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Pioneering operation for hip replacement lets patient walk out of hospital within 24 hours

Health Editor,Jeremy Laurance
Friday 03 October 2003 00:00 BST
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Speedier, less painful hip operations were promised yesterday after a woman from Hertfordshire who had a pioneering procedure was able to return home after 27 hours - the shortest hospital stay after such an operation in Europe.

Shirley Mattin, 68, was up and about within three hours of the surgery at Chase Farm Hospital in Enfield, north London, and was allowed home the following day. The average length of stay for patients having the standard hip replacement is eight days.

Surgeons said the new minimally invasive technique could revolutionise hip surgery, for which there are some of the longest queues in the NHS. The procedure was developed three years ago in America, where about 500 operations have been done, and 38 have been completed in Britain.

Some specialists have said that the new hips are untested and evidence suggested they could fail sooner than the standard hip replacement.

Howard Ware, Mrs Mattin's surgeon, said: "Seventy per cent of patients in the US who receive this procedure leave hospital within 24 hours of admittance and in the UK it is already dramatically reducing the amount of time patients need to stay in hospital. In the future this could benefit up to 70-80 per cent of patients who need a hip replacement."

Mrs Mattin, from Potters Bar, said she had been offered the new operation by Mr Ware because he told her she would be an ideal candidate.

"I have had both hips replaced by the same surgeon. The first one was done as a standard hip replacement and the second one was done using this new technique. There is simply no comparison.

"I have had less bruising, swelling and pain this time and was walking up and down stairs the next day. Last time I was in hospital for 11 days. I can't praise the surgical team and nursing staff enough."

The standard hip replacement involves making a large incision down the side of the upper thigh, cutting through muscle and exposing the hip joint. The head of the femur (thigh bone) is then removed with a saw and replaced by a prosthesis, which is driven into the thigh bone and cemented in place.

The operation causes extensive pain, bruising and swelling and requires one to two weeks in hospital.

For the new procedure, two small incisions are made either side of the hip joint and the muscles are parted to expose the joint rather than being cut. Specially designed instruments are used to remove the old bone and fit the prosthesis, which is driven into the thigh bone in the same way but not cemented.

Development of the new procedure has been backed by Zimmer, the world's largest manufacturer of prostheses, which claimed it could reduce hospital stays by up to 10 days and might eventually help to save the NHS more than £77m a year.

Its calculations are based on National Audit Office figures suggesting a reduction in hospital stay of between two and six days could save the NHS between £15.5m and £46.5m each year.

The new procedure was introduced to Britain from America by Sarah Muirhead-Allwood, an orthopaedic surgeon at Whittington Hospital, north London, and is also being used at Whipps Cross Hospital as well as Chase Farm. It requires specialist training in addition to specially adapted instruments.

Nick Samuels, director of communications for Barnet and Chase Farm Hospitals, said: "The new hip replacement will be a real advance for our patients, who recover quicker, experience less pain and leave hospital earlier. In addition, it could lead to significant savings for the NHS. This has been a great team achievement from across the hospital and in the community."

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