant resource... Data from every single hip/knee procedure done in the UK has to be submitted to it... So, if you go directly to http://www.njrsurgeonhospitalprofile.org.uk you can put in the name of your surgeon (as well as the 'excellent' one your boss told you about) and look at their stats - number of procedures done, outcomes, etc. - and see where they sit against the average. You can also look at the data by hospital. This will put your mind at rest as much as anything ever could, because it's based on the cold, hard facts - not anyone's personal opinion.  You may know about it already but, if not, hope you find it helpful. And good luck in making your choice and having the op. I'm 20 days post RTHR and on the road to recovery :-)

It's hard - the commute is taking it out of me, even on 3 day weeks.

I have been referred to 'Mr.C' at RNOH, and have my appointment next month now.

Graham - 🚀💃

Yes I can imagine the commute is difficult. I went into town twice last week on the tube and found it draining and I'm pretty much recovered. I saw a Mr C at Stanmore wonder if it's the same one? He had the same last name as that character from Dynasty in the 80s. Was married to Chrystal (and the Joan Collins character)!! If it is him he was very good. Very thorough and knowledgeable. 

Catrin 🚈

Hi Jeremy

You are lucky to be referred to Stanmore.

I requested Stanmore and was refused.

Reason given that it is a tertiery hospital and only accepts referrals ftom other hospitals because it specialises in difficult and problem cases.

You can check surgeons on the njr (National Joint Register) hospitals too,

Good luck

Joy

 

Hi Joy,

i got got told the same but I'm a persistent so and so and I found on their website that it said they did accept referrals from GPs so I went back to my GP and persuad her. Might be worth a try if you haven't had your surgery yet. 

Catrin

Thx Joy. I was sent the website via a private message. An extremely useful site. Very factual. Has all kinds of info on every surgeon in the UK who has performed joint surgery including of course hip, knee etc. Essential reading before finalising op arrangements. In my case I became aware of it only today. Luckily I am quite happy with what the site says about my surgeon. All, please check it out. Jeremy

Hi Joy, sorry you didn't get Stanmore. But there are many other top hospitals in the UK. As I said in earlier post, I discovered the site you mention. Invaluable!

Best of luck. Jeremy

That's the Mr C.

Yes, I'm a difficult problem case  ..... well I am now anyway 

Well he was excellent with me - not the best bedside manner possibly but he knew what he was doing on the hip front and all the support staff are good too. It's a fabulous hospital (even if the buildings as a little dated). Good luck with it. 

 

I was told that Orthopaedic surgeons have the worst bedside manner - according to my friendly nurse they are known for it.

Graham - 🚀💃

I suspect you have always walked to your own beat .... but a difficult problem case?!

Yes - my ceramic acetabular inser was put in at an angle - and they were unable to remove it at my revision operation.    Big problem if it ever needs to be removed. 

Graham - 🚀💃

Hi all,

I have added the NJR link to the pinned discussion, link below. Also there is no problem mentioning surgeon names. The only time we don't allow it is if it is a private clinic and users post names repeatedly.

https://patient.info/forums/discuss/thr-useful-resources-487147

Regards,

Alan

Hi Mark as I said before, this is brilliant. Ripe for creating a spreadsheet from it, then filtering/analysing the spreadsheet for many, many purposes, eg reporting in descending order number of hip ops performed in 12 months; ditto 36 months; by age group; by gender; revisions etc etc etc. Any of you guys with spare capacity, or access to new trainee/ intake to do this? It would make a worthwhile addition to Graham's site. would, but afraid not in a position to take this on. Sorry. Jeremy

With 218 pages of 10 surgeons per page, 2180 surgeons, each with :-

  HOSPITALS THE SURGEON HAS ACTIVITY RECORDED IN NJR

  12-MONTH PRACTICE PROFILE (1 YEAR)

  36-MONTH PRACTICE PROFILE (3 YEAR)

  ABOUT THE HIP PATIENTS WHO WERE TREATED

  HIPS – 90-DAY MORTALITY

  USE OF ODEP RATED IMPLANTS

that's a lot of data to transcribe, let alone show graphically and clearly.

and to be honest, what does it show - that my surgeon did x number of hips in the last 3 years, but what I want to know is how many were successful, and how many were failures like mine.

No doubt my hip is shown in there as a primary and as a revision - with no detail that the outcome of the primary was a failure enough to warrant having a revision, and that the revision failed to correct the failure of the first operation.

Graham - 🚀💃

Hi Graham, I agree it doesn't provide answers to every question but I believe there is enough information on the site to help with the decision making process on who to go for. It would be useful primarily for people who are considering a hip op. I think better to have access to this data then not, don't you agree? Regards, Jeremy