Quick recovery, minimal risk of breakage
In our institution, we strive to get the patient back on his feet as soon as possible, which is why we start the mobilization early: our physiotherapist visits our patients a few hours after the operation, in order to deal with them individually on a daily basis. This also reduces the risk of thrombosis and recovery is faster. Usually, after 2-3 days, the patient is in good general condition and can safely go home with 2 elbow crutches. In addition, at the Duna Medical Center, we routinely apply the steps of the accelerated rehabilitation protocol, including careful and detailed information before the operation, information on the tasks and events surrounding the operation, admission to the hospital on the day of the operation, careful pain and bleeding control during and after the operation period, so-called as little opioid anesthesia as possible, local infiltration technique, surgical technique without a drain, early mobilization, assisted discharge.
Thus, at the Duna Medical Center, our patients can benefit from the fastest possible rehabilitation in Hungary, to which soft tissue-friendly and safe posterior excision can greatly contribute.
Our patient who has undergone a rapid rehabilitation hip replacement surgery takes the stairs - on the 2nd day after the surgery:
The same patient, two weeks after the operation, is already walking on our terrace:
How to expose - from the front, back or side?
In relation to hip prostheses, you can hear a lot about the advantages and disadvantages of different surgical explorations, and recently the Hungarian Orthopedic Society and Professional College issued a professional statement. Many patients waiting for hip replacement surgery try to find their way based on the often contradictory information found on the Internet and heard from friends.
Those who argue in favor of anterior opening say that recovery after early surgery is faster, so the patient leaves the hospital and goes home sooner, and can do his daily activities sooner. Visibility is not so good during the front opening: it is technically much more difficult to operate on a more muscular, overweight patient, and the risk of bone fracture during surgery is also greater, in the case of osteoporotic patients. A special operating table is often required to perform the anterior opening correctly and to ensure the proper position of the limb. According to several studies, during anterior exploration, the bleeding seen during the operation is greater, so the risk of the patient receiving a blood transfusion after the operation is higher. Damage to a skin nerve can also occur more often with this opening, which supplies the lateral-frontal area of the thigh.
Posterior dissection is most common in Western countries, as it makes it easier and better to expose the hip joint, thereby making all anatomically important details more visible even to the assisting physician. In addition, this method does not damage the main moving muscles, and quick rehabilitation is also available and guaranteed here. Almost anyone can be operated on through a posterior opening, regardless of whether the patient is more muscular or overweight, or if the quality of the bones is poor or if they have osteoporosis. This method of exploration has been distinguished by outstanding patient safety indicators for several decades.
In Hungary, most hip replacement surgeries are performed with a lateral opening . During this, the muscle group (glutes) located on the side of the hip, which plays the most important role in the stability of the pelvis while walking, is separated from the joint. This type of surgery may have the longest average recovery period.
It is important to know that from the sixth week after the operation, the differences resulting from the individual explorations disappear!
Anterior or posterior hip joint exploration: the risk of fracture is the difference!
A study comparing the advantages and disadvantages of posterior and anterior hip arthroplasty in the United Kingdom was published in a prestigious professional journal, the Bone and Joint Journal. They examined 448 patients who participated in a so-called accelerated rehabilitation protocol. 265 patients underwent hip joint prosthesis implantation through anterior and 183 patients through posterior exploration.
The results showed no difference in average nursing time or pain between the two groups either on the day of surgery or on the first, second, or third day after surgery. Also, the patients could be mobilized at a similar time at the earliest, and there were no differences in the incidence of infection or dislocation. As in the occurrence of reoperations and repeated hospitalization within 28 days.
The only significant difference was in the incidence of bone fractures around the prosthesis: the incidence of bone fracture was significantly higher in patients who underwent anterior hip arthroplasty.
Source: Malek, IA, Royce, G., Bhatti, SU, Whittaker, JP, Phillips, SP, Wilson, IRB, … Starks, I. (2016). A comparison between the direct anterior and posterior approaches for total hip arthroplasty. The Bone & Joint Journal, 98-B(6), 754–760
Infection: Stop the pathogens
Avoiding infection is a critical element of surgery and post-care. So far, we have not documented a hospital infection in our institution, and we will continue to do everything in order to maintain this for as long as possible, in compliance with the regulations, which we strictly monitor. In addition to the fact that our doctors and nurses pay extra attention to hygiene, in accordance with the most modern hand hygiene principles, we carry out an MRSA screening for our patients in accordance with the English regulations before every major joint prosthesis operation (we take a sample from the nose and the skin of the inguinal fold with a small stick and send it for microbiological culture). , thus further reducing the risk of possible infections.
The most important thing: Know what awaits you!
Hip and knee replacement surgeries are serious interventions. At the Duna Medical Center, we place great emphasis on detailed information prior to surgery, as you need to know exactly what awaits you before and during surgery, as well as during rehabilitation. The condition for performing the intervention is that you receive answers to all your questions before the operation. Read them by clicking below:
Get to know our orthopedic surgeons:
Our patients who have undergone successful hip replacement surgery
From the operating room to the pulpit
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Thanks to the quick "change of parts", the engine of the Reformed church in Pesterzsébet is running at full speed again: Tamás Takaró attended church services six days after his hip replacement surgery, a week later he was walking with a cane, and in the third week he was again standing in the pulpit without help, to the great surprise of the congregation and for your pleasure!
He is a patient
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As a long-distance runner, our patient was used to physical tests, but because of the increasing hip pain over time, he already thought twice about each step. So when he learned that he needed a hip replacement due to advanced hip wear and tear, he was more than relieved. Ágnes Saághy Elam, who works as a researcher - true to her profession - examined all possibilities and finally voted for the Duna Medical Center and Dr. Zsolt Hegedűs. Now, a few months after the surgery, she is confident that she made the best decision possible.
Jumping into the Danube - interview with Dr. Zsolt Hegedűs
In 10 years, he performed many types of surgery using the latest techniques, in a very large number and with outstanding quality indicators - he admits that this is what an orthopedic surgeon who loves to operate can only dream of. As a "returnee", he believes that a lot has changed in the country, but this is not enough: he would like the results of doctors and health care providers to be accurately measured at home. Orthopedic surgeon Dr. Zsolt Hegedűs is perhaps in the best place to start this.
Our patients said - about Dr. Zsolt Hegedűs
- "I have the utmost confidence in him."
- "The best doctor we have ever dealt with."
- "He is an excellent specialist, empathetic, a real doctor, with great professional security and knowledge."
The first steps
At the Duna Medical Center, we pay special attention to all the needs of our patients. If you already have a diagnosis, but would like to consult an orthopedic surgeon, we now offer a discounted option for requesting a second opinion. You can find out about our prices here:
https://dunamedicalcenter.org/szolgaltatasok/mutetek/ortopediai-mutetek
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You can book an appointment at our institution by phone at +36 (1) 790 7070 or on our website.