We speak to Consultant Orthopaedic Surgeon Miss Sarah Muirhead-Allwood and question if we’ll see an increase in professional athletes undertaking surgery due to the advances in techniques.
With such an illustrious career as an orthopaedic surgeon, what made you specialise in hip surgery?
How does hip resurfacing differ from hip replacement?
In essence, the socket is replaced with a hemispherical shell as in total hip replacement but in resurfacing, the bearing is metal and its internal diameter approximates the native femoral head diameter. On the femoral side, instead of replacing the femoral head and neck with a metal stem fixed in the femoral medulla, the existing femoral head is capped with a hollow, metal ball.
We believe this solution can produce a result with higher function and a reduced risk of dislocation, although the downside is the problems associated with metal bearings and compromises to longevity.
With men under 60 being preferred candidates for hip resurfacing, will we see more elite sportspeople choose this type of hip surgery over more traditional methods?
The preferred candidates for hip resurfacing are young men because this group is the group which in large series such as the British Hip Registry have been shown to have the lowest failure rates and to have failure rates approximating to conventional hip replacement. Women, because of their smaller femoral head sizes and possibly greater range of hip movements, have had a much higher failure rate. Because of the improvement in function, keen sportsmen have been opting for resurfacing for the last two decades. Elite sportsmen now seem to be trying to return to their super demanding sports and are succeeding. Providing that they continue to succeed, undoubtedly the number of elite sportsmen will choose this option rather than retire.
What does the future hold for hip surgery? Will we see an increase in the use of technology such as artificial intelligence or augmented reality?
Interest in different approaches to the hip such as the direct anterior approach is encouraged in the US as it is seen to reduce patient cost, though not improving function and having probably a higher complication rate.
Prosthesis companies are championing robotically assisted surgery in order to improve their market share and these technologies are attractive to surgeons wanting to practice build. Existing robotic hip surgery adds significant cost to the procedure and studies will have to show a benefit if it is to gain acceptance. Linking navigation programmes with augmented reality and AI technology to fine tune the component positioning may well prove to be a better route.
About Miss Muirhead-Allwood
More information here.