Firas Ashouri: Several Criteria Required for Successful Hip Replacement in

In a significant advancement in joint replacement surgeries, Dr. Firas Ashouri, a consultant at the Hip and Knee Surgery Center at Al-Mawasat Hospital, revealed that a complete hip replacement can be performed as a same-day surgery in the hospital.

In an interview with Al-Rai, Dr. Ashouri explained that performing joint replacement as a same-day procedure is a first for Al-Mawasat Hospital and in Kuwait. While certain specialized centers around the world conduct such surgeries, he noted that the success rate of these procedures depends on several criteria, including the surgeon's experience, the support team, available resources, the patient's health status, psychological state, and age.

He highlighted several benefits of performing hip replacement as a same-day surgery, including reduced rehabilitation time and the avoidance of some complications, such as venous thrombosis. Here are the details of the interview:

• You recently performed a major surgery through same-day surgery, which is a significant advancement. Can you shed light on the operation?

This was a hip replacement surgery for a young patient suffering from avascular necrosis, where blood supply to the hip joint is lost, leading to severe arthritis in some cases. Unfortunately, this is the condition that this 35-year-old young man reached. Typically, this surgery is not performed as a same-day procedure, but after discussions with the patient, it was decided to proceed with it as such. This marks the first time it has been done at Al-Mawasat Hospital and in Kuwait, with only a few centers worldwide performing same-day hip replacements.

• Are there any specific preparatory procedures prior to the surgery?

It's essential to prepare the patient psychologically for the surgery, providing them with guidelines regarding the severe pain they were experiencing beforehand. This included some exercises to strengthen the muscles around the joint, coordinated with a physical therapist.

• How was the patient's condition after the surgery?

During the surgery, we used modern techniques that resulted in minimal pain afterward. The patient was able to walk immediately after waking up from anesthesia, which is different from the norm for such procedures, where patients typically need a day or two to start physical therapy and then walk.

• Are there specific criteria that determine the success rate of these types of surgeries?

The success of the surgery depends on the surgeon's experience and their ability to handle the tissues well. The greater the damage to the tissues, the more pain the patient will experience post-surgery.

• How do you see the future of hip replacement as a same-day surgery?

I believe this will be the actual future, provided that the necessary criteria for success are met. These include the surgeon's experience, the team working with them, available resources, and the patient’s health, age, and psychological state, ensuring that they are ready to undergo such a significant surgery and leave the hospital the same day.

• Are there specific advantages to hip replacement as a same-day surgery?

Yes, there are several benefits, most notably a shorter rehabilitation period and avoidance of complications such as venous thrombosis, which significantly reduces the likelihood of clot formation.

• What complications might arise if the surgeon lacks experience?

I must emphasize the importance of having hip or knee replacement surgery performed by a specialized surgeon to avoid complications such as improper positioning of the joint, leading to imbalance or dislocation, as well as potential infections, thrombotic complications, and the risk of fractures during the procedure.

• What is the lifespan of a prosthetic joint?

This varies from person to person; generally, it ranges from 15 to 20 years. However, this does not mean that every patient will need to revisit the joint after this period, as some may retain their joint for 30 years. This largely depends on how the joint is placed, the surgeon's expertise, the type of prosthetic used, and whether it was sourced from reputable registries such as the British, American, Australian, or New Zealand joint registries. It also depends on the patient's age.

• Any specific advice for extending the lifespan of a prosthetic joint?

It's crucial post-surgery to strengthen the muscles around the joint, focus on physical therapy, maintain a healthy weight, and adopt a healthy lifestyle while engaging in regular physical activity.

• With the successes achieved by Al-Mawasat Hospital in these types of surgeries, has it become a center for them?

Yes, Al-Mawasat Hospital has become a primary center for hip and knee replacement surgeries, and we hope for continued success.

Rehabilitation Protocol After Surgery

Dr. Firas Ashouri confirmed that there is a protocol post-surgery that involves pain management to ensure the patient does not feel discomfort, along with an updated physical therapy program implemented at the hospital. The patient typically requires about two weeks to return to normal daily activities, including driving.

Robot-Assisted Joint Surgery at Al-Mawasat

Dr. Ashouri mentioned that the facilities at Al-Mawasat Hospital for performing these types of surgeries are fully equipped, including operating rooms, equipment, and the types of prosthetics used. In a few months, robotic-assisted joint surgery will be available at the hospital.

Duration of the Surgery: Only One Hour

Dr. Ashouri explained that the surgery took approximately one hour, emphasizing that shorter surgery times, while adhering to proper technical procedures, contribute to higher success rates.