Ross' Story
A 12-year-old British boy has become one of the first children in the world to undergo a pioneering keyhole hip operation.
For the first time, doctors at London’s Portland Hospital have been able to assess and treat a damaged hip joint in a child through three tiny incisions using X-ray controls and specialised keyhole instruments.
Schoolboy Ross Laws, from Thurrock, Essex, needed the operation after developing Perthes' disease – a painful condition caused by a temporary loss of blood supply to the hip joint, which results in the bone dying and collapse of the hip joint.
During the procedure, carried out under general anaesthetic, Ross was put in a new special device that holds the legs in place and opens up the hip joint, allowing surgeons to insert tiny cameras so they can see inside the joint and assess and repair the damage.
Until now, hip surgery involved a large 10 to 15 centimetre incision through the skin and muscle and then dislocating the joint, which left patients with a big scar and relatively immobile for up to three months.
In Perthes' disease, with the complication of severe hip stiffness, this would have previously needed either prolonged plaster treatment or long-term insertion of specialised metallic devices into the bone through the skin to open up the hip joint.
Both options are vey uncomfortable and inconvenient for the affected child.
According to Manoj Ramachandran, a consultant orthopaedic surgeon who also works at St Bartholomew's and the Royal London Hospitals, this is the first time this particular operation has been done on a child anywhere in the world.
“This is a new operation and the first time that it has been performed on a child,” he said.
“Hip keyhole surgery has always lagged behind knee surgery by about 30 years – the knee is easier to access whereas the hip joint is much deeper.
“Now, in the same way that we no longer open up the knees but use keyhole incisions, we can do the same for hips.
“It’s great for patients. The operation takes around an hour instead of up to three hours and it is mostly day-case surgery.
“It also means that instead of treating young people 10 or 20 years down the line when they already have progressive arthritis, with this technology and advanced imaging, we can treat conditions in the early stages to prevent arthritis from developing or to delay its progression. We can also use the technology to treat other hip disorders in childhood and adolescence, including sports injuries, tears of the lining and coverings of the hip joint."
Perthes' disease affects one in 10,000 children mainly between the ages of five and 10.
For Ross, the condition meant he had hardly any movement in his hip, making walking almost impossible. Before seeing Mr Ramachandran, he had been told there was nothing more doctors could do to help him.
His mum Sharon said: “Ross has really been through a lot. He would scream out in pain because the painkillers didn’t work. His walking became more and more impaired and in the end he needed crutches to get around. The disease took away his childhood.”
Following the groundbreaking surgery last month the pain immediately improved and almost disappeared, and rather than being in a fixed position, he had almost the full range of movement back in his hip and was back at school within days.
Ross said: “ Before the op my movements were very restricted and now I find myself able to do so much more."
Ross now does exercises every day to strengthen his leg and hip and sees a physiotherapist once a week. He is making good progress but it will be another three to six months before doctors can say whether the surgery has been a success.
Sharon added: “I am so pleased Ross has had the opportunity to undergo this operation. Mr Ramachandran has worked miracles on him. He will never be able to do manual work but this operation has the potential to transform his life. He is so inspired he now wants to be an orthopaedic surgeon.”
