“My mother required a total hip…

My mother required a total hip replacement due to advanced osteoarthritis. She was understandably anxious regarding the procedure and wanted to ensure she was seen by an excellent Surgeon. Working as a musculoskeletal physiotherapist myself I have worked closely with numerous Orthopaedic Consultants and for me Parag was the outstanding clinician I recommended to carry out the procedure. My mother is now 12 weeks post op and is back walking 7,000 steps + daily and now has her life back. My mother cannot speak highly enough of Parag and wanted to highlight his kind and reassuring bed side manner, clear explanations of the whole process from start to finish and compassionate nature throughout. My mother was taking daily pain medication and struggling walking. She is now is now back walking across Hampstead Heath and getting back to activities she previously loved. I have worked with Parag rehabilitating many of his patients. I know the incredible results his patients have post surgery as I have seen them first hand hence why he was the first person I suggested my mother go to see. I continue to see many of Parag’s patients for Physiotherapy and would highly recommend any patient seeking an orthopaedic opinion on any knee / hip pathology to see Parag Jaiswal. He is an outstanding Surgeon!”

I was humbled by this review by a physiotherapist colleague. He had recommended his mother see me for consideration of a total hip replacement. Working as a NHS and private physiotherapist, he could have chosen a number of different surgeons and I was truly honoured.

With any surgical procedure, I always inform patients of the three phases to achieve the best possible outcomes.

• Prehabilitation exercises
• Meticulously planned and performed surgery
• Rehabilitation program

I could talk about all 3 points for hours and indeed have done so in many meetings with physiotherapists, sports physicians and other hip and knee consultants. In this blog, I would like to focus on Surgery and what patients can expect from my team and I.

In my practice, surgical planning begins long before you have entered the hospital on the day of your surgery. I take special calibrated X-rays after our initial consultation that allows me to calculate within millimetres the amount of bone resection required. I choose the best implant to match the shape of femur (thigh bone) and socket. Usually, the implants are the best performing implants in the National Joint Registry (a record is kept of all implanted hip and knee replacements in UK). Occasionally, there may be abnormal anatomy and I may require a CT scan. More recently, I have used personalised hip replacement that more accurately restores patients’ anatomy (there will be more on that in another blog). In and very active patients I use a ceramic liner and ceramic ball which has the best wear characteristics and lasts longer than conventional hip replacements. I was not entirely surprised to hear that 70 year old patient of mine ran a marathon a year after his left hip replacement when he came to have his other hip replaced.

On the day of the surgery, you will be seen by myself and my anaesthetist. I almost always advocate the use of spinal anaesthesia (SA – like an epidural, where you lack feeling from the waist below), rather than general anaesthesia (GA – where a machine breathes for you). The recovery is so much quicker (you do not have the hangover effect from GA with SA). During the surgery I use high volume local anaesthetic which ensures you have very good pain relief immediately after the surgery. I use enhanced recovery programs and encourage patients to be standing and walking on the day of surgery. This has been shown to improve recovery. This way/using this approach patients stay in hospital for only a day or two and enjoy being back at home much earlier.

If you have any questions or queries, then please do not hesitate in contacting my team.