No. In most cases, there is no need for an urgent operation except in cases of severe destruction of the hip joint. Arthritis is not a malignant (life threatening) condition. Joint replacement is an operation to improve quality of life. You should always start by using non-operative management of the condition as outlined on this website. But in the majority of cases, by the time you come to see me you would have exhausted all non-operative treatments.

The youngest patient I have operated on so far is 28 years old for a hip replacement. Yes, it does increase your risk of re-do surgery in the future. The general figure is about 29% risk of revision in your lifetime. It all depends on your quality of life during the most active years of life. I will be able to offer all pros and cons of surgery and other treatments available based on my assessment of your condition.

No. The oldest person on my books is 96 years of age for hip replacement and 94 years of age for revision operation. It depends on your anaesthetic fitness and of course disability caused by the underlying problems.

It depends on various factors identified in the detailed assessment before surgery. Unfortunately, morbid obesity does increase your potential risks of complication around the surgery period but overall outcome in obese people is similar to non-obese patients provided that they do not develop complications. I always advise my patients to make a sincere effort to lose weight as it will improve your symptoms and also reduce the chance of complications after the operation should you need it in future. Patients do find it very difficult to do it on their own and professional help should be sought from a reliable weight reduction expert.

​No. I am ‘fee assured’ with all insurers for both consultation and surgical fees which is in line with all insurers’ fee schedule. You will not have to pay anything extra. If you have an excess on your policy, your insurer will advise you in advance.

 

Yes. You can self-fund your treatment in the private sector. Our customer care team will provide you a very clear written ‘Fixed Quote’ depending on the procedure required. They also have a finance options available should you wish to consider that.

 

​A ‘Fixed Quote’ will be provided detailing the package based on each procedure and likely implants required.

 

​I understand that, not everyone can afford private care. In these cases I will take over your care if you wish on an NHS basis. If you need an operation then the Betsi Health board allows us to put patients directly onto the NHS waiting list.

 

​Your safety is our prime concern. Depending upon your health condition, I may recommend you to have the procedure through the NHS because of potential back-up required from other medical teams. I will undertake the necessary formalities to put you on an NHS waiting list.

 

​Fortunately, untoward complications are very uncommon nowadays. It depends on lot of factors such as the complexity of the procedure and any underlying health conditions. In my experience, the less than satisfactory outcome is related to the inability of a surgeon to meet patient’s expectations. I will take extreme care in my assessment of your condition and will give you an honest opinion of likely chances of improvement and what to expect after the operation. I am delighted to let you know that, I haven’t had an unsatisfied patient so far after an operation under my care.

 

This depends on lot of variables like your gender, age and physical activity. Just like any mechanical parts, the implants will wear out at some point, albeit at a very slow rate. There is still a misconception that a hip or knee replacement will last for only 10 years! The latest evidences suggest that majority of these implants will last for 20-25 years! In addition, the technology of implants has become extremely refined and we are very confident in their durability for many years to come. Hence, we are able to perform these operations in very young patients.

 

​No. Based upon significant issues with metal-on-metal articulation identified a few years ago and improvement in technology of other bearing materials like ceramic and highly durable polyethylene, I don’t think it is worth taking a risk.

 

​Yes. Based on my extensive national and international training,  I can perform hip replacement operations leaving a scar of only 8-10 cm in most cases. Similarly, my knee replacement incisions are also less than six inches. I do feel that it does makes your recovery quicker.

 

​No. I was fully trained to do hip replacement with this approach but my own award winning research suggested no difference in outcome between direct anterior and posterior approaches. The direct anterior approach also has a significant higher rate of devastating complications. I feel my MIS posterior approach provides similar quicker recovery without potential higher risks of fractures and nerve injury.

 

Anaethesia has advanced significantly over the past few decades. The potential risks and complications are very rare. I only work with extremely experienced and highly skilled anaesthetists who are great at their job so there is no need to worry at all.

 

​Our consultant anaesthetist will recommend the best anaesthesia for your circumstances. I do prefer epidural/spinal anaesthesia especially for knee replacement as it also gives you a very good pain relief immediately after the operation.

 

​Any joint replacement will be painful initially but we utilise ‘Enhanced Recovery After Surgery’ protocol which includes state of the art pain management techniques including local anaesthesia infiltration and nerve block modalities. This does give you an excellent pain relief initially. After that, it is important to stay ahead of pain and take regular pain killers at least for the initial two weeks after surgery.

 
Yes. I will use titanium implants using ceramic bearing for hip replacement. Similarly, I will utilise a different implant for knee replacement using Oxinium material as well.
 
​The average length of stay in hospital is about two days but it depends on your recovery and progress. I have done hip replacements as ‘day case’ procedures as well.
 
​Yes. There will be a waterproof dressing on your wound. Just dry it nicely afterwards and check to make sure it is well applied. You will be given additional dressings as well just in case it becomes wet.
 
No. I use dissolving sutures and glue to seal your wound. Only the ends of the stitches will be trimmed by myself at two weeks.
 
Unfortunately, these are always a possibility after surgery. The important thing is to try to minimise the risk as much as possible and deal with it straight away. I will always be available to deal with any issues in a timely manner.
 
​I take full ownership of your new joint. You will hear me saying ‘After the operation, it is my joint and I should be first one to know if anything is wrong with it’. Please contact my secretary or ward staff straightaway and I will advise you of the next steps.
 
​I do not believe in six week rules for crutches. It depends on your recovery. I will personally assess your progress at two weeks and advise you accordingly. Most of my patients are walking unaided by six weeks.
 
It depends on the side of the operation, the type of car you drive and your progress at two weeks. Most of my patients will resume driving by four weeks.
 
​No. I allow my patients to sleep on their side with sets of pillow next to their opposite leg to prevent accidental excessive crossing during your sleep.
 
​It depends on the nature of your work. Most of patients involved in office work should be able to return to work after 4-6 weeks. It may take longer for patients involved in heavy manual jobs especially after knee replacement.
 

Short haul flights less than 2.5 hours: 6 weeks.

Long haul flight more than 2.5 hours: 3 months.

Make sure you drink plenty of liquid (not alcohol!) during your flight, take frequent breaks from sitting and do foot and calf exercise to minimise risk of potential vein thrombosis.

​Most of my patients after hip replacement report excellent recovery by six weeks and it continues to get better up to 6-12 months.

Knee replacement patients can expect up to 80% of their recovery by three months and the rest will happen slowly over 12-18 months.

​Yes. Most of my patients report improvement in their sexual function after hip and knee replacement. This generally happens naturally by 4-6 weeks or even earlier. You do need to be careful to avoid extreme positions and ‘spooning’ is generally recommended following hip replacement.