A rapid hip operation that allows patients to walk again after two hours could help halve waiting lists in Britain

A hip replacement procedure that sees patients leave hospital just 24 hours after surgery could halve waiting lists in Britain.

The technique, in which doctors reach the joint through an incision of just 5 cm, has a remarkably low infection rate.

It also spares the muscles around the joint, allowing 90 percent of patients to be able to stand and walk on the same day as surgery – without crutches.

And although it is currently mainly available privately in Britain, a number of expert surgeons have told The Mail on Sunday that they expect the operation to become the gold standard procedure for the National Health Service within a decade.

“Hip replacements are the most common operation in orthopedics,” says Professor Adrian Wilson, consultant orthopedic surgeon at private clinic Oveli Healthcare.

‘And what this very clever technique has done is transform a procedure that already works well in terms of safety and speed.

‘The average time for a double hip replacement via standard surgery is 90 minutes – we can now do them in a third of that time. Cutting waiting times and saving the NHS millions will help thousands of people.”

Just under 100,000 people in Britain had hip replacement surgery last year. Recovery from surgery usually takes a few months, and the average wait time is 128 days – compared to 87 days pre-Covid.

The new technique, called the ‘Rapid Recovery’, or Rottinger Approach, promises to get patients out of the hospital as quickly as possible and with far fewer complications.

Unlike the most common hip replacement procedure in the UK, where surgeons operate from the back of the hip, Rapid Recovery surgery involves doctors making an oblique incision from the side of the body.

They cut off just 5-6 cm of skin and a thin layer of tissue and then move the two muscles underneath using retractors to expose the hip joint – all in less than a minute.

The joint is removed and replaced with a titanium shell that goes into the socket, a plastic insert and a ceramic head that serve as the new joint before the retractors are removed and the incision and tissue are stitched closed.

‘The main approach in Britain is through the posterior or back of the hip,’ says Dr Wilson. ‘It takes about 20 minutes to reach the hip and requires the muscles to be loosened and later sewn together, making for a slower recovery time.’

The speed of the Rapid Recovery procedure also reduces the chance of infection, Dr. Wilson explains, because the body does not have enough time to recolonize bacteria on the skin – the leading cause of surgical infections.

The procedure’s developer, German surgeon Dr. Kristian Kley, says he has had just three infections in more than 7,000 procedures over the past 15 years. In Britain, the average infection rate for double hip replacement is about two to three in a hundred.

The procedure is currently offered at Cromwell Hospital in London, where surgeons say 80 percent of patients can walk within two hours – and 95 percent walk out the next day. “Because people get back on their feet so quickly, the risk of blood clots is greatly reduced,” says Dr. Wilson.

The technique that allows 90 percent of patients to stand and walk on the same day of surgery – without crutches (archive photo)

‘After a double hip replacement, patients are often told that they are not allowed to drive for six weeks, but we say that this is possible after fourteen days.

The recovery is much faster and much safer – and we plan to make the procedure available to as many people as possible as quickly as possible.”

The operation costs around £17,000 privately. But Dr. Wilson and Dr. Kley say they run courses to teach the procedure to NHS surgeons, and they also run a visitation and fellowship program at Dr. Kley in Germany.

And NHS consultant knee and hip orthopedic surgeon Dr Arj Imbuldeniya hopes to offer the operation at the Chelsea and Westminster Hospital in London early next year.

“Although other successful techniques exist for hip replacement surgery with next-day recovery, the Rottinger approach takes less than half the time and data shows it is safe,” he says.

‘I wanted to help our long NHS hip replacement waiting lists by increasing the number of hip replacement cases I could safely do in one day from the current three cases to a maximum of six.

‘It is a safe and cost-effective solution for our poor patients who are currently waiting a very long time for surgery on the NHS.’