Frequently Asked Questions
I understand that you may have a lot of questions about your pain, health and how I can help.
I have answered some questions that I am asked more frequently below but if you have any other queries, please contact me directly.
Seeing Mr Arvinte
Where can I see Mr Arvinte if I have hip or knee pain?
Mr Arvinte can see you privately at Bridges Clinic, Bedford Hospital South Wing or at BMI The Manor Hospital, Biddenham, Bedford. You can arrange an appointment directly with either hospital or you can contact Mr Arvinte via email: firstname.lastname@example.org. If you have further questions, you can also contact Mr Arvinte’s Secretary: Jackie Bennett, on 07906 586687.Back To Top
How long does a new and follow-up consultation last?
Usually, a new consultation with Mr Arvinte lasts around 30 minutes and a follow-up one 15 minutes. However, Mr Arvinte will spend more time with you, if necessary, free of charge. He believes establishing a professional, close rapport and trust with the patient is essential and is important in ensuring the success of the agreed treatment.Back To Top
I was told I need a hip/knee replacement. Will Mr Arvinte just do it?
Mr Arvinte is a very experienced clinician and surgeon. Though the person who told you that you will need surgery might be right, Mr Arvinte will talk to you and examine you thoroughly to make sure you are given the best chance to have your problem sorted. He will consider what other treatment(s) you have had, take into account any other medical issue(s) and discuss with you all possible types of treatment - and the risks and benefits of these. If hip or knee replacement is likely to be the best long-term solution for your problem, Mr Arvinte will book you in and perform the procedure for you.Back To Top
What happens after the consultation as a new patient?
If an agreement was reached that you need surgery and you want to proceed, you will have to sign the informed consent form, and will be booked in for the procedure. Mr Arvinte will try to operate on you as soon as possible. The current waiting time (for private surgery) is between 1 and 3 months but does depend on available hospital capacity, at any given time.Back To Top
Will I need to see Mr Arvinte again before surgery?
Usually not, unless there are changes in your medical condition(s). You will need to be assessed at the Preoperative Assessment Clinic (2-4 weeks preoperatively), where you will see a specialist nurse and have blood tests, ECG and/or any other tests deemed necessary from the medical point of view, to assess your fitness for surgery. A Consultant Anaesthetist will be involved if there are queries regarding your fitness.Back To Top
Paying For Treatment
How much is a consultation with Mr Arvinte?
Mr Arvinte charges £200 for a new consultation and £150 for a follow-up consultation.Back To Top
How much will I have to pay for a specific procedure (such as a hip or knee replacement) if done by Mr Arvinte?
Mr Arvinte charges fees as agreed by the Bridges Clinic/Bedford Hospital and BMI The Manor Hospital - and the minimal agreed fees by various insurance companies. To get an exact price, please contact Bridges Clinic or BMI The Manor Hospital (for self-pay patients) or your private health insurance company. Mr Arvinte will not charge you for 2 follow-ups, after your surgery.Back To Top
About Your Surgery
Is knee/hip replacement risky?
Hip and knee replacement surgery is major surgery. However, the surgery is “life-changing” and is successful in more than 80-90% of cases. Any surgery comes with risks. Mr Arvinte will discuss your operation and associated risks in detail with you. According to available literature, the quoted risk of infection is between 1-2% of cases, risk of dislocation after hip replacement around 3% and intra-operative fracture less than 1%. You will be given special medication to prevent infection and clotting (deep venous thrombosis, pulmonary embolism). Mr Arvinte’s rate of complications is less than the ones quoted above.Back To Top
Will I need X-rays or other imaging/investigations?
It is very likely that a new X-ray will be necessary, unless you have had the relevant imaging investigation done within 6 months of the consultation, and it is available for Mr Arvinte to see. If you have a hip problem, possibly requiring a hip replacement, Mr Arvinte will ask you to have a special hip X-ray with a marker/calibrating ball. This will enable him to plan your surgery with more accuracy (for example, to determine the necessary size and type of implant) and avoid leg-length discrepancy. Further imaging such as MRI or CT might be necessary, but usually this is not the case. Blood tests and ECG will be performed before surgery, if surgical management has been agreed.Back To Top
What type of metal is a hip/knee replacement made of?
The implants used for hip/knee replacement are made from metals which are biocompatible (well tolerated by the human body). These are either cobalt/chromium alloy or titanium. In between the metal pieces, a hard “plastic” (polyethylene) is put on, in the knee replacement procedures. The bearing in total hip replacement is metal on plastic, ceramic on plastic, or ceramic on ceramic. The bearing is chosen according to the patient’s age, weight and the level of activity expected after surgery.Back To Top
Will my hip/knee replacement be cemented or uncemented? Which one is better?
For your total knee replacement, cement will be used to fix the metal components to the thigh bone and tibia. This is currently considered the “gold-standard”. For partial knee replacement, Mr Arvinte uses the modern technique of “microplasty” (minimal invasive surgery). If bone quality is good, uncemented (“press fit”) implants will be used. A helpful video shows details of this procedure.
The hip replacement can be cemented or uncemented. Mr Arvinte uses Hybrid Total Hip Replacement for patients over 70 years old (uncemented cup and cemented stem) and uncemented Total Hip Replacement for patients under 70 years old (providing the bone quality is good for “press-fit”), in compliance with the UK GIRFT (Getting It Right First Time) National Programme. Mr Arvinte uses implants that have got published survivorship of more than 90% at 10-15 years.
As has been emphasised above, the knee replacement is cemented. For hip replacement, there is no evidence that cemented or uncemented implants are better. The uncemented implants are used more in younger individuals, aiming for “biological integration” of the implant, and are based on a “press-fit” technique using special instruments. In older individuals, with poorer bone quality, “press-fit” technique can lead to intraoperative fractures, therefore the cemented implants are used, with the cement acting like a “glue” to fix the implants to bone.Back To Top
After Your Surgery
How long will I be in hospital after surgery?
If you had knee arthroscopy, you will be discharged on the same day. After hip/knee replacement surgery, you will be in hospital for 2-4 days and will follow an enhanced rehabilitation programme.Back To Top
How many follow-ups will I need after my surgery?
After surgery, the stitches/staples (if used) will be removed at your local Doctor’s Surgery, after 2 weeks. Mr Arvinte will see you 6 weeks after your operation and, depending on the operation you had, a new set of X-rays will be done. The next follow-up is usually 6 months after surgery when, if everything is going very well, you can be discharged.
Mr Arvinte encourages his patients to contact his secretary (mobile number on the website) or himself (email available on the website) as soon as possible if there is anything you are worried about after surgery - such as increasing pain, increasing swelling, redness around the wound, excessive oozing of the dressing or wound healing problems, etc.Back To Top
Will I be able to play sports after a hip/knee replacement?
Knee and hip replacement, though very successful procedures, are artificial joints. This means that physical activities have to be adapted, as wear of the bearing and loosening of the implants can happen quicker if the joint is repeatedly overloaded. Also, the risk of periprosthetic fracture is higher if involved in high-impact sports. Recently reviewed literature shows that, when it comes to athletic activity, recommendations and guidelines for sports remain unclear. Golf and doubles tennis remain the most recommended activities. No-impact, low power sports like swimming and bicycling are generally allowed. Although jogging is not considered a factor for short-term implant failure, longer-term analysis is needed. Contact and high-impact sports, like football or basketball, are not recommended. There are no recommendations regarding alpinism and field hockey.Back To Top
What about other recreational activities?
A successful hip and knee replacement should give you your life back. You just have to “listen” to your replaced joint, as it will tell you when you have done too much. Nonetheless, you should be careful with sudden twisting movements and overbending if you have had a hip replacement. Mr Arvinte will be happy to advise you accordingly - and you should not hesitate to contact him if you have any queries, even if you have been discharged from his Clinic.Back To Top