Hip op, don't stop Inside the world of joint replacements

A new hip or knee is no longer just for older people. With thousands of operations in the UK each year, can technological advances help?

- Nicola Davis

I an Doncaster is remarkably chipper for a man about to undergo major surgery. "I have a busy life. So it's nice to have a break," he jokes. It is 8.30am on a chilly December morning and here at Warwick hospital he is about to receive a new knee - or part of one.

At 62, Doncaster has always been active: he played rugby when young, until a knee injury and subsequent operation meant he had to trade that in for other sports. But now the knee is causing problems again. As a self-employed chartered engineer, he needs to be able to get up and down tower blocks. Even going hiking with his wife seems a wistful dream. "Going forward, it's only going to get worse," he says.

Which is why Doncaster is having a patellofemoral replacement, a partial knee replacement in which the wornout cartilage that covers the end of the femur and underside of the kneecap will be removed and implants inserted.

Pre-op, he has the air of someone who has watched a YouTube video or two. "It's brutal stuff. They cut the knee in half. They rip it apart. I mean, orthopaedic surgery is carpentry, isn't it?" Doncaster says. He's not wrong: when it comes to joint replacements, the tools of the trade wouldn't look out of place in a workshop.

After donning a gown and receiving anaesthetic into his spine, Doncaster is wheeled into the theatre and his leg swiftly wrapped in a yellow antimicrobial film.

Half a dozen or so nurses clad in blue scrubs and masks are ready for action. What is undoubtedly a big day for Doncaster is just a normal morning for the team: typically, such operations are finished in just over an hour.

The nurses check they have the right patient, and the right procedure, and ensure all the instruments - from hefty power tools to delicate scalpels - are primed for use.