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In a partnership of surgery and rehabilitation, the Villar Bajwa Practice and Progress, the Cambridge Centre for Health & Performance guide Perthes’ Disease sufferer on a journey back to a better way of life...
Having been diagnosed with Perthes’ Disease as a child, family man Andy Tibbot has been living with the pain and a lifelong limp ever since. Although Andy’s condition was treated during childhood with an osteotomy to reshape his hip bone, he was told that he would most certainly need a new hip by the age of forty.
This affected Andy’s quality of life on many levels; from the way he walked, to physical activities and everyday life with his wife and two children – he was also on continual medication to help cope with the pain. At 48 years old Andy was assessed by his GP who referred him to leading specialist, Mr Ali Bajwa, Consultant Orthopaedic Surgeon at the Villar Bajwa Practice, Spire Cambridge Lea Hospital. Acclaimed for his expertise and ethos in providing patient-centred care, Mr Bajwa ensures every procedure is tailored to each individual based on the best available evidence, which may include surgical or non-operative treatment.
Mr Ali Bajwa explains: “Andy is a young man and I first wanted to discover what was troubling him most. He said that he missed playing with his kids and being able to do everyday things in life, of course there was the limp and the pain always in the background, which he has lived with for many years."
“Although we were able to cure the limp, this was not in fact Andy’s big issue – for him it was the pain and functionality. We needed to see how bad the joint was and that would dictate how to achieve the best outcome for our patient. At this point we had three possible options: the first was to do nothing at all and let nature to take its course; the second option was to perform keyhole surgery, although the chances of success in this case would have been fairly modest; the third would be to find a moderate joint replacement that would conserve enough of the bone, yet give ample function and relief.”
Happy patient Andy Tibbot recalls: “Mr Bajwa did a lot of great work. Not only did he replace my hip, but he corrected the leg length and also adjusted my right leg, which was twisted out. Following the op, the first person you see, after your consultant, is your physio – encouraging you to get up just a few hours after surgery. It makes you completely understand that rehabilitation through physiotherapy is actually just as important as the operation itself.”
Caroline Clarke, Chartered Physiotherapist at Progress, the Cambridge Centre for Health & Perfromance, who worked with Andy following his surgery, says: “Physiotherapy is incredibly important after any operation, but with something like a total hip replacement it is vital. A patient has usually been in pain for a fairly prolonged period of time before they have this procedure and often find that their walking and general function have deteriorated. While surgery is essential to take away the pain, patients have to relearn how to walk, how to strengthen their muscles and regain the function they have been losing over a period of time."
“Medical advances in anaesthetics mean that patients don’t have to lie in bed for so long, in Andy’s case he was up the evening of surgery. It takes a whole lot of reassurance and encouragement to make this happen, but the entire team is involved, patients have the appropriate pain relief and they are supported by a nurse and a physio. The building of this relationship between patient and physiotherapist continues in order to establish confidence during the important rehabilitation process.”
Mr Ali Bajwa adds: “Physiotherapy is hugely important following surgery. It’s like taking ‘baby steps’, you have to teach patients everything again and help them get the range of motion in the joint, be it knee or the hip itself. The next stage is getting the muscles balanced, not just strengthening one group of muscles, but ensuring the whole balance is absolutely right, and not only around the joint – around the core, the back and the abdomen.”
At Progress, patients like Andy have access to state-of-the-art equipment and highly experienced physios who liaise continually with the leading consultants at the Spire Cambridge Lea Hospital.
Caroline says: “Andy is a motivated patient and has already started using the cross trainer and the Alter G, our antigravity treadmill, which allows him to undertake weight-bearing exercises so he is now able to run without putting too much pressure on his new hip. He is making great progress and we’ll get him running around the garden with his children in no time.”
Says Mr Ali Bajwa: “Just looking at X-rays and MRI scans alone is pointless. Understanding what patients actually want to do within their lives is paramount! If Andy had ambitions to undertake endurance events then we would have considered a different strategy, but here is a chap who wants to enjoy everyday pain-free life and play with his kids, so we found the best solution for him.”
Andy concludes: “I’ve been treated so very well every step of the way – my questions have been answered and my suggestions considered. It was like a partnership really, I didn’t ever feel like I was being told what to do – I was listened to and advised, now my hip is stronger than it was even in my twenties."
“I’m not asking to compete in a triathlon and I believe the goals that I have set myself are now achievable. You don’t need to be in pain and it doesn’t have to affect your quality of life. In my personal experience, the treatment at Spire Cambridge Lea has made a huge difference to my life – I only wish I had done it sooner!”