Dr Suhail Suresh says better materials mean hip implants can last longer and reduce the need for regular replacements. — LOW LAY PHON/The Star
AN ORTHOPAEDIC surgeon describes hip replacement surgery as “one that changes people’s lives, which may improve quality of life and increase mobility of the patients”.
“The hip degenerates when the cartilage between the ball and socket in the hip becomes thinner or destroyed over time.
“The cartilage with the joint fluid is like a lubricant, so when it is worn out, even simple movements in the hip can become a struggle,” said Sunway Medical Centre, Sunway City consultant orthopaedic, arthroplasty and robotic surgeon Professor Dr Suhail Suresh Abdullah.
“As the disease progresses, simple day-to-day activities could progress to excruciating, constant pain.
“A successful hip replacement surgery could allow someone who previously could barely stand or only walk a few steps, to walk longer distances or take the stairs, and resume good quality of life.”
Dr Suhail Suresh shared an example of a patient who experienced such severe pain in both hips and would only move by shuffling along on the buttocks.
This left the patient entirely home-bound and reliant on the children for help.
“The patient’s limited mobility was initially assumed due to a stroke, but it was diagnosed as a hip problem.
“After undergoing surgery and rehabilitation, the patient regained full mobility and resumed old routines.
“This meant that the patient was able to be independent, work and rejoin society,” said the doctor who has extensive experience in total joint replacement surgery and is also a lecturer at Sunway University.
He said common causes for hip degeneration were wear and tear particularly for those aged 60 and above, excessive exercise and post-trauma injury from falls or motor vehicle accidents.
“Less common are those who experience hip septic arthritis due to childhood infection and those with inflammatory arthritis, an autoimmune condition where the body’s immune system mistakenly attacks healthy tissues.
“A person’s pain progression and tolerance is linked to their ‘envelope of function’,” said Dr Suhail Suresh.
The concept suggests that the body has a specific limit of how much load and frequency it can handle without getting hurt.
Activities that used to be “inside” the envelope suddenly fall “outside” of it.
A person who makes a noticeable change in daily routines, such as avoiding stairs or swapping trips to shopping centres for smaller neighbourhood stores, is likely experiencing a shrinking in the “envelope of function” as they cannot move as much.
“Hip replacement surgery technology and procedures have improved so vastly that many orthopaedic surgeons find it professionally rewarding due to the functional improvement a patient may experience post-surgery,” said Dr Suhail Suresh.
“Better hip implant materials, such as ceramic and highly crossed-linked polyethylene with vitamin E, mean these implants can last longer and reduce the need for regular replacements.”
Another improvement is robotic-assisted hip surgery, which is a surgeon-controlled process that uses advanced technology during the operation.
“Before the surgery, a CT scan will be taken of the patient’s hip, which is then uploaded into a software system that creates a 3D virtual model of the bone structure,” said Dr Suhail Suresh.
“This model helps the surgeon decide the right implant placement position and reduce limb length discrepancy (for better accuracy and fit) and greater soft tissue balance.”
He likened a surgeon with robotic assistance to a pilot using advanced navigation, where the robot provides the map and precision, but the surgeon is always in control of the operation.
“A hip replacement surgery is a high-risk surgery due to anaesthesia and surgery risks,” said Dr Suhail Suresh.
“Among the risks are infection, potential dislocation of the hip joint, deep vein thrombosis and limb length discrepancy.
“However, robotic-assisted hip surgery is a surgeon-controlled procedure that incorporates digital planning tools and imaging guidance.
“This approach is designed to support surgical precision and may help minimise soft tissue disruption and support recovery, depending on individual patient factors.”
He shared that patients usually reported noticeable improvements in recovery time – especially those who underwent conventional surgery on one hip previously, versus robotic-assisted method on the other.
