Surgical Techniques

Two principles underpin every modern technique. The first is protection of the soft tissues: approaches that pass between muscles rather than cutting them, smaller incisions, less bleeding, less pain. The second is accuracy of implant placement: a correctly oriented prosthesis lasts longer, dislocates less and produces a more natural gait. Intraoperative fluoroscopy in the hip and robotic assistance in the knee serve exactly this purpose.

Technique alone is not enough. It is combined with enhanced recovery protocols: multimodal analgesia instead of opioids, avoidance of routine drains and catheters, feeding and mobilisation on the day of surgery, a short hospital stay and structured physiotherapy. The result is patients who leave hospital in two to four days and return to normal life in weeks rather than months.

The decision rests on the combination of symptoms, function, age, bone quality and expectations — not on the radiograph alone. The same radiographic grade of arthritis can mean conservative treatment for one patient and joint replacement for another.