Hip replacement ops ‘FAIL to get people moving – and can do more harm than good’

THE NHS is wasting millions of pounds a year on hip replacements that fail to get people moving again, a study suggests.

Around 78,000 people have the operation on the NHS in England each year, at a cost of up to £11,795 a time.

The most common reason patients give for going under the knife is to “ease pain on movement”.

But a new review of evidence shows post-op activity levels are typically no higher than they were pre-op.

Patients who remain inactive after a hip replacement are at greater risk of heart disease, type-2 diabetes and cancer than inactive people who did not have surgery.

Experts say this means the procedure – which cost taxpayers an estimated £676million a year – may actually be doing more harm than good.

Total hip replacement is one of the most common elective operations, with more than 620,000 procedures performed in the UK from 2003 to 2013.

Around 93 per cent of cases are due to osteoarthritis, which occurs when the protective cartilage on the end of bones breaks down, causing pain and stiffness.

Academics from the University of East Anglia analysed activity data on 1,030 hip-replacement patients, in the first systematic review of its kind.

The study – published in the journal Clinical Rehabilitation – examined whether patients were walking longer distances, walking more quickly, cycling and climbing stairs after the op.

It concludes: “There is no statistically significant difference in physical activity levels before and up to one year after unilateral primary total hip replacement.”

Lead researcher Tom Withers, from UEA’s School of Health Sciences, said: “There’s potentially money being wasted on hip replacements for people who want to become more active, but in all likelihood will not.

“Research shows people are at greater risk of inactivity-related illnesses if they remain inactive after a hip replacement, than if they did not have the operation.

“And you also get a spike in their body mass index, which is a good measure of obesity.

“If a patient’s pain is being controlled well on medication, their surgeon should be questioning if an operation is the right thing to do.

“You could argue the ops will do some people more harm than good.”

He added: "It's important people are encouraged to move more after having a hip replacement."

Tom was unable to put a figure on the number of “wasted” operations that fail to achieve their objective of increasing mobility.

Toby Smith, a physiotherapy lecturer at UEA, said: “Healthcare professionals and researchers need to better understand this lack of change and how patient’s perceptions of physical activity might be modified to increase their engagement in physical activity post-operatively.”

Olivia Belle, from the charity Arthritis Research UK, said: “Hip replacement surgery is an essential treatment and a life line for thousands of people with osteoarthritis who have often been living in pain for years, waiting for surgery.
"It is mainly used to help relieve pain, as well as increase mobility.
"But joint replacement alone is not enough.
"People undergoing surgery must have access to physiotherapy post-surgery and the support to do the appropriate exercises which help stabilise and strengthen the joint.
"But more than anything, we need earlier diagnosis and better treatments for osteoarthritis, so that waiting in pain for a joint replacement is not the only option.”

Figures from NHS Digital show there were 78,195 hip replacement procedures carried out in hospitals in

England in 2014/15, a slight increase of 2.1 per cent from 2013/14.