Is there a risk to delaying hip replacement surgery?It is not unusual to wish to put off major surgery for as long as possible. As well as having concerns about the procedure itself and the associated risks, many patients are apprehensive about the necessary downtime after the surgery and the upheaval that will bring.

With joint replacement surgery in particular, there is often a desire to delay the procedure, as London hip and knee surgeon Mr Simon Bridle knows only too well.

When a patient has been suffering with joint pain for some time, it may seem that putting off surgery by a few months will only be extending the current suffering. But are there unseen risks involved in delaying a hip replacement procedure?

Risks of delaying total hip replacement

It is fair to say that delaying joint replacement surgery by a few months will probably not create major problems. However, it is important to be appraised of all the facts when considering having – or delaying – any form of surgery, and there are some complications associated with a prolonged postponement of total hip replacement surgery. It is always a good idea to speak to your surgeon before making any major decision around hip replacement surgery.

Problems with the joint itself

Depending on your particular hip problem, there is a possibility that the problem will worsen over time. This can mean that a deformity of the joint progresses – although this is generally a gradual process, that joint stiffness increases, or that the muscles surrounding the joint become weaker as you are using your hip less. Sometimes progressive damage to the joint makes the surgery more complex and recovery longer.

Compensatory problems

When you have pain in one hip, the natural tendency is to put more pressure on other joints. There is very little clinical data to support the theory of compensatory joint problems, but anecdotal evidence is common: many patients who visit Mr Simon Bridle’s London hip clinic experience back problems and pain in other joints, as well as the affected hip. The longer surgery is delayed, the greater the chance that this pain, as well as the pain in the affected hip, will increase.

General health problems

Increasing levels of disability with progressive hip arthritis leads to a more sedentary existence and will have an effect on patients’ general health. They tend to lose physical fitness and put on weight and this can have an effect on the heart and lungs, as well as other body systems. Prolonged use of pain killers can also have an effect on the kidneys. All this can increase the small risk of complications associated with surgery.

Can I avoid or delay hip replacement surgery?

A study published in Annals of the Rheumatic Diseases in 2013 did offer some hope, suggesting that exercise could delay or avoid the need for hip replacement surgery in patients with osteoarthritis.

The study showed that patients who took part in an exercise programme for one hour, twice a week over a twelve-week period, were 44 per cent less likely to need hip replacement surgery in later life than their peers who did not exercise.

If you have already been told that you need hip replacement surgery, it is unlikely that exercise will avoid the need for the operation. However, there is no doubt that low impact exercise will improve patient’s physical fitness, which can only be a good thing when approaching major surgery.

To find out more about your own situation and whether there is anything that can be done to delay surgery, why not book a consultation with London hip surgeon Mr Simon Bridle today.

recent joint replacement studiesTwo studies on the effects of joint replacement have hit the news recently – one, from the University of Oxford, examined the long term benefits and limitations of knee replacement surgery.

The second study, which gained a lot of media coverage, came from the University of East Anglia and looked at activity levels in patients before and up to one year after hip replacement surgery.

Studies like these are very useful to help improve the practice of orthopaedic surgeons, such as London hip and knee surgeon Mr Simon Bridle, but there is often a danger when they are reported in the mainstream press that the results can be taken out of context.

Here, we will look at each of these studies objectively and examine the results in more detail.

The knee replacement study

This piece of research has not received much general press coverage, but was reported by Arthritis Research UK, who have provided a neat summary of the results for patients.

The study looked at the long term benefits of knee replacement surgery, as well as investigating factors that can affect the effectiveness of treatment. A group of 1,980 people receiving total knee replacement surgery were assessed by the research team both before the procedure and again ten years post op, to find out more about their individual outcomes.

Researchers found that both pain and function of the knee joint improved over the ten-year period, although pain significantly more so, showing that while knee replacement surgery is shown to be effective in relieving knee pain, the less satisfactory functional results suggest that improvements in implant design and surgical techniques will further improve results.

A number of factors were identified which were associated with less good results. Patients who are overweight and who have had previous operations on their knee tend to do less well other patients.

Consultant hip and knee surgeon Simon Bridle welcomes studies such as these, which allow him to give more accurate information to patients considering knee replacement surgery, as well as providing a catalyst for the improvement of surgical techniques and technology.

The hip replacement study

This study, conducted by researchers from the University of East Anglia, is equally useful to orthopaedic surgeons like Mr Bridle. Unfortunately, however, media coverage such as this piece in the Sun has misled the general public and caused concern amongst many hip replacement patients.

The study itself looked at the activity levels of patients, both before and up to one year after hip replacement surgery. Rather than researchers assessing patients themselves, this paper was a review of 17 different studies on the subject, carried out between 1976 and 2016.

Having analysed the results of all the different studies, researchers found that there was “no significant statistical difference in physical activity levels before and up to one year after unilateral primary total hip replacement.”
Does this mean hip replacement doesn’t work?

Articles like the one in The Sun have claimed that the study shows that hip replacement surgery is unnecessary. However, it is always important to analyse all aspects of a study.

As Mr Martyn Porter, Medical Director of the National Joint Registry, explains:

“Joint replacement surgery offers significant benefits – getting patients back to their chosen lifestyle sooner, free from pain and with improved mobility. Of 91,760 patients surveyed in 2013, 92% described themselves as being either ‘excellent’, ‘very good’ or ‘good’ six months after surgery.
“The main reason for doing hip replacement is to improve pain and there is overwhelming evidence that hip replacement is a wonderful success at improving pain dramatically for the vast majority of patients.”
Mr Porter goes on to say that the overwhelming majority of hip replacement patients report a marked improvement in functionality after the procedure, something that is reflected in Mr Bridle’s own London hip replacement clinic.

To read Mr Porter’s full response to the media furore surrounding the study, click here.

To find out more about how hip replacement surgery could improve your hip problems, contact us to book a consultation with Mr Bridle.

If you’ve been struggling with the discomfort and loss of mobility associated with arthritis of the hip and knee, then you may be contemplating a joint replacement procedure. Your choice of orthopaedic surgeon to carry out this surgery is probably the most important decision you will make.

There are four important factors you should take into account when choosing your joint replacement surgeon

1. Experience

How long has your surgeon been practicing? Mr Bridle has been a Consultant Orthopaedic Surgeon since 1994, specialising in hip and knee replacement and revision surgery. He has set up a hip and knee Multidisciplinary Team to deal with patients with hip and knee problems. In addition, he has been active in NHS management, holding important roles such as Lead for Orthopaedics, Clinical Director for Surgery and Clinical Director for Major Trauma at St George’s Hospital, London.

2. Expertise

How many knee or hip replacements do you perform a year? Choose a surgeon who regularly performs hip or knee replacements and can discuss their results with you. Over the last ten years, Mr Bridle has performed nearly 1000 primary hips and 500 primary knee replacements and specialises exclusively in this form of surgery.

3. Choice of prosthesis

It is very important that the prosthesis we put in lasts a long time, avoiding the need for complex revision surgery. There are a very large number of hip and knee implants available on the market. Hip and knee implants are rated by ODEP, with the long-term results available through the National Joint Registry. Mr Bridle uses only the best-rated implants, with the best long-term survival. More details on this are available on the website.

4. Complication rate

There are a number of rare, but important potential risks and complications associated with joint replacement surgery, including infection and dislocation, and your surgeon should be able to provide you with their rates of incidence. Mr Bridle has a very low complication rate in his own primary replacement procedures and his experience and expertise is such that he is often called upon to treat complex revision procedures. This is dealt with in more detail on the website.

Details of how to arrange a consultation are covered on the website. Alternatively, please call Mr Bridle’s PA Diana on 02089479524 of email her ( for more information.