Author: Hip Videos

Am I too young for a knee or hip replacement?

Posted by - joint replacement

 

Every week in our clinic we hear the question “am I too young for a hip/knee replacement.”  The simple answer to this question is – No, there is no age requirement to have joint replacement surgery! But let me explain this in more detail…

Total hip replacement (THR) and total knee replacement (TKR) are two of the most successful operations for improving quality of life, mobility and pain relief. In Australia 40,000 THRs and 50,000 TKRs are performed each year and of these 12 % and 7% are performed in patients less than 55 years of age respectively…meaning there are tens of thousands of younger Australians whose lives have been improved with joint replacement surgery.

There are several factors to consider when making the decision to proceed with joint replacement surgery. This includes the severity of the joint disease and symptoms, age of the patient, co-morbidities (such as cardiac problems, diabetes, obesity, pain syndromes or mental health) and whether a trial of non-operative management has been undertaken.

The primary concern for younger patients having joint replacement is that the implants will wear out over time and revision surgery will be required. A common myth is that most joint replacements will only last 10 years. Based on the Australian joint registry data only 1 in 9 THRs and 1 in 6 TKRs will require revision surgery after 18 years in patients who have their primary surgery before the age of 55, meaning we expect the majority of joint replacements to last many more years. Revision surgery can be minor or major and is not something necessarily to be scared of given how commonly it is now performed and the advances in implant technology.

Other concerns for younger patients include a higher dissatisfaction rate in some studies (especially for TKRs) and worries regarding inability to return to certain activities. However, a way to overcome this is by making sure patients are well informed and patient expectations are managed through comprehensive education. Most people would be surprised what type of low impact exercise can be performed after joint replacement surgery. There are also some people hoping for magical new treatments (such as stem cells) that are going to “cure” their arthritis however unfortunately these just do not exist.

In summary, when a patient presents with joint disease who has failed non-operative management and their symptoms are sufficiently severe to justify the risks of surgery, joint replacement can be performed regardless of age. By giving patients pain relief and improved function, people often are happier and healthier, even when having joint replacement at a young age.

If you would like to discuss your options we are happy to help so please contact our practice.

Scott Tulloch
Orthopaedic Surgeon

Sporting Chance Foundation supporting indigenous athletes

Posted by - Knee Surgery

Dr-Scott-Tulloch-knee-operation

Victorian Orthopaedic Group surgeons perform operations to return indigenous athletes to sport

Article first published at  https://www.cabrini.com.au/

Victorian Orthopaedic surgeon Dr Scott Tulloch in partnership with Sporting Chance Foundation and Cabrini Hospital are making a difference to the lives of young indigenous athletes by providing the surgery they need to return to the sporting field.

Unfortunately, a sporting injury, such as an anterior cruciate ligament rupture of the knee, during adolescence, can significantly impact a promising sporting career, particularly if the athlete doesn’t have private health insurance or is unable to access timely specialist medical care.

As part of Cabrini’s mission to provide high-quality, accessible care for all, Cabrini has partnered with the Sporting Chance Foundation to cover the costs associated with the hospital stay to accommodate operations for two Sporting Chance recipients.

The Sporting Chance Foundation helps aspiring young indigenous athletes to fulfil their sporting dreams following a significant musculoskeletal injury by helping to provide access to the necessary surgery to get them back to their sport. The surgeon, Dr Scott Tulloch will perform the surgeries pro bono, and anaesthetist David Brewster will also provide his services pro bono. Travel, accommodation and rehabilitation following the surgeries will be covered by the Sporting Chance Foundation.

Two young indigenous female rugby players from Queensland, 16-year-old Genesis Ngeru and 14-year-old Stevie Smith, will receive anterior cruciate ligament (ACL) surgery at Cabrini to get them back on their feet.

Mr Tulloch said he became involved in the program because he saw immense value in helping young athletes, in the prime of their career, return to the sporting field.

“ACL injuries are most commonly caused by accidents in Australian Rules football, rugby, netball or soccer, really any sport that involves pivoting motions puts you at risk,” he said.

“It is nearly impossible for players to return to these sports without having knee reconstructive surgery. ACL rupture is an injury that doesn’t heal on its own. After the surgery, patients will need to undergo extensive physiotherapy and a 12-month rehabilitation program to return to the rugby field.”

“This surgery allows these young athletes to get back to the sport they love and hopefully fulfil their sporting dreams. For young athletes in their prime, being sidelined from their chosen sport can not only affect them physically, but it can also take an enormous toll on their mental health.”

Genesis said rugby was her life and she couldn’t wait to get back to it.

“I love it with a passion, it’s quick, it’s aggressive and it’s a good way to show who I am,” she said.

“Watching on the sidelines has been tough, every time I watch I get itchy feet, I just want to get back out there and play again.”

Genesis also said she wanted to continue playing rugby and hopefully make a career of playing professionally.

“I would love to play for an indigenous team in Australia or New Zealand. I want to be an inspiration to other young girls who want to play sport at a professional level. It is vital for me to continue sport. I am so happy to be able to have this surgery so I can get back to playing the sport I love,” she said.

Stevie said she was looking forward to having the surgery so she could get back to playing rugby.

“Playing rugby makes me happy, it has been hard to watch since I have been injured but I still go along to every game to support my team,” she said.

“If it wasn’t for Cabrini and the Sporting Chance Foundation, I wouldn’t be able to afford to have the surgery done and I wouldn’t be able to play rugby again, so I am just incredibly thankful to have this opportunity.”

“I’d love to play professionally, so I hope this surgery will allow me to get back to playing rugby. Hopefully, I can pursue my sporting dreams.”

Dr Tulloch said he was hopeful the surgeries would return the athletes to their full pre-injury function.

“Outcomes from this type of surgery are usually very good and it will be personally rewarding for me to see these athletes return to the rugby field,” he said.

For more information about orthopaedic surgery services for sporting injuries please contact us to arrange an appointment.

Hip and Knee Surgery, Zero Out-of-Pocket Expenses

Posted by - No Gap Surgery For Patients Requiring Joint Replacement

doctor explaining knee surgery to a woman

Joint replacement is among the most effective surgeries for improving quality of life, and more than 30,000 hip replacement and 50,000 knee replacement procedures are performed in Australia each year.

Now, thanks to a new initiative by Vermont Private Hospital in partnership with the Victorian Orthopaedic Group, Nexus and Medibank, together we can offer no out-of-pocket costs (besides hospital excesses if applicable) for some types of hip and knee replacement surgeries for eligible Medibank members.

Lead orthopaedic surgeon and director of Victorian Orthopaedic Group, says the new initiative was about providing a brighter future for patients with better outcomes.

“I’m a big believer in rapid recovery and providing the best environment for patients to heal and get their life back on track as soon as possible,”

“I specialise in a minimally invasive total hip replacement and rapid recovery total knee replacement and perform several hundred procedures each year. Experience and research tells us that with the right support, patients achieve better outcomes and a better healing experience when they recover in the comfort of their own home (1,2).

“It’s exciting to be part of this new initiative which through working together in partnership, we can provide a brighter future for our hip and knee surgery patients.”

Director of Nursing at Vermont Private Hospital, Fiona Langley, said her hospital is committed to working with surgeons to deliver superior patient care and surgical outcomes.

“We believe in creating a sustainable healthcare system, and are proud to be involved in developing a care model that gives patients certainty over both the level of care, and the costs involved in their surgery,” Ms Langley said.

“We want to provide the best value for patients with private health insurance and I’m grateful to Nexus and Medibank for working together with us to ensure this new initiative makes it possible for eligible Medibank patients to have no out of pocket medical costs.”

How does Zero Out Of Pocket (ZOOP) work?

  1. Pay no out of pocket costs– Nexus and Medibank have worked together to eliminate medical out of pocket costs for hip and knee replacement surgeries for eligible Medibank members. The program is available to Medibank members with appropriate cover, in consultation with their treating practitioner.
  2. Spend less time in hospital– Vermont Private Hospital’s innovative model of care means you can avoid a long stay in hospital, and have the option to recover in the comfort of your own home. Studies have shown that with the right support in place, patients have better outcomes and a better experience when they recover in the comfort of their own home.
  3. Get back on your feet faster– Nexus and Medibank are working together to support patients before and after surgery, including prehabilitation services prior to surgery (delivered by Nexus), and if clinically appropriate, offering Medibank at Home rehabilitation after surgery.

(Read the latest research on joint replacement techniques and recovery below.)

medibank logo

Eligible Medibank Members may also have access to additional support before and after their hospital admission, including options for in-home rehabilitation with expert physiotherapy and other allied health support, when clinically appropriate. Nexus is offering eligible Medibank members zero out-of-pocket medical costs; contact Medibank to find out more. Hospital policy excesses still apply.

 

nexus logo

About Vermont Private Hospital

Located 20km east of Melbourne’s CBD in Vermont South Medical Centre, Vermont Private Hospital is part of the Nexus Hospital Group.

It is renowned for its outstanding patient care and specialist orthopaedic focus. The purpose-built facility is equipped with the latest surgical technology, including four fully integrated operating theatres. Dedicated nursing and support staff are trained in orthopaedic care, and will take of your needs from admission to post-operative recovery.

joint replacement surgery brochure

Download the a Zero Out of Pocket Brochure Here

For more information contact us via phone: 03 9853 7099 or email: reception@vicorthogroup.com.au

 

 

 

[1] What‘s new in hip arthroplasty; MH Huo et al; JBJS Am; 2005 Sep, 87(9):2133-46

[2] Single-incision anterior approach for total hip arthroplasty on an orthopaedic table; JM Matta et al; Clin Orthop Relat Res, 2005 Dec, (441): 115-24

[3] Minimally Invasive total hip arthroplasty: anterior approach; F. Rachbauer; Orthopäde, 2006 Jul;35(7):723-4, 726-9

[4] Mini-incision anterior approach does not increase dislocation rate: a study of 1037 total hip Replacement; T Siguier et al; Clin Orthop Relat Res,2004 Sep, (426): 164-73

Why it’s important to take care after knee replacement surgery

Posted by - Uncategorised

doctor-bends-knee

I perform hundreds of knee replacement surgeries every year so I see first-hand just how important it is for people to take the right steps to recover.

The first tip to rehab after a knee replacement surgery is to use an ice compress. This method is crucial in reducing swelling and pain, which will ultimately increase movement of the knee. In my practice, we provide patients with an Ice Machine to loan following their surgery to encourage this.

Secondly, let your body recover and don’t overdo physiotherapy. All prescribed exercises should be done in short duration with more repetitions. Most people want to get back to normality as quickly as possible but sometimes when they push themselves too hard, it can have the opposite effect.

In saying that, exercise is still paramount so regular, short walks is one of the best ways to help your body return to normal function.

At Victorian Orthopaedic Group, we also put a huge emphasis on prehab, which involves getting our patients to practice using crutches and start their exercises before the surgery.

If you would like to discuss the knee condition you are managing and treatment options available, please contact us.

DR DAEVYD RODDA
VICTORIAN ORTHOPAEDIC GROUP

Six Tips For Managing Osteoarthritis

Posted by - Uncategorised

grand parents cured with Osteoarthritis running after their grand children

If you’re living with Osteoarthritis it can be debilitating and have a major impact on your quality of life. Being informed about your condition and using a range of strategies to help you maintain your health can help reduce pain, increase movement and go a long way to getting back to doing the things you love to do.

Six tips for managing Osteoarthritis

Education:Be thoroughly educated on your chronic condition, and this will assist you in your best choice of treatment. There is a lot of information available on osteoarthritis, but make sure you are researching what is relevant to you.

Weight Management: Maintaining a healthy lifestyle is one effective treatment method for joint pain. Ask your GP to check your BMI, and suggest effective methods of weight loss and maintenance in necessary.

Medication Management: The best medication for joint pain is Panadol Osteo (or equivalent). It is a relatively safe medication, but always check with your GP before commencing, particularly if you have liver disease.

Physiotherapy: Visit your physiotherapist and request some strengthening and range of motion exercises which are useful tools for managing the symptoms of joint pain.

Lifestyle Modification: Modify the activities that you perform if you suffer from joint pain. Choose low impact activities such as walking, swimming and cycling, rather than high impact activities such as running which can exacerbate your pain.

Injections:There are a number of injections available to help treat joint osteoarthritis. Discuss the most suitable options for you with your GP or a joint Specialist.

Victorian Orthopaedic Group specialise in hip and knee replacement to help you get back to doing the things you love. Please consult your GP for further advice on any of these tips and if you would like to discuss your options for lower limb joint replacement please contact us.

What Is The Anterior Approach For Total Hip Replacement?

Posted by - Uncategorised

doctor briefing patient for anterior approach for hip replacement

If you are experiencing debilitating osteoarthritis pain in your hip and you’ve tried everything, a total hip replacement can restore function and decrease pain.

The contemporary approaches for hip replacement surgery are posterior, anterolateral and the anterior minimally invasive approach (1,2,4). When performed well, all of these approaches are likely to have an excellent result.

My preference is to perform the anterior, minimally invasive approach for nearly all hip replacements. This is a technique that I teach to other surgeons and am quite passionate about.

My preference is due to the potential benefits of quick recovery, lower dislocation risk and a smaller scar(3,4). Obviously, all approaches have potential complications as well.

In conjunction with your GP, choose a surgeon who is highly skilled in their preferred approach, not based on which approach they perform.

Your surgeon should make you feel comfortable with their recommended approach.

Always ask your surgeon the number of these procedures they perform and their outcomes. Never be afraid to ask for a second opinion if you are not comfortable.

DR DAEVYD RODDA
(1) What‘s new in hip arthroplasty; MH Huo et al; JBJS Am; 2005 Sep, 87(9):2133-46
(2) Single-incision anterior approach for total hip arthroplasty on an orthopaedic table; JM Matta et al; Clin Orthop Relat Res, 2005 Dec, (441): 115-24
(3) Minimally Invasive total hip arthroplasty: anterior approach; F. Rachbauer; Orthopäde, 2006 Jul;35(7):723-4, 726-9
(4) Mini-incision anterior approach does not increase dislocation rate: a study of 1037 total hip Replacement; T Siguier et al; Clin Orthop Relat Res,2004 Sep, (426): 164-73

New “No Gap” Trial for Private Health Cover Patients

Posted by - No Gap Surgery For Patients Requiring Joint Replacement

New cooperation between private hospital operator, doctors and health insurer guarantees “no gaps” for patients having joint replacement surgery. 

Vermont Private Hospital (part of the Nexus Hospitals Group) in Melbourne’s eastern suburbs is the first to offer a new style of private health insurance arrangement guaranteeing that patients needing joint replacement can have their surgery with no out-of-pocket costs.

The new service is a first-of-its-kind cooperative arrangement between private hospital, doctors and private health insurer which eliminates out of pocket costs for privately insured patients and implements an innovative model of care which reduces the time patients need to stay in hospital.

Nexus Hospitals CEO Andrew Petering says the new ‘Zero Out of Pocket’ or ‘ZOOP’ arrangement is aimed at giving patients certainty that – apart from any applicable excess under their policy – all other costs for their hospital admission will be covered by their private health insurance.

“Patients with private health insurance want their insurance to cover all of their out of pocket costs.  Historically, private health insurance in Australia hasn’t been able to provide that certainty because of the way that the healthcare system is regulated.

“When you take out car insurance, you know that if you need to use it, all of your costs are covered.  All you pay is a pre-agreed excess and everything else is taken care of by your insurance company.  We’ve introduced ZOOP to give patients with health insurance that same peace of mind.”

Under the new arrangement, patients will also receive cover for additional services both before and after their hospital stay, aimed at improving their recovery and helping patients get back on their feet faster.  These include “prehabilitation” assessment and education by a specialist physiotherapist to optimally prepare them for surgery, access to smartphone app technology to customise their recovery, and options to receive nursing and rehabilitation care at home.

Orthopaedic surgeon was the first surgeon to perform joint replacements at Vermont Private Hospital under the ZOOP initiative.  He said he has wanted to be able to offer this kind of service to patients for some time, but the way the healthcare system is regulated couldn’t guarantee patients wouldn’t pay a gap.

“Eliminating out of pocket costs for patients is the holy grail for private hospital care.  The only way we can ensure no gaps for patients is to have doctors, the private hospital and the private health insurer cooperating to ensure everything is covered.”

“One of the first patients to have their knee replacement at Vermont Private also needs to have her other knee as well as a hip replaced.  Without access to this kind of arrangement she would have had significant out of pocket expenses to cover the cost of all three surgeries, which was prohibitive for her.  Now, she can use her health insurance and be fully covered with no gaps.”

Nexus Hospitals Chief Operating Officer, Scott Bell, says that the additional support services provided before and after surgery means that patients are able to have a much shorter hospital stay after surgery.  A recent patient of Dr Rodda’s was able to have a total knee replacement surgery and was discharged home the same day – the first such procedure performed in Australia as day surgery.

“New surgical and anaesthetic techniques for joint replacement mean that patients can be back on their feet and recovering much faster.  With the right support in place at home, research has shown time and again that patients have better outcomes and a better experience when they recover in the comfort of their own home.”

“The average stay in Australian hospitals after hip or knee joint replacement surgery is over four days, plus many patients have an additional stay for rehabilitation which can be a week or more.  In other countries length of stay has been shortened dramatically in recent years as new surgical techniques have been introduced, and in the US and Europe many hip and knee replacements are being performed as day surgery or discharged the next morning.”

Medibank is the first Private Health Insurer to support the Nexus ZOOP arrangement for joint replacement surgery at Vermont Private Hospital.  Nexus and Medibank are proposing to expand the arrangement to cover joint replacement surgery in other locations around Australia, and Nexus is also looking at expanding the arrangement to offer no-gap surgery for other treatments such as hernia repair.

About Vermont Private Hospital:

First opening in 2016, Vermont Private Hospital is a short stay hospital offering surgical care in orthopaedic surgery, ophthalmology, plastic and reconstructive surgery, chronic pain and other specialties.  Vermont Private is part of the Nexus Hospitals Group. Ph: 03 8547 1111.

MEDIA ENQUIRIES:

Scott Bell  0414 686 073  s.bell@nexushospitals.com.au