Dr. Dutton has been in clinical practice since 1996 after graduating from Marist College, Canberra and the University of New South Wales, Sydney, Australia. Dr. Dutton has worked at the Prince of Wales Hospital, Sydney and the St. George Hospital, Sydney before completing his orthopaedic surgery training in Singapore.
I treat a large number of international patients in my practice.
Their reason for coming to Singapore for treatment is that they believe Singapore has well-trained doctors with up-to-date facilities and equipment. This has allowed Singapore to develop into a respected, regional medical hub.
Three months ago, Mrs. A and her daughter from Russia came to visit my clinic. I noticed that she was limping in pain and using a walking stick. She had been living with hip pain for the past two years. During this time the pain became increasingly severe and she was taking painkillers regularly. Her daughter noticed that she was no longer able to walk for prolonged periods. As a result she stopped socializing with friends, stopped sports and stopped travelling. She was also gaining weight because she was unable to exercise due to pain.
When I examined Mrs. A, I noticed that she has a stiff hip joint with associated shortening of the leg.
X-rays and an MRI demonstrated severe osteoarthritis of the hip joint.
The hip and knee joints are normally covered with a layer of cartilage. The cartilage allows the joints to move smoothly without friction. The loss of cartilage causes friction that may lead to pain and swelling of the hip or knee.
Mrs. A told me that she did not want to continue to take painkillers as she was worried about the side effects of damaging the stomach or kidneys. She wanted a permanent solution.
She was worried about surgery because a few of her friends had undergone hip surgery but they never fully recovered or the hip pain became worse after a few years after surgery.
I talked to her about my experience in treating other Russian patients after failed hip surgery. I have had patients whereby I have had to re-do the hip surgery which was initially done by another doctor. The surgery was more complex and took much longer to perform.
There were two important factors for the unsuccessful result. Firstly, the hip implant must be manufactured properly at a licensed facility and the design must have a proven track record. Unfortunately, there are implants being used in surgery that are not properly designed for a long lasting hip implant. These implants are often cheaper and manufactured in developing countries that do not have strict guidelines.
The implants that I use for my patients are manufactured by the world’s largest orthopaedic implant company. The implants are manufactured in the USA and have a track record of over 20 years. Recently, I was invited by the Singapore Government’s Health Science Authority to sit on the expert panel of Orthopaedic Medical Devices.
Successful hip surgery not only depends on the implant but on the expertise of the doctor. Orthopaedic surgeons treat problems with various joints. My subspecialty is treating hip and knee problems. Research studies have consistently demonstrated that if a procedure is performed by a doctor who has done it many times, then the result is improved. I have performed literally thousands of surgeries on the hip and knee. Having this experience has allowed my to publish my work in international medical journals on the latest techniques for hip and knee surgery.
Hip surgery can now be performed using a minimally invasive technique. This means that the cut for minimally invasive surgery is almost half the size of the conventional surgery done by older methods. It also means that the muscles are split rather that cut. There is less blood loss, less pain and a faster recovery.
With this in mind, I offered Mrs. A hip surgery using what I considered the best, long lasting implant. It has a track record of 95 percent longevity at 15 years which is difficult to improve upon. The surgery would be done using the latest minimally invasive technique.
Mrs. A went ahead with hip surgery and recovered well. Her pain resolved, her leg lengths were equalized and she was able to walk without the use of a walking stick. Her mental state became positive and happy.
As I was saying farewell to her at the end of the last visit, she told me excitedly: “Finally, I can wear my high heals again.”
This article is written by Dr Andrew Quoc Dutton, Medical Director, SMG Orthopaedic Group, a Singapore Medical Group (SMG) Clinic.
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