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New Orthopaedic Service Introduced in Colchester

A new type of surgery has been introduced at Colchester General Hospital to treat patients with hip pain and to help them regain an active lifestyle.

 

Mr Nic Wardle, Consultant Orthopaedic Surgeon (centre), is pictured with some of his colleagues shortly before undertaking a hip arthroscopy operation. His colleagues (left to right) are: Frank Sanchez, Operating Theatre Nurse; Jojo Brusola, Deputy Charge Nurse; Anania Carpela, Staff Nurse; Barry Thomas, Healthcare Assistant; Dr Venkatesh Annam, Consultant Anaesthetist.

Before the introduction of hip arthroscopy in Colchester, patients from north east Essex needing this type of treatment had to travel to either Southend or Cambridge.

The service has been set up and is being led by Mr Nic Wardle, one of 12 consultant orthopaedic surgeons employed by Colchester Hospital University NHS Foundation Trust.

The Trust, currently one of only two hospital trusts in Essex to provide hip arthroscopy, has invested £70,000 in specialist operating theatre equipment.

Mr Wardle said: "Patients benefiting from this new service are commonly aged between their 20s and early 40s.

"Often, their condition is sports-related and they will present with symptoms such as hip pain, clicking, their hip giving way or restricted movement.

"Hip arthroscopy is a keyhole surgery technique which relieves pain by repairing tears and damage and enables patients to resume normal activities and a good quality of life.

"Although comprehensive outcome data is still immature, it is thought the procedure has the potential to delay the progression of certain conditions to osteoarthritis and the need for an early total hip replacement."

Mr Wardle, who joined the Trust in 2012, was trained in hip arthroscopy during fellowships in Berlin and Bournemouth.

An arthroscope, which is a small camera, is passed through a small cut in the skin and into the hip. It lights up and magnifies the structures inside the joint, displaying images on a monitor. Arthroscopy is more commonly used in knee and shoulder surgery.

In addition to simply looking inside, a surgeon can use fine instruments which are passed into the hip through a small incision in the skin (keyhole surgery). These instruments are used to cut, trim and take samples to be studied under a microscope (biopsy).

Mr Wardle said hip arthroscopy had been in existence for more than 15 years and had started to become more mainstream in the past 5-10 years. The National Institute for Health and Care Excellence (NICE) is now recommending it for early hip problems.

The most common condition it treats is femoroacetablular impingement (FAI), where the bones of the hip are abnormally shaped.

Because they do not fit together perfectly, the hip bones rub against each other and damage the joint. The surgeon can correct the FAI by trimming the bony rim of the acetabulum (socket) and also shaving down the bump on the femoral head (the ball shape on top of the thigh bone which fits into the socket).

Other conditions that hip arthroscopy helps with include tears to the labrum, a type of cartilage found in the hip joint, in which the surgeon will either repair or smooth the edges of the torn or frayed cartilage using arthroscopic shaver blades or radiofrequency energy.

Hip arthroscopy procedures take 1-1½ hours to complete and are carried out under a general anaesthetic. Currently, patients spend one night in Colchester General Hospital after surgery but there is potential to provide the service on a day case basis.

Patients see a physiotherapist after their operation and are encouraged to do special exercises after they leave hospital and before they return for an initial follow-up appointment six weeks post-surgery.

Demand for hip arthroscopy is rising, so one of Mr Wardle's consultant orthopaedic surgeon colleagues, Mr Jeremy Parker, is due to be trained in the technique.

Patient story: Simon Rae

"Life-changing" and "transformational" are two of the ways Simon Rae describes the hip arthroscopy operation he had at Colchester General Hospital in January.

Mr Rae, 46, who lives in the Birch Glen area of Colchester, had a condition called femoral neck bone island, probably as a result of an accident he had in 2001 when a car hit his motorcycle while he was stationary at traffic lights.

He had torn tissues and a lump at the end of his left thighbone (femur) which rubbed against his hip socket, resulting in excruciating pain and meaning he eventually had to give up work in 2011.

During his 1½ hour operation, Mr Wardle shaved off the lump and removed the torn tissues.

Mr Rae said: "As soon as I came round after the operation, I could feel the difference and knew instantly everything was going to be all right.

"There was a time when I thought I would be using crutches and walking sticks for the rest of my life but now I'm able to take the dog out for walks and have just started to apply for jobs.

"I used to get pain spasms which felt like being knifed in the groin with a red-hot poker and the simplest tasks, like putting on socks, having a shower or getting out of a chair, were a challenge.

"There were times when the only way I could get up the stairs was on my hands and knees.

"I used to joke to friends that I would only bend over to pick up a £20 note - and nothing any smaller because the pain was unbearable."

Mr Rae, whose last job was as a delivery driver, has three children and a grandson Oscar, who will be two in July.

He can now pick up his grandson and play with him whereas before he could only sit with him on his lap in a chair.

 

Source: Colchester Hospital University

 

 

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The Operating Theatre Journal, OTJ, is published monthly and distributed to every hospital operating theatre department in the UK. The distribution includes both the National Health Service and the Private Sector.

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