Mr Jonathan Hutt, Consultant Orthopaedic Hip Surgeon at The London Hip Unit, part of The Princess Grace Hospital, talks about the changes in hip replacement surgery in the last few years, whether he thinks COVID-19 and the numerous lockdowns have impacted people’s hips and why it’s important that hip replacements are personalised to each individual patient.

What made you want to become an orthopaedic consultant?

What I really like about orthopaedics is the focus on restoring function and quality of life for people. Although I am a specialist hip surgeon, I still see a very diverse group of patients. I treat everyone from adolescents who have had prior hip disorders as a child, to sports injuries and activity-related pain, as well as people of all ages who have worn out their joints and require a hip replacement or have a problem with a previous replacement. 

One of the benefits of being a specialist hip surgeon is that whatever stage of life the patient is at, or the hip problem that they have, we have the ability to figure things out and form a strategy for getting them back to their desired level of activity and optimum quality of life.

What have been the advances in hip surgery in recent years?

The main goal of hip surgery is to get the patient back doing what they love as soon as practical after surgery and for the intervention to have a long-lasting, positive impact. In hip preservation surgery, there have been continual advances in keyhole surgery (arthroscopy) techniques and our 3D understanding of anatomy to understand a patient’s hip function, as well as better research into what influences the outcomes of our operations.

With joint replacements, there have been advances in surgical approaches to improve accuracy and minimise trauma, improved peri-operative care to enhance recovery and the use of improvements in technology for optimal component positioning. Although we continue to research the ideal place for these advances in our armoury, these step-changes are moving hip replacements forward to allow a short and efficient recovery for patients and get them back to more normal life quicker.

How will a patient know if they have a problem with their hip?

Hip pain can be quite general but the most obvious symptom that my patients will present with is pain around the groin and upper thigh. That said, many patients will also report having back pain, buttock pain, thigh pain or knee pain emanating from a hip issue, and progressive stiffness in the hip area is often another trigger to seek advice. 

Symptoms start to become a concern for people when they begin impacting their function, level of activity and quality of life. It is worth saying that many patients who come to see me do not need surgery. They can often be helped with information, advice and referral to physiotherapy or other specialist colleagues. 

Total hip replacement versus hip resurfacing – what are the differences?

Both are effectively forms of joint replacement, and both replace the acetabular or ‘socket’ side in a similar way. In a total hip replacement, the head of the femur (‘ball’ part of the joint) is removed and a stem is placed in the thigh bone. In a hip resurfacing procedure, instead of removing and replacing the ball, it is instead shaved down to an appropriate size and shape to allow a cap to be placed on top.

Deciding which option is performed depends on the patient, their hip anatomy and the cause of their hip pain - it should take into account what they want out of their surgery and what the future holds for them. There is a lot of information out there and one of the important parts of a consultation is ensuring that patients fully understand the evidence behind the procedures and have a chance to discuss things in detail. 

How do you think lockdown will impact people’s hip health?

The changes in our lifestyles in the last year has heightened the risk of muscle deconditioning. It’s so important for good musculoskeletal health to keep joints moving and muscles firing to reduce pain and prevent injury. I would hope that despite the longevity of the restrictions people have been living under, much of the muscle deconditioning will be reversible with the right advice and input as we head in the direction of a more normal life. 

Why should a patient choose London Hip Unit for their care?

Our clinic is renowned for being one of the UK’s only dedicated private facilities for the specialist treatment and care of hip problems and our expertise covers every aspect of hip joint pathology. I am very excited to be joining the team and look forward to contributing my specialist experience to our first-class care for patients and their hips. 

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