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Skilled Total Hip Replacement on The Gold Coast
Dr David Agolley is a hip surgeon on the Gold Coast who performs total hip replacement, including complex revision hip replacement procedures. Dr Agolley uses some of the most reliable prostheses and modern techniques including minimally invasive posterior and direct anterior approach hip replacement. Both uncemented and cemented techniques are used where appropriate, with materials that have some of the lowest rates of bearing surface wear, potentially prolonging the life of your replacement.
Pain from arthritis (osteoarthritis), is due to the loss of protective cartilage, and stimulation of pain fibres in the bone underneath the cartilage of your joint. A total hip replacement (THR) reliably alleviates the pain of the ball and socket joint by resurfacing the socket (acetabulum) and replacing the ball (femoral head) with implants specifically matched to your anatomy.
In an arthritic hip without a replacement, your joint will become progressively more painful and stiff. It will progressively become more difficult for you to walk, stand from a sitting position, put on shoes and socks, and drive a car. The benefit of a THR, is to decrease or even eliminate your pain, and improve your ability to walk, play sport and enjoy your quality of life.
What are the symptoms?
People with hip arthritis may have problems stemming from as early as childhood, had been on certain medications that affects joints, or had a previous trauma to the joint. Alternatively, your joint may not have had any problems in the past, and with wear and tear over time, your hip becomes arthritic at an older age. Pain and stiffness come on gradually over time, and may be localised to the groin, buttock, or radiate down to your thigh or knee. Standing up from a sitting position, driving a car, putting on shoes and socks, walking on the beach and performing tasks that you would otherwise had not thought about, all become increasingly difficult. More advanced cases of hip arthritis may cause pain in the night that interferes with your sleep, and impedes your ability to walk around the house, work and take part in enjoyable activities in your life.
What investigations will be required?
Plain x-rays of the pelvis and your affected hip joint are always essential. Dr Agolley will request further scans if indicated after consultation.
When should I have surgery?
Dr Agolley may recommended non-surgical treatments such as low impact activity (swimming and cycling), keeping your weight down, changing your activity or occupation, using a walking aid (stick) in your opposite hand to the hip pain, physiotherapy and taking pain medication as these can be helpful in reducing your pain.
If these management strategies are ineffective, intervention by a surgeon may be necessary. Dr Agolley will discuss your options in proceeding with total hip replacement. For very worn hips, total replacement is the single most reliable procedure providing a dramatic reduction in your pain. Dr Agolley prefers the minimally invasive direct anterior approach to total hip replacement, which allows surgeons to avoid the cutting of muscle tissue, and has a rapid recovery compared to some other hip replacement approaches.
Depending on the degree of wear in your hip and the cause of your pain, Dr Agolley may recommend procedures to preserve your own joint and not to replace the joint with implants. For certain patients these are more appropriate procedures.
The procedure and post-operative recovery
The specific type of replacement required will be discussed with you by your surgeon, as there are many factors for consideration and Dr Agolley will customise each procedure to each patient. In general for most patients
- Your anaesthetist will perform general anaesthetic and/or regional (spinal) anaesthetic as discussed with you prior
- The surgeon makes an incision over your hip and the joint is approached to avoid important blood vessels and nerves in the area
- The joint is exposed and the worn portions are removed by the surgeon
- Hip replacement implants are measured by the surgeon to be a specific size match to your anatomy
- A trial of the implants is performed to ensure stable functional range of motion, and that your anatomy has been correctly restored.
- The definitive implants are seated and re-trialled
- The wound is thoroughly cleaned and closed
The post-operative recovery consists of:
- An inpatient hospital stay for approximately 2-5 days
- Weight bearing through your operated hip immediately with the support of a mobility aid for 2-6 weeks
- To prevent deep vein thrombosis, you will have a combination of treatments including medication in either an injected or a tablet form.
- Walk without mobility aid at 2-6 weeks
- Back to sedentary work 2-4 weeks
- Back to driving 4-6 weeks
- Back to running sports 4-6 months
There may be numbness on the side of the thigh or in the inner thigh. This usually resolves quickly, but may persist for a few weeks. Major nerve or blood vessel injury is uncommon. Blood clots in the legs and lungs are also very uncommon with blood thinning treatment. Infection is uncommon as several steps are taken to minimise risk. The Australian Joint Registry reports that 96% of hip replacements have not required revision by 10 years, and independent data reports high survivorship rates 30 years onwards after hip replacement.
Pain coming from your hip joint or structures in front of the hip, typically presents as pain in the groin. However pain may present as pain in the buttock, back, hamstring, front of the thigh, and knee.
Direct Anterior Approach for THR
The benefit of the direct anterior approach for hip replacement is as the approach allows the surgeon access to the joint exploiting the interval between muscles, no cutting of muscle is required. This allows for a more rapid recovery after hip replacement.
For more information, see the American Academy or Orthopaedic Surgeons website
About our Gold Coast practice
Dr David Agolley is an orthopaedic surgeon with 13 years’ experience as a medical practitioner. With extensive training and experience in the practices of hip and knee replacement, ACL reconstructions, sports injury treatment and hip arthroscopy, Dr Agolley has helped many patients regain an active quality of life.
As a surgeon, Dr Agolley advocates modern, comprehensive methods of care using the latest techniques and technology including the minimally invasive direct anterior approach to total hip replacement.
Based on the Gold Coast, Dr Agolley consults from John Flynn Private Hospital and Gold Coast Surgical Private Hospital. He operates at the John Flynn, Gold Coast Surgical Private Hospital, The Tweed Hospital at Tweed Heads and Murwillumbah District Hospital. Contact his office on 07 5598 0530 to schedule a consultation or for more information on any of his procedures including director anterior hip replacement.