• Be realistic. A stay in a tropical location may sound alluring, but could you get the same treatment or better nearer home?

• Work out the travel costs. India has fantastic medical centre's but it is a nine-hour flight away. Think of the cost of taking a companion along to accompany you too.

• Think of the physical implications of the journey —a day in economy class is a long time when you are recovering from an operation. Business class is comfier but much more expensive.

• Stay in constant touch with the medical facility you have chosen. Ask which physician will be performing the operation, how many he has done before.

• Ask what kind of post-operative support the facility has.

• Ask what arrangements are made for transfers between the airport and the medical centre on arrival and departure.

• What arrangements are made for your carer?

• Ask for testimonials of patients who have undergone procedures at the medical facility. Contact the people personally.

Total Hip Replacement or Hip Resurfacing?

Total Hip Replacements allow good mobility, but reduce the range of movement of the leg. Following a Total Hip Replacement It is not possible to return to full active sports however light activity such as golf is OK even light tennis (one of our clients was beaten at tennis before coming for her hip replacement by a lady with two total hip replacements)!

Today candidates prefer Hip Resurfacing rather than Total Hip Replacement. There are several reasons why candidates have a preference for resurfacing these are addressed further on in this publication.

Total Hip Replacement is indicated in..

• Males over 70 and females over 65 (with week or thin bone stock)
  
• Those with a degenerative bone disease such as AVN or arthritis
  The prosthesis may be constructed of various materials but is usually made of forged steel rather than cast steel (these were prone to break). The exterior of the unit is rough and porous so that the unit when press fitted with combine with the bone, which actually grows into the unit. This creates an immensely strong bond, which is hard to separate (rather like barnacles on a ship).

The ball will probably be titanium, cobalt crome plated or ceramic (there is some concern from patients as to whether the ceramic ball will break but providing the unit is properly engineered this is extremely unlikely). The advantage of ceramic is that it is both extremely robust and has a very low friction coefficient, which means a low wear rate.


Sometimes the cap may be ceramic but these in rare cases have been known to break under excessive stress conditions. One popular combination is a ceramic ball and composite cap, these are found to have less wear. Modern units can wear at the rate of 1 micron a year; some years ago wear rates were more likely 200 microns a year so great improvements have been made. One thing to be weary of is ensure that your surgeon is fitting a leading manufacturers unit not a generic copy such as those that you may receive in cheaper surgery. If it is possible find out what the surgeon will be fitting and do they fit a very good standard of unit. If you are a private patient that is paying their way you should be able to ask these questions and receive a satisfactory answer. Government health services will fit units from a standard procurement list. This list may be quite limited by the number of models and sizes, as health services seek discounts by bulk purchasing methods. In addition the prosthesis on the procurement list may be dated as it takes time for new products to be accepted. Zimmer is our organisations brand of choice simply because we consider them the best on the market, they have an excellent proven track record and are the largest makes in the market. Incidentally their units are also the most expensive but when choosing prosthesis we always choose the best.

Hip Arthroscopy..

Hip arthroscopy is performed through small incisions using a camera to visualize the inside of a joint. Through several small incisions (about 1 centimeter each) your surgeon will insert a camera into one incision, and small instruments through the other incisions.

What is the benefit of hip arthroscopy compared to open surgery? The nice part about hip arthroscopy is that it is much less invasive than traditional hip surgery. This means:

• Early Rehab
  
• Accelerated Rehab Course
  
• Outpatient Procedure
  
• Smaller Incisions
  
• Early return to Sport

Hip Revision Surgery..

Revision surgery takes place when a hip prosthesis has worn out. This surgery takes longer than usual as the old prosthesis needs to be removed. Cost of revision surgery are significantly higher.

Bilateral Surgery..

Occasionally we get requests for Bilateral Hip replacement or resurfacing surgery. This is particularly relevant when the patient is traveling a long distance for surgery or particularly requests bilateral surgery. With Bilateral surgery the surgery is carried out on one side first followed by the other side one week later. This gives time for the first side to receive some physiotherapy prior to the second replacement. The duration of stay in hospital is significantly increased with bilateral hip replacement or resurfacing.