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Dr Roger Brighton
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Dr Roger Brighton and Sarah Geracitano, orthopaedic patient

Above L to R: Erin Chew, Lakeview Private Hospital physiotherapist and Sarah Geracitano, orthopaedic patient

Patients can recover from surgery more rapidly and are able to resume their normal lifestyle sooner thanks to advances in implant technology and early mobilisation according to Dr Roger Brighton, Lakeview Private Hospital Orthopaedic Surgeon.

“Improvements with techniques and implants mean joint replacements now withstand more stress enabling patients to get moving earlier. It also means that the implants, particularly the bearing surfaces, are lasting longer,” said Dr Brighton.
A recent patient at Lakeview Private Hospital to have hip replacement surgery and rehabilitation was 36 year-old, Sarah Geracitano. Sarah was diagnosed with rheumatoid arthritis at the age of 11 and lived with debilitating hip pain for over 25 years. “My pain was chronic. I would take pain medication daily just to be able to function,” said Sarah.

Sarah underwent a bilateral total hip replacement with Dr Brighton as it was felt that both hips were equally diseased and rehabilitation for one side only would be problematic until the other could be treated. The damaged cartilage and bone was removed from the hip joint and replaced with artificial components.

“Sarah was the beneficiary of a number of improvements in techniques and implant technology,” says Dr Brighton. Sarah’s chronic inflammatory (Rheumatoid) arthritis meant using a cemented prosthesis was the most reliable choice on account of poor bone quality. “So-called third generation cementing techniques including vacuum mixing of cement and pressurisation improve the strength of the reconstruction and long-term durability. The patient can fully weight bear from Day One.”

In terms of the implants, Sarah received a ceramic head on highly cross-linked polyethylene bearing. “This combination has wear properties rivalling ceramic-on-ceramic or metal-on-metal bearings, particularly important at just 36 years of age, as well as avoiding the potential complications of breakage, squeaking or reaction to metal debris.”

“These considerations are of the upmost importance in a young patient, anxious to be active again,” said Dr Brighton.
Sarah was transferred to Lakeview Private Hospital Rehabilitation and early mobilisation was commenced under the care of Dr Joanna Murray, Consultant Physician in Rehabilitation Medicine, and the multidisciplinary team of allied health professionals.

Mutually agreed rehabilitation goals were set focusing on the short, medium and longer term. Targeted physiotherapy exercises initially focused on improving Sarah’s quality of movement, strength and endurance, combined with occupational therapy which worked on improving her daily living tasks.  Accurate implant positioning meant Sarah and her therapists could have great confidence in restoring hip range of movement and gluteal strength. Quadriceps, hamstring and calf strengthening exercises were also important to improve the control of the hip joint during weight-bearing activities.

By the six week mark, Sarah no longer relied on her crutches to walk and was well on the way to achieving her goals. “It was such a thrill to be independent and to do ‘normal activities’ without relying on pain medication or other people,” she said.

Sarah continued to receive treatment as an outpatient at Lakeview Private Hospital to further build endurance, strength and control of her muscles surrounding her hip joint, however she only needed a handful of sessions. “The team set me up so well, that I was able to do my exercises at home with ease and comfort, alleviating the need to come in more frequently,” said Sarah.

At the time of writing, Sarah had signed up to an eight week yoga course. Sarah reflects, “My life before (the surgery) was all about supporting my limitations. But now my outlook is different. I feel normal. And at this stage, it’s almost hard to believe I put up with the pain for so long”.