Orthopaedic Surgery

Orthopaedic conditions treated:

Dr Matthew Broadhead has a subspecialty interest and training in treating hip pain. He will ensure that all conservative options are considered prior to surgery using an evidence-based approach. He has experience in hip surgery for traumatic, inflammatory and degenerative conditions of the hip, with additional Fellowship training in direct anterior approach hip replacement, complex primary hip replacement and revision hip replacement surgery. 

When do I need a hip replacement?

Hip replacement surgery is typically recommended for people who have severe hip arthritis and have not had relief from less invasive treatments, such as medications, physical therapy, or assistive devices. The goal of hip replacement surgery is to reduce pain and improve mobility and function in the hip joint. Dr Broadhead may recommend hip replacement surgery if you have:

• Severe pain in the hip joint that interferes with daily activities, such as walking or standing

• Limited range of motion in the hip joint

• Difficulty standing up from a seated position or climbing stairs

• Swelling or tenderness around the hip joint

• A limp or change in the way you walk

Dr Broadhead will consider a number of factors when deciding whether or not to recommend hip replacement surgery, including your age, overall health, and level of physical activity. It is important to discuss all treatment options to determine the best course of action for your specific situation.

How is a hip replacement performed?

Hip replacement surgery is a procedure in which the damaged ball-and-socket joint of the hip is replaced with a prosthetic implant. The surgery is typically performed under spinal and/or general anesthesia, meaning the patient is unconscious during the procedure.

There are two main approaches, used by Dr Broadhead, for hip replacement surgery: the posterior approach and the direct anterior approach. The appropriate approach for a given patient will depend on the individual’s specific medical need. During the surgery, an incision is made in the skin over the hip joint and then the damaged ball-and-socket joint is removed. The bone surfaces of the pelvis and femur (thigh bone) are then prepared to receive the prosthetic implants, which may be made of metal, ceramic, or plastic. Once the implants are in place, the incision will be closed with sutures and a dressing applied to the wound. The patient will then be taken to the recovery room to wake up from the anesthesia.

What are the differences between posterior and direct anterior approach hip replacement surgery?

There are two main approaches, used by Dr Broadhead, for hip replacement surgery: the posterior approach and the direct anterior approach.

The posterior approach involves making an incision on the back of the hip and involves splitting and detaching some of the muscles from the bone in order to access the hip joint. The surgeon then removes the damaged ball-and-socket joint and replaces it with a prosthetic implant. 

The direct anterior approach involves making an incision on the front of the hip and does not require detachment of the gluteal muscles. This approach has gained popularity in recent years because it may result in a faster recovery time and less pain after surgery, although the evidence for these benefits is mixed.

Both approaches have their own advantages and disadvantages, and the appropriate approach for a given patient will depend on the individual’s specific medical needs. It is important for patients to discuss the options and to make an informed decision about the best approach for their individual circumstances.

What is a hip replacement made of?

There are several different types of implants that can be used in a hip replacement, and they are typically made of materials that are durable, biocompatible (able to be tolerated by the body), and resistant to wear and tear. The main types of materials used in hip replacement implants are:

• Metal: Many hip replacement implants use metal alloys, such as cobalt-chromium or titanium, for the ball and socket components. These materials are strong and durable, and can withstand the forces placed on the hip joint during movement.

• Plastic: Some hip replacement implants use plastic or polyethylene for the socket component. This material is smooth and wear-resistant, and helps to reduce friction between the ball and socket.

• Ceramic: Ceramic materials, such as zirconia or alumina, can also be used in hip replacement implants. These materials are hard, smooth, and wear-resistant, and may be used for the ball or socket component.

Dr Broadhead will discuss the different implant options with you and help you choose the best one for your needs.

How long does a hip replacement last for?

The lifespan of a hip replacement can vary depending on a number of factors, including the type of implant used, the patient’s age and activity level, and the presence of any underlying health conditions. In general, hip replacements can last for many years, and many people are able to return to their normal activities after surgery. According to the National Institutes of Health (NIH), most hip replacements last for 15-20 years or more. In 2023, the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) reported that the cumulative percent revision rate, for conventional total hip replacement performed for hip osteoarthritis, was 8.1% at 20 years.

What are the risks of hip replacement surgery?

Like any surgery, hip replacement surgery carries some risks. Some possible complications of hip replacement surgery include:

• Infection: There is a risk of infection after hip replacement surgery. This can be treated with antibiotics, but may require additional surgery to clean the wound and remove the implant.

• Blood clots: There is a risk of blood clots forming in the leg or lung after hip replacement surgery. These can be treated with blood thinners.

• Dislocation: The artificial hip joint may become dislocated after surgery, which can cause pain and limit mobility.

• Loosening: Over time, the artificial hip joint may become loose and may require revision surgery to tighten or replace the implant.

• Fracture: There is a risk of the thigh bone or pelvis breaking during or after hip replacement surgery.

• Nerve or artery damage: There is a risk of damage to the nerves or arteries around the hip during surgery.

• Allergic reaction: There is a risk of an allergic reaction to the materials used in the artificial hip joint.

• Implant failure: There is a risk that the artificial hip joint may fail, either due to wear and tear or a manufacturing defect. Dr Broadhead will discuss the risks of hip replacement surgery with you and will work with you to minimize the risk of complications.

Dr Matthew Broadhead has a subspecialty interest and training in treating knee pain. He will ensure that all conservative options are considered prior to surgery using an evidence-based approach. He has experience in knee surgery for traumatic, inflammatory and degenerative conditions of the knee, with a particular focus on early recovery after surgery (ERAS) and further training in robotic-assisted knee replacement. 

When do I need a knee replacement?

A knee replacement is typically recommended for people with severe knee arthritis who have not responded to other treatment options, such as medications or physical therapy. The decision to undergo knee replacement surgery is typically based on the severity of the pain and disability caused by the knee arthritis. In general, a knee replacement may be considered when:

• The pain interferes with daily activities and is not relieved by other treatments

• The knee joint is severely damaged and the range of motion is limited

• The knee joint is deformed or has lost its normal shape

It is important to discuss the benefits and risks of the procedure to determine if a knee replacement is the right treatment option for you. Dr Broadhead will consider factors such as your age, overall health, and lifestyle when deciding whether a knee replacement is appropriate.

How is a knee replacement performed?

A knee replacement, also known as knee arthroplasty, is a surgical procedure in which the damaged parts of the knee joint are removed and replaced with artificial components. The procedure is typically performed under spinal and/or general anesthesia. During the procedure, an incision in the front of the knee will be made and the damaged bone and cartilage will be removed from the joint. The remaining bone will be prepared by smoothing the surfaces and shaping them to fit the artificial components, which are made of metal and plastic. The artificial components are then secured in place with cement or special materials that allow the bone to grow into them over time.

What is a knee replacement made of?

A knee replacement is made up of artificial components that are designed to replace the damaged parts of the knee joint. The components are typically made of metal and plastic. The metal components of the knee replacement are usually made of cobalt-chrome or titanium alloys, which are strong and durable materials that can withstand the wear and tear of daily activities. The plastic components of the knee replacement are typically made of polyethylene, a type of plastic that is smooth and wear-resistant.

The components of a knee replacement are designed to mimic the natural movement of the knee joint and allow the individual to perform activities of daily living, such as walking, climbing stairs, and standing for long periods of time. However, it is important to note that the artificial components of a knee replacement may not function exactly like a natural knee and may have some limitations.

How long does a knee replacement last for?

The lifespan of a knee replacement can vary depending on a number of factors, such as the individual’s age, weight, and activity level. In general, knee replacements can last for many years, with some studies suggesting that they may last for more than 20 years. In 2023, the Australian Orthopaedic Association National Joint Replacement Registry reported that the cumulative percent revision rate, for total knee replacements performed for knee osteoarthritis, was 7.7% at 20 years. However, it is important to note that knee replacements can wear out over time, and the artificial components of the knee joint may become loose or wear out. When this occurs, the knee replacement may need to be revised or replaced to maintain proper function and relieve pain.

What are the risks of knee replacement surgery?

Knee replacement surgery is a common and effective procedure for relieving pain and improving function in people with severe knee arthritis. However, like any surgery, knee replacement surgery carries some risks. Some of the potential risks of knee replacement surgery include:

• Infection: There is a risk of infection after any surgical procedure. The risk of infection after knee replacement surgery can be reduced by taking antibiotics and careful wound care following surgery. In some circumstances, additional surgery may be required to clean the wound and remove the implant.

• Blood clots: Blood clots can form in the legs or lungs after surgery, which can be dangerous if left untreated. Dr Broadhead may prescribe medications or recommend other measures to prevent blood clots from forming.

• Bleeding: There is a risk of bleeding during and after the surgery. Dr Broadhead will take steps to minimize this risk and will monitor the patient for signs of bleeding.

• Nerve or blood vessel injury: There is a risk of injury to the nerves or blood vessels in the leg during the surgery. Dr Broadhead will take steps to minimize this risk and will monitor for signs of nerve or blood vessel injury.

• Implant failure: There is a risk that the artificial components of the knee joint may become loose or wear out over time, which may require additional surgery to repair or replace them.

• Loosening: Over time, the artificial knee joint may become loose and may require revision surgery to tighten or replace the implant.

• Fracture: There is a risk of the femur or tibia breaking during or after knee replacement surgery.

• Allergic reaction: There is a risk of an allergic reaction to the materials used in the artificial knee joint.

It is important to discuss the benefits and risks of the procedure to determine if a knee replacement is the right treatment option for you. Dr Broadhead will consider factors such as your age, overall health, and lifestyle when deciding whether a knee replacement is appropriate.

Dr Matthew Broadhead has a subspecialty interest and training in treating sports injuries, with a particular focus on anterior cruciate ligament (ACL) reconstruction. Dr Broadhead was awarded a Master of Surgery (ChM) by the Royal College of Surgeons Edinburgh for research on ACL reconstruction techniques. He will ensure that all conservative options are considered prior to surgery using an evidence-based approach, taking into account a patient’s lifestyle, physical demands and sporting aspirations.

I have an ACL tear. Do I need surgery?

The decision to undergo surgery for an anterior cruciate ligament (ACL) tear will depend on a number of factors, including the severity of the tear, the patient’s age and overall health, and the type of activities they participate in.

In general, ACL surgery is typically recommended for individuals who have a complete or near-complete tear of the ligament and who experience instability in the knee joint. This is because a torn ACL can lead to ongoing knee instability and may increase the risk of further injuries, such as meniscal tears or cartilage damage.

For individuals who are active in high-impact sports or who have a high level of physical demands, surgery may be recommended to help restore stability to the knee joint and to allow them to return to their desired level of activity.

However, for individuals who are less active or who have a low level of physical demands, nonsurgical treatment options, such as physical therapy and bracing, may be sufficient to manage the symptoms of an ACL tear and allow them to maintain an acceptable level of function.

How is an ACL reconstruction performed?

ACL reconstruction surgery may be performed using a variety of techniques. In most cases, the surgery is performed using arthroscopic (key hole) techniques, which involve making several small incisions in the skin and inserting small instruments and a camera into the knee joint.

During the surgery, any damaged tissue will be removed and then the bone will be prepared to accept the new ligament. The new ligament may be made from a tissue graft, which may be taken from the patient’s own body (autograft), such as the patellar tendon or the hamstring tendon; or a donor graft (allograft).

Once the new ligament is in place, the surgeon will secure it to the bone using screws or other fixation devices. The incisions will then be closed, and the patient will be moved to a recovery room to begin the post-operative recovery process.

ACL reconstruction surgery is typically performed on an outpatient basis, meaning that the patient will be able to go home the same day as the surgery. However, some patients may need to stay in the hospital for one night.

What are the differences between the different grafts used in ACL reconstruction?

There are several different types of tissue grafts that may be used, including:

• Autografts: Autografts are tissue grafts that are taken from the patient’s own body. The most commonly used autografts for ACL reconstruction are the patellar tendon and the hamstring tendons.

• Allografts: Allografts are tissue grafts that are taken from a donor, rather than the patient’s own body. These grafts may be used if the patient’s own tissue is not suitable for use or if the patient has a high risk of graft failure.

Each type of tissue graft has its own advantages and disadvantages, and the best choice for a particular patient will depend on a number of factors, including the patient’s age, size, overall health, and the specific needs of the procedure. It is important to discuss the different types of tissue grafts with Dr Broadhead to determine the best option for your specific situation.

What are the risks of ACL reconstruction surgery?

While the surgery is generally successful in restoring stability to the knee and improving function, it does carry some risks, as with any surgery. Some of the potential risks of ACL reconstruction surgery include:

• Infection: There is a small risk of infection after any surgery. Symptoms of an infection may include fever, redness, swelling, and discharge from the incision.

• Blood clots: There is a risk of blood clots forming in the leg after surgery, which can be serious if they travel to the lungs or other organs.

• Nerve or blood vessel damage: There is a small risk of nerve or blood vessel damage during surgery.

• Graft rupture and revision surgery: In some cases, additional surgery may be needed to correct problems that occur after the initial surgery. It is possible for the graft to rupture and require revision surgery.

• Knee stiffness: Some people may experience stiffness in the knee after surgery, which may require physical therapy to improve mobility.

How soon can I return to sport after an ACL reconstruction?

The recovery time after an ACL reconstruction surgery will depend on a number of factors, including the specific type of surgery that was performed, the patient’s age, overall health, and the demands of the sport they plan to return to.

In general, it is typically recommended that patients avoid high-impact activities for at least the first few weeks following surgery to allow the incision to heal and the knee to begin to stabilize. After this initial period, patients can gradually resume physical activity as tolerated and as directed by Dr Broadhead and the physiotherapist.

Most patients will be able to return to low-impact activities, such as cycling or swimming, within a few weeks of surgery, but it may take several months (9-12 months) before they are able to return to higher-impact activities, such as running or playing contact sports.

It is important to follow the recommendations of Dr Broadhead and the physiotherapist, and to progress slowly and cautiously as you return to physical activity. It is also important to continue with your rehabilitation exercises to help strengthen the muscles around the knee and improve your range of motion.