Cure_Hip Replacement article_April 2022


Dr Rainhard van Zyl
Orthopaedic Surgeon

Early-onset arthritis from accidents or disease could be causing one of your most underappreciated assets to need surgical intervention. Your hips are at the centre of your body’s mobility. The freedom you have to sit, stand, bend, run and jump are largely because your hips function properly.

However, chronic conditions, catastrophic injury or deformities from childhood hip conditions can cause your hips to deteriorate, potentially leaving you immobile.

Dr. Rainhard van Zyl, orthopaedic surgeon at Cure Day Hospitals Somerset West says baring chronic conditions like rheumatoid arthritis, a younger workforce is also experiencing hip ailments resulting from past injuries, motor vehicle accidents and other high impact sports or activities.

Indirect causes include certain medications (steroids, HIV medication), excessive alcohol use, blood clotting disorders, pregnancy and a wide variety of bacterial and viral infections.

“Far from being exclusively an ‘old person’s’ surgery, hip replacements are performed for a variety of indications. We have been tackling the misconception that hip replacements are only done for older patients. Newer implants and surgical techniques are making it more accessible and showing improved longevity.”

Dr. Van Zyl says another misconception he has been addressing is that hip replacements are excessively painful surgeries.

“Hip replacements are considered one of the most successful operations of the century. We’ve got the benefit of great technological advancement in orthopaedics. The fact that we can continue to improve on a surgery that is already so successful, just reinforces that if you fall victim to deteriorating hip health, there is great optimism that you will be able to return to a quality of life you once enjoyed.”

Dr. Van Zyl is one of the few surgeons in South Africa to implement the latest in hip replacement techniques via the direct anterior minimal invasive approach – an operation so successful that you could be wheeled into surgery and walk out of hospital in three days.

“Our approach is truly minimally invasive and not just a small scar. What we are doing differently, is instead of cutting through muscle and nerves, we’ve trained ourselves to work between these vital support structures. Patients benefit from improved recovery times, lower pain levels and improved patient satisfaction.” This is what helps get you back on your feet again.

Dr. Van Zyl is humble about the skill it requires to “work between” muscle and nerves. He was introduced to the technique during his specialist training at Tygerberg Hospital and gained further exposure during his fellowship in Australia. Back home he continues to work with other orthopaedic surgeons to perfect this technique. One of them being Dr. Johan Charilaou. Collectively, they have done many surgeries together with incredible results.

“The effect of this strategy is that the patient enjoys a shorter recovery time and post-surgical rehabilitation is also exponentially less painful. Before a surgeon cuts, they have got to connect empathetically with what the patient is going through and what the patient deserves to have after surgical intervention. It is also important that the patient understands what the surgery entails including the benefits and risks. With this technique, we are doing the heavy lifting (by working between muscles and nerves instead of cutting through them) leaving the patient’s focus solely on recovery.”

Dr. Van Zyl says reduced pain and early mobility aids goal setting for recovery in patients who have undergone a major surgery like a hip replacement.

“What we know about pain is that it can inhibit post-operative progress. Not only are hip replacements not always as painful as they are made to seem, but this minimally invasive approach assists with manageable discomfort which can help a patient put their rehabilitation into better context.”

We don’t think about quality of life until we face the reality that our body has broken down. It is then that some of our most profound growth takes place. In the hands of a surgeon whom you know connects with both your pain and plea for relief, a major surgery like a total hip replacement can be made exponentially easier.

What we know about Dr. Van Zyl is that when it comes to surgery, his relentless, unshakable drive to restore full functionality to patients lies in his empathy. The other thing we know is that the arduous, often passion-filled pursuit of his purpose to heal will never dim.

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