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Last Updated: Thursday, 2 October, 2003, 13:26 GMT 14:26 UK
'Home in a day' hip replacements

Surgeons say a pioneering operation could allow patients to be able to go home the day after they have a hip replacement.

Patients who have standard hip replacements have to stay in hospital for an average of eight days.

Developers of the new procedure say it could cut waiting lists and save the NHS millions of pounds.

The news comes as the High Court ruled that patients suffering an "undue delay" for an operation could claim the cost of having treatment abroad.

Yvonne Watts, 72, lost her case to force the NHS to pay for her hip operation in France, but the judge approved the claim in principle.

The National Audit Office has suggested a reduction in hospital stays for hip replacement patients of between two and six days could save the NHS between 15.5 and 46.5m each year.

Experts say the new hip operation looks promising, but patients need to be monitored for several years.

NHS waiting times in the UK will have to be drastically reduced.
Richard Stein
Solicitor in Watts case

The company behind the 2-Incision procedure say it could reduce hospital stays by up to 10 days and may eventually help save the NHS over 77m.

It claims 68-year-old Shirley Mattin from Hertfordshire, who had the operation, set a European record by being able to walk just four hours after the operation and being discharged from hospital only 27 hours after surgery.

'No comparison'

The 2-Incision procedure is being carried out at three London hospitals, Chase Farm, the Whittington and Whipps Cross.

Shirley Mattin
There is simply no comparison
Shirley Mattin

In the operation, the replacement joint is inserted through two cuts, as small as four to five centimetres in length. Muscles are moved aside during the operation.

In contrast the traditional procedure needs a 30cm incision, and extensive cutting of the leg and hip muscles.

The company Zimmer, which developed the 2-Incision technique, say its benefits include a shorter hospital stay, smaller scars, reduced blood loss, faster and less painful rehabilitation and the possibility of a quicker return to work and daily life activities.

Mrs Mattin said, "I've had both hips replaced by the same surgeon.

"The first one was done as a standard hip replacement and the second one was done using this new 2-Incision technique. There is simply no comparison.

"I have had less bruising, swelling and pain this time and was walking up and down stairs the day after my surgery. This time, I was ready to leave hospital the next day. Last time I was in hospital for eleven days."


Howard Ware, the consultant orthopaedic surgeon at Chase Farm, who carried out the procedures, said: "The 2-Incision has the potential to revolutionise the way that surgeons carry out hip replacement procedures.

The majority of hip replacements carried out in the UK use "cement" to connect the joint - only 10% do not.
But the cement technique cannot be used with the 2-Incision procedure.
However some surgeons argue the cement could be used in fewer operations - so the new technique could be used more widely.
"Seventy per cent of patients in the US who receive this procedure leave hospital within 24 hours of admittance and in the UK this technique is already dramatically reducing the amount of time patients need to stay in hospital."

He added: "As soon as more surgeons are trained in the technique it will become much more widely available. In the future this could benefit up to 70-80% patients who need a hip replacement."

Mr Hugh Phillips, vice-president of the Royal College of Surgeons, told BBC News Online he welcomed the introduction of the 2-Incision procedure.

But he said the operation would not work with the kind of replacement joints used in the majority of operations in the UK.

He also said surgeons would need specialist training to use the equipment to carry out the operation.

Mr Phillips added: "It's experimental in the sense that we don't know the long-term results.

"Then it would have to be compared to the extensive results we have for the traditional hip replacement operation.

"Hip replacements are currently one of the top four operations in terms of improving quality of life."

He added: "If you can get patients out of hospital in two to three days, the costs of their treatment will be transferred to the community."

The BBC's Vicky Young
"The new procedure is less invasive"

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