Mr Marcus Bankes is one of the few orthopaedic surgeons in the UK who specialises exclusively in treating patients with hip problems. Hip replacements are a large part of his work, but, as he explains, he is one of a group of orthopaedic hip specialists at The London Clinic who offer effective surgical treatment for any hip problem, even the rare and unusual.

Mr Marcus Bankes has been Consultant Orthopaedic Surgeon in the orthopaedics department of Guy’s and St Thomas’ Foundation NHS Trust since 2002. He specialises in treating any problem that affects the hip joint. He is a leading expert in arthroscopy, hip resurfacing, hip impingement and dysplasia as well as hip replacement surgery. He has been a pioneer in developing hip replacement techniques that are suitable for patients with sickle cell anaemia.

Hip replacements: much less traumatic these days

Hip replacement surgery has become routine in many parts of the world, with hundreds of thousands of operations of this type done in the NHS and in the private sector every year in the UK. Success does still depend on the skill of the surgeon and the quality of aftercare but, generally, hip replacement surgery has become a much smaller operation than it used to be.

“When I first started as an orthopaedic surgeon it was common for a patient to be in hospital for two weeks. They had drains and catheters in place for days after surgery, injectable morphine for pain relief and a significant proportion would need a blood transfusion because of the amount of blood lost during the operation.

Today, the incision used is much smaller and recovery time has reduced. Someone having a hip replacement here at The London Clinic today would be in hospital for no more than four nights and we rarely need to use injectable painkillers at all.”

The prosthetic hip joints used today are also very durable.

“Traditional metal-on-plastic hip replacements start wearing out in 10-15 years. The hip prostheses that I use today are now able to last many decades, so revision hip replacements that are required due to prosthesis failure should really reduce over the next few years.”

Better materials, better fitted

“My favoured hip prosthesis has a ceramic-on-ceramic bearing and wears out very slowly at around one hundredth of the rate of the best metal-on-plastic replacement hip. For this reason, ceramic hips are particularly good for younger patients.

The early ceramic hips were attached to the skeleton with cement and the ceramic materials were nowhere near as good as they are today. We are just getting the 10-year data on modern ceramic-on-ceramic hip replacements attached to the skeleton with contemporary techniques. I seldom use cement; if the prosthesis is fitted well, it is better for it to bond to the bone naturally. The data is showing outstanding results; virtually none of the ceramic-on-ceramic hips done in the last 10 years have failed, apart from a very few cases of infection or dislocation, which were not connected to the type of prosthesis.”

Can hip technology still improve?

The trend towards medical innovation is strong and it is likely that new materials and techniques will be developed. However, as Mr Bankes points out, not all developments in hip replacement technology have been beneficial.

“Just because something is new does not mean it is better. It is important for hip replacements to be done by surgeons who are skilled in the surgical techniques but who are also very clued up with the data. We need at least 10 years’ data or more before we are convinced that a new material is as good as what we currently have, and the best surgeons are able to choose the right prosthesis for the right patient, and then fit it well.”

The London Clinic is a centre of hip expertise

Mr Bankes also offers arthroscopic hip surgery for femoroacetabular impingement and performs open hip surgery for adult hip dysplasia. 

“The London Clinic is without doubt the UK’s premier private hospital for hip dysplasia and other young adult hip disorders because we have two surgeons who can offer that – me and Mr Johan Witt. Most other hospitals have one surgeon with some experience in this area, if they are lucky. Between us, Mr Witt and I treat hip dysplasia for most of London and the south east within the NHS and both of us being at The Clinic allows the hospital to offer a unique service within the private healthcare sector in the UK.

The Clinic also has Mr Angus Lewis who does a great deal of pelvic fracture and revision work; Mr Rob Pollock who treats reconstruction after bone tumours; and Mr Alister Hart who is a great expert on problems with metal-on-metal hip replacements. As a team, we are a very unusual and important group of sub-specialists within orthopaedics.

The volume of work we do is always important. If you are going for private treatment for a hip problem, you need to choose a surgeon who does many procedures each year. I do about 150 hip replacements every year, which is about half of my work. The rest is still focused on the hip and includes at least 150 arthroscopic hip operations and 40 pelvic osteotomies, making up around 400 hip cases in a year.”

The advantage of excellent facilities

Mr Bankes thinks that the combination of such surgical expertise and the facilities offered by The Clinic make this a leading centre for hip surgery in the UK.

“The theatre facilities are good, the nursing is good, surgeons and patients always have what they need and everyone works together in great teams. The physiotherapy and hydrotherapy available also helps patients during recovery and rehabilitation.”