Macau Matters | My new left hip – part I

Richard Whitfield

It seems that, in combination with other issues, I played too much sport when I was younger and then got fat and lazy, so now I have arthritic hips and knees. I consulted a Hong Kong surgeon a few years ago after walking became noticeably difficult, and the end result is that I now have a brand new artificial left hip. Already, I am feeling that it has been an excellent decision and that I will soon be walking like somebody 20 years younger.

All my reading and talking with experts (and others) says that “practice makes perfect” for this kind of surgery, but as well as experience, you also need a surgeon who keeps up with the latest trends. Moreover, joint replacement surgeries are among the most successful and life changing medical procedures, with very high success rates.

I did not even consider getting the work done in Macau – it is too small to get the requisite experience, and I do not trust the healthcare system here. Also, building a rapport with your medical team is very important and very difficult to do with significant language barriers. I did consider Thailand/Malaysia and Hong Kong but in the end I opted for Australia, based on acceptable costs, a very sophisticated and experienced healthcare system, and family support, which is very important when you are facing 3 months of recuperation.

I found several surgeons online, and picked the most compatible for me based on speedy response time to my questions, professionalism and extensive information sharing, personal rapport, and most importantly, lots of experience with the latest approaches and techniques.

Like most human joints, the hips can easily come apart and are held together by a muscle capsule (there is no bone interference holding the joint together). Then there are bigger muscles near the joints that control movement. Long recovery times for skeletal surgeries are often because of the need to cut muscles, which also severely scar as they repair themselves.

Traditional hip replacement surgeries come in from the back (posterior) cutting through your bum muscles and then the muscle capsule around your hip joint. This avoids major nerves and veins but necessitates longer recovery periods. By contrast, the modern (anterior) approach comes in from the front, cutting at your bikini line. The surgeon has to work around more nerves and big veins, but there is little muscle cutting. At the front it is even possible to spread the muscles in the joint capsule apart to avoid cutting most of them. I took my first steps with a walker six hours after my surgery, and the surgeon has forbidden bed-rest and wants me walking as much as possible as soon as possible. He also tells me that it is easy to “go in again” to do any maintenance on my hip, if it is needed in 10+ years.

Historically, hip replacement surgery is also done under full anaesthetic, which takes a long time to recover from. Nowadays, they lightly sedate you and give you an epidural pain killing injection. I was awake, compos mentis, and with full feeling and no after-effects within 2 hours of my surgery, and I was home 33 hours after being admitted for surgery. I also learned that when you breathe naturally your ribs and diaphragm muscle expand to create a low pressure region in your lungs so that air naturally rushes in. This is also true when you are sedated. However, under full anaesthetic they have to use a tube and pump to force air into your lungs, which is very unnatural and may cause damage.

I would not wish surgery on my worst enemy, but at least I am finding it a very interesting learning experience. And one that many more people will have to face as our lifespans increase.