What implants do you use? Where are these manufactured?
Mr Freedman uses a variety of implants, depending on individual patient anatomy, age and other considerations. The prostheses used most frequently are designed and manufactured in Switzerland. Mr Freedmam often favours ceramic bearing surfaces. These ceramic implants are manufactured in Germany. Just as the Swiss and Germans engineer and manufacture great watches and fantastic cars, they also make excellent hip and knee prostheses.
Is the implant cemented into my body? If not, how does it stay in position?
Total joint implants come in both cemented and uncemented varieties. In most situations Mr Freedman prefers to use uncemented (i.e no cement) implants. The implants are coated with a material called hydroxyapite which stimulated the surrounding bone to grow on to the implant. That way the implant is biologically stabilised and does not require cement to hold it in place. Cemented implants perform very well too, but cement is a foreign material which the body slowly tried to break down. Mr Freedman correspondingly feels that there is a risk that cemented implants may slowly become loose over time and thus will try to avoid these implants in younger patients. Avoiding the use of cemented implants also shortens the procedure time, and correspondingly the amount of time that the patient is under anaesthetic.
How long will I need to be in hospital after hip arthroscopy or minimally invasive hip replacement?
Answer: Mr Freedman utilises various enhanced recovery mechanisms so that you will be dressed in your normal clothes (and not a hospital down) and up and walking the same day as your surgery. Patients are often safe for discharge Day 1 after surgery. However, there are some benefits of being in hospital a bit longer such as access to inpatient physiotherapy services and also being away from home responsibilities allows you to focus on your rehab and recovery. Therefore, Mr Freedman will often advise you not to rush home too quickly but rather to spend 2-3 nights in hospital so that you are confident and comfortable at discharge.
How should a patient chose their orthopaedic surgeon?
Answer: The standard of Orthopaedic Surgery training in Australia is world class and there are thus many very competent orthopaedic surgeons. However, a particular surgeon’s expertise and abilities in a specialised field will depend on his/her training and experience in that area.
When chosing a surgeon you should ask whether he/she has completed a subspecialist fellowship in that area of orthopaedics, how many such procedures they have performed and what their results have been. You should also consider whether you have rapport with the surgeon.
It is often helpful to obtain a second opinion before committing to surgery. A good and appropriately confident (but not over confident) surgeon should be happy to openly discuss his/her level of experience with a particular technique, be able to acknowledge past complications and should be comfortable in assisting you to obtain a second opinion. An additional aspect you may wish to consider is cost of treatment as there is wide variety with respect to a surgeon’s fees for any operation.
I’ve had successful surgery on 1 hip and the other hip has the same shape abnormality that the first one had but I do not have any symptoms on the other side. Should I have surgery?
A: Generally Mr Freedman will not consider surgery if you do not have symptoms. However, if you have an obvious CAM lesion or shape abnormality to your hip Mr Freedman will educate you regarding symptoms to look out for and will carefully follow your clinical progress. Early pain symptoms (but when the joint does not yet have significant damage) is often a good time intervene.
Where did you do your training?
Mr Freedman completed University (Medical School) at the University of Melbourne and then Surgery and Orthopaedic Surgery training in Victoria, through the highly regarded Australian Orthopaedic Associations’s Victorian Training Program. After completing his orthopaedic training, Mr Freedman undertook two international orthopaedic fellowships. The first of these were with Professor Damian Griffin in the UK (University Hospital Coventry and Warwickshire) and the 2nd was with Dr Frederic Laude at Clinique du Sport in Paris, France.
Do all orthopaedic surgeons undertake fellowships?
No. It is fairly popular for surgeons to undertake subspecialist fellowships but this is not a requirement. Some surgeons will enter practice straight from graduating the orthopaedic training program. Many surgeons who do undertake fellowships will do so locally in their home state or may travel interstate in Australia. Fellowships are often very poorly paid and so many doctors, with considerable debts from medical school and surgery training will not have the means to travel overseas for fellowship training. Mr Freedman was very fortunate to receive two scholarships (1. Arthritis Australia and 2. European Federation of Orthopaedics and Trauma) which enabled him to travel overseas twice for his international fellowship training.