Many years ago, in the late 1970’s, I was invited to attend a ceremony in London where a number of people were receiving awards relating to their achievements. One of the recipients was a very elderly gentleman called Sir John Charnley. I learnt that in the 1960’s Sir John had performed the first successful hip replacement operation to relieve the symptoms of osteoarthritis.
A presentation was shown of the operation and at that time I vowed I would never have hip replacement surgery. The cut was from the knee to the hip and the resulting scar looked very unsightly! Years later I realised how wrong I was, as advances in material technology over the years have greatly reduced the wear rate compared to the materials Charnley had available. Charnley’s operation involved removing the femoral head of the hip joint and replacing it with a socket and ball implant composed of polythene and steel and anchored with acrylic cement. Charnley was well aware that the materials would wear out over time and thus would not perform the procedure on younger patients. For a long time surgeons tried to reserve hip and knee replacements for older patients (despite the fact that a lot of younger patients would benefit) to try to ensure the joint would last for the rest of their lives.
A few years later, I started to have problems with one of my hips. I decided to ignore the discomfort and carried on with my normal very active life, trying to adjust my walking to alleviate the pain. I didn’t even realize how badly I was limping even though at times my friends would mimic my gait! I just carried on believing that they were exaggerating.
Gradually, over a period of 15 years or so, the pain became progressively worse, especially at night. The problem had also spread to the other hip and I became dependent on very strong painkillers. Still I soldiered on, determined that I would be the one that could manage without a hip replacement operation.
Getting in and out of the car became a problem, as the joints had stiffened up with the osteoarthritis. Likewise, I had great difficulty bending over to reach the electric plugs in my house and getting in and out of the bath became problematic as I had difficulty lifting my legs high enough to get them over the rim of the bath. Still, I carried on. I remember driving to London to attend work meetings. I had to arrive at such meetings at least half an hour before the start and walk around to get mobile enough to arrive at the meeting without looking totally incapacitated. I couldn’t believe this was happening to me, as I had been so athletic and active throughout my younger years.
The pain and mobility got worse and worse. At night I had difficulty sleeping, as the pain was now in my knees as well. Later I learned that this was a “referred pain” from my hips and that my knees were fine.
I sought help from my GP who said that the X-rays showed that I needed an immediate hip operation! Still I resisted, but I did agree to see an orthopaedic surgeon of my choice.
I spent ages researching hip replacements and discovered that great advances had been made since Charnley’s days. If you had the right surgeon you could have something called “minimally invasive surgery” which to my amazement meant the cut could be as short as one and a half to two inches long.
I researched orthopaedic surgeons and took a lot of advice and a couple of recommendations stood out against others. I decided to choose Mr Evert Smith, who looked as if he had very good credentials.
At my first consultation, I told Mr Smith that I really wasn’t keen on having a hip replacement at that time (by now both hips needed doing) and that I preferred to wait until I was so incapacitated that I couldn’t walk at all! He was extremely patient with me and gave me lots of good advice and promised to follow me up on a regular basis.
After a further two years, I was getting so bad that I asked him if I could try a steroid injection. He said that he was happy to give me one, but warned me that it might speed up the deterioration of my hips. The first injection worked like magic. I was back with the mobility I had when I was in my 30’s. However, 6 months later the hips were getting worse again. After a further three injections the benefits declined and I found myself completely unable to move without the help of two crutches.
I knew that a hip operation was inevitable – at least an operation couldn’t make me any worse than I was now! I asked for both hips to be done at the same time, but Mr Smith advised that it was preferable to have a gap of about 8 weeks between the operations.
I had the first operation in mid-March, with the second one in mid-May. Within two weeks of the second operation and with the help of very good physiotherapists, I was walking normally without the aid of sticks or crutches. It was like a miracle had happened. Over the next two or three months the hips became stronger and stronger. I had very small cuts that hardly showed and which had healed very quickly and I started resuming long walks, runs, dancing and swimming again.
This operation is completely life changing and enhancing. Now, nearly 14 years post operation, I am still as mobile and active as ever. If anyone feels they might like help regarding the osteoarthritis in their hips, don’t hesitate, have a hip replacement. I promise that you won’t regret it and it will transform your life.
Mr Smith is an exceptionally clever surgeon and now amongst other roles he is directing his own charity “Arthroplasty for Arthritis Charity” in a pro bono capacity, which supports research into muscular skeletal problems and is engaged in a quest to find an even longer lasting and more durable hip replacement solution. Today, most hip replacements last approximately 20 years plus, but for all kinds of reasons a lot of young people also need this operation, so it is of particular importance to improve the longevity of such procedures.
Supporting this work will help so many people continue to live active and worthwhile lives well into old age
Mary Jenkins - September 2023