Description
The presentation begins with Andrew Manktelow extending warm greetings to the audience at the British Indian Orthopaedic Society meeting in Mansfield, humorously referencing England's recent cricket successes. He expresses gratitude for the opportunity to discuss the challenges and advancements in revision hip arthroplasty.
Manktelow emphasizes that despite the challenges faced by hip surgeons, the nature of hip surgery can be incredibly fulfilling due to the life-changing impacts of hip replacements. He notes the increasing rates of both hip replacements and revisions, correlating this with an aging and more active population, and outlines the significant risks associated with revision surgeries compared to primary procedures, highlighting factors such as infections and dislocations.
He elaborates on common reasons for hip failure—including infections, fractures, implant issues, and complications related to joint mechanics. He contrasts simple revisions with more complex scenarios involving severe bone loss and infection management. Manktelow shares statistical insights from registries indicating shifts in the most common reasons for hip revisions, such as a rise in infections and dislocations, indicating the need for refined surgical approaches.
A significant focus is placed on the complexities of managing instability post-revision, underscoring its prevalence among revision cases. Manktelow discusses surgical techniques and the importance of understanding various factors contributing to dislocation to tailor effective management strategies.
He presents innovative solutions including dual mobility implants, which aim to reduce dislocation rates in higher-risk patients, as well as advancements in femoral revisions utilizing modern implant designs that improve fixation and biomechanics. Manktelow also sheds light on managing acetabular bone loss using trabecular metal implants, which have revolutionized reconstruction capabilities.
Furthermore, Manktelow highlights the importance of inter-surgical coordination through networks that enhance collaboration among orthopedic surgeons in the region. He shares his experiences with the East Midlands Specialist Orthopaedic Network, detailing their weekly meetings aimed at reviewing and strategizing around complex revision cases to improve patient outcomes.
In conclusion, Manktelow expresses appreciation for the audience's attention, thanking them for inviting him to share insights on the evolving landscape of hip surgery and the joy it brings to practitioners. His engaging narrative is peppered with humor and real-world examples that resonate with the audience, demonstrating both the challenges and triumphs of modern orthopedic surgery.