We are delighted to highlight the recent publication of Mr Gerard A. Sheridan, Consultant Orthopaedic Surgeon at Bon Secours Hospital Galway, in the prestigious Journal of Bone & Joint Surgery.
Mr Gerard A. Sheridan is an academic Orthopaedic Surgeon specialising in total hip and knee replacement surgery at Bon Secours Hospital Galway, as well as University Hospital Galway and Merlin Park University Hospital. He is a reviewer for Journal of Arthroplasty and has authored over 100 peer-reviewed publications to date. He is also an honorary Senior Lecturer at the University of Galway.
Mr Sheridan addresses the latest advancements in hip replacement surgery in the following excerpt: Total hip replacement has been quoted as the “operation of the century” due to its ability to eradicate osteoarthritis hip pain, restore mobility and function and ultimately return the patient to an enjoyable quality of life.
As with all areas of medicine, hip replacement surgery must constantly adapt to emerging research and evidence in the scientific literature. A recent publication in the prestigious Journal of Bone & Joint Surgery entitled “What’s New in Hip Surgery” by Lisa C. Howard (University of British Columbia, Canada) and Mr Sheridan details a number of recent trends emerging as best practice in hip replacement surgery:
- Prehabilitation is the concept of patients undergoing strengthening, conditioning and rehabilitation before their surgery. This improves their ability to engage with the postoperative physical therapy protocol and ultimately gets patients mobilising independently sooner than if they did not have prehabilitation. The physiotherapy department at Bon Secours Hospital Galway is a strong supporter of prehabilitation.
- Tranexamic Acid (TXA) is a medication that works as an anti-fibrinolytic (reducing the breakdown of clot that has formed during surgery – of note it does not promote clot formation and therefore does not increase the risk of deep vein thrombosis or pulmonary embolism). This leads to more stable clot formation and significantly reduces blood loss during and after total hip replacement surgery. Recent evidence has shown that TXA significantly reduces the need for postoperative transfusion. It also significantly reduces postoperative pain, likely due to the reduced incidence on postoperative haematoma. Mr. Sheridan uses TXA for all hip replacements performed at Bon Secours Hospital Galway.
- The Caprini Score is a valuable tool in tailoring perioperative venous thromboembolism (VTE) prophylaxis to the patient-specific risk profile. A check list of questions determines what the likelihood is of a patient developing a DVT or PE after total hip replacement surgery. For the majority of patients, aspirin is an appropriate medication to reduce the risk of VTE. In some circumstances where the Caprini score is at the highest (9 or above), stronger medications such as apixaban (Eliquis) may be used instead of aspirin for postoperative VTE prophylaxis, on a case by case basis. Mr. Sheridan applies this score to all patients undergoing hip replacement surgery in Bon Secours Hospital Galway.
- Highly-Crosslinked Polyethylene (HXLPE) is arguably the greatest advancement in implant design in total hip replacement surgery in modern history. The wear rates of this liner up to 20 years are negligible. This means that the old teaching that “hip replacements wear out after 10-15 years” is old news. Multiple publications have proved excellent wear properties of this bearing surface up to 20 years after surgery. The ability to use a thinner liner allows for the use of a larger femoral head which significantly improves hip stability and significantly reduces the risk of hip dislocation after hip replacement surgery. HXLPE is used by Mr. Sheridan for all patients undergoing total hip replacement at Bon Secours Hospital Galway.
Read the full article in the Journal of Bone & Joint Surgery
At Bon Secours Hospital Galway, we are an active academic affiliate with the University of Galway. The latest scientific evidence always informs our approach to patient care, our guidelines and our policies.
Patients undergoing total hip replacement at Bon Secours Hospital Galway can rest assured that their care will be driven by the latest evidence available in the literature. We look forward to providing the highest standard of evidence-based care for patients undergoing total hip replacement surgery into the future.