Hip Replacement

1. Orthopaedic Surgeon · turn 1

   Good afternoon, Mr Gao. I’ve reviewed your X-rays and the results of your previous examinations. Unfortunately, the arthritis in your hip has progressed considerably, and the joint is now quite badly damaged. How have you been coping with the pain recently?

   高先生，下午好。我已經看過你的X光片和之前的檢查結果。很遺憾，你髖部的關節炎已經明顯惡化，關節目前受損得相當嚴重。你最近是怎樣應付疼痛的？

2. Mr Gao · turn 2

   醫生，你好。我真的很擔心。我才四十歲，現在走路已經越來越困難了。我不想下半輩子都躺在病床上。有沒有比做手術更好的辦法？

   Hello, Doctor. I am really worried. I am only 40, and walking is already becoming increasingly difficult. I do not want to spend the rest of my life confined to a hospital bed. Is there a better option than surgery?

3. Orthopaedic Surgeon · turn 3

   Don’t panic. We generally recommend surgery only when non-surgical treatments, such as painkillers, anti-inflammatory medication and physiotherapy, are no longer effective in relieving the pain or improving mobility. We’ve tried those treatments for some time now, and unfortunately they haven’t improved your condition significantly. In your case, I believe a hip replacement is the best option.

   先不要驚慌。我們通常只會在止痛藥、消炎藥和物理治療等非手術治療已無法有效緩解疼痛或改善活動能力時，才建議進行手術。我們已經嘗試這些治療一段時間，可惜你的情況並沒有明顯改善。就你的情況而言，我認為髖關節置換術是最佳選擇。

4. Mr Gao · turn 4

   髖關節置換術？聽起來挺嚇人的。這個手術具體是怎麼做的？我聽說要把骨頭換掉，而且還要選不同材質的人工關節。這可是大事。換了之後能用多少年？是不是越貴的材質越好？

   A hip replacement? That sounds rather frightening. How exactly is the operation performed? I have heard that the bone has to be replaced and that there are artificial joints made from different materials. This is a major matter. How many years will it last after replacement? Is a more expensive material necessarily better?

5. Orthopaedic Surgeon · turn 5

   The operation usually takes around two hours. We don’t actually replace the entire bone. We remove the worn or damaged surfaces of the hip joint and replace them with prosthetic components. The artificial joint can be made from materials such as metal, ceramic and polyethylene, which is a highly durable type of plastic. Modern artificial hip joints can withstand considerably more stress than older designs and generally last around 20 to 30 years, although this varies depending on your age, weight, activity level and the amount of wear on the joint. Given your age and condition, I would recommend a ceramic component because it’s durable and has good wear characteristics. However, we’ll discuss the advantages and disadvantages of each option before making a final decision.

   手術通常需時約兩小時。我們實際上並不是更換整根骨頭，而是移除髖關節磨損或受損的表面，再以人工組件取代。人工關節可由金屬、陶瓷和聚乙烯等材料製成；聚乙烯是一種非常耐用的塑膠。 現代人工髖關節比舊式設計能承受大得多的壓力，一般可使用約20至30年，但實際壽命會因你的年齡、體重、活動程度和關節磨損程度而異。考慮到你的年齡和病情，我會建議使用陶瓷組件，因為它耐用，而且耐磨性能良好。不過，我們會先討論每個選項的優點和缺點，然後才作出最終決定。

6. Mr Gao · turn 6

   你能幫我做微創手術嗎？我之前切除闌尾就是微創手術，不是很痛苦，而且只有很小的傷疤，幾天就恢復了。所以如果可以的話，我還是比較希望做微創手術。

   Could you perform minimally invasive surgery for me? I previously had my appendix removed through minimally invasive surgery. It was not very painful, left only a small scar, and I recovered within a few days. Therefore, if possible, I would prefer minimally invasive surgery.

7. Orthopaedic Surgeon · turn 7

   I’ve actually been considering using specially designed surgical instruments to carry out a minimally invasive hip replacement, as this approach can cause less damage to the muscles and other soft tissues around the hip. There are several surgical approaches, including the anterior, anterolateral and lateral approaches. However, minimally invasive surgery isn’t suitable for everyone. I’ll need to assess your anatomy, general health and the extent of the joint damage before deciding whether you’re a suitable candidate.

   其實我一直在考慮使用特別設計的手術器械進行微創髖關節置換術，因為這種方法對髖部周圍肌肉和其他軟組織造成的損傷可能較少。 手術有多種入路，包括前方、前外側和外側入路。不過，微創手術並不適合所有人。我需要評估你的身體構造、整體健康狀況和關節受損程度，才能決定你是否適合接受這種手術。

8. Mr Gao · turn 8

   你是我的主刀醫生，我聽你的。我就是想知道一下這個手術有沒有什麼風險，比如併發症什麼的，讓我有個心理準備。畢竟是個大手術，我多少還是有點擔心。

   You are my surgeon, so I will follow your advice. I would just like to know whether there are any risks associated with the operation, such as complications, so that I can prepare myself mentally. After all, it is major surgery, and I am still somewhat worried.

9. Orthopaedic Surgeon · turn 9

   That’s understandable. Hip replacement is generally a safe procedure, but like any major surgery, there are risks. After the operation, you can expect soreness around the hip for several weeks, as well as some temporary pain and swelling in the thigh and ankle. Possible complications include an unexpected reaction to the anaesthetic, infection, bleeding, dislocation of the new joint and the development of a blood clot known as deep vein thrombosis, or DVT. We’ll take precautions to reduce these risks, and we’ll monitor you closely during your recovery.

   這是可以理解的。髖關節置換術一般是一項安全的手術，但與任何大型手術一樣，也存在風險。 手術後，你的髖部周圍可能會痠痛數週，大腿和腳踝也可能暫時疼痛和腫脹。可能出現的併發症包括對麻醉劑產生意外反應、感染、出血、新關節脫位，以及形成稱為深層靜脈血栓或DVT的血塊。 我們會採取預防措施降低這些風險，並在你的康復期間密切監察你的情況。

10. Mr Gao · turn 10

    那我就放心一點了。我以前很喜歡滑雪和徒步旅行，後來腿越來越疼，走一段路都受不了，只好把這些活動都放棄了。醫生，你可以告訴我術後要怎麼康復嗎？我想盡早恢復正常生活，以後如果可以的話，我還想重新去旅行和徒步。

    That makes me feel a little more reassured. I used to enjoy skiing and hiking, but later the pain in my leg became progressively worse. I could not even tolerate walking a short distance, so I had to give up those activities. Doctor, could you tell me how I should rehabilitate after the operation? I would like to resume normal life as soon as possible and, if I can, travel and hike again in the future.

11. Orthopaedic Surgeon · turn 11

    Certainly. Rehabilitation is a very important part of your recovery. You’ll usually start moving with assistance quite soon after surgery, and a physiotherapist will show you how to walk safely and gradually increase the amount of weight you put on the operated leg. You’ll need to follow a structured physiotherapy program for at least six weeks after the operation. During the early stages of recovery, you’ll also need to avoid certain positions and movements, such as crossing your legs or rotating the operated leg too far inwards or outwards. You shouldn’t rush back into strenuous activities. We’ll review your progress regularly and let you know when it’s safe to increase your level of exercise.

    當然可以。復康是康復過程中非常重要的一環。手術後不久，你通常就會在協助下開始活動，物理治療師會教你如何安全走路，並逐步增加手術側腿部的負重。 手術後，你需要接受至少六週有系統的物理治療。在康復初期，你亦需要避免某些姿勢和動作，例如交叉雙腿，或將手術側腿部過度向內或向外轉動。 你不應急於恢復劇烈活動。我們會定期檢視你的康復進度，並告訴你何時可以安全地增加運動量。

12. Mr Gao · turn 12

    那滑雪和徒步旅行呢？如果手術成功，是不是以後就可以像以前一樣做這些運動？

    What about skiing and hiking? If the operation is successful, will I be able to participate in these activities as I did before?

13. Orthopaedic Surgeon · turn 13

    Our aim is to relieve your pain and restore as much mobility as possible, but having a hip replacement doesn’t necessarily mean you can return to every activity you did before. Low-impact activities such as walking, swimming and cycling are generally encouraged once you’ve recovered. More demanding activities need to be considered individually because excessive impact can increase wear on the artificial joint. We’ll assess your recovery before advising you about hiking or skiing.

    我們的目標是緩解你的疼痛，並盡可能恢復活動能力，但接受髖關節置換術並不一定代表你能恢復以前做過的所有活動。康復後，我們通常鼓勵步行、游泳和踏單車等低衝擊活動。 較高強度的活動需要按個別情況考慮，因為過度衝擊可能增加人工關節的磨損。我們會先評估你的康復情況，然後再就徒步旅行或滑雪向你提供建議。

14. Mr Gao · turn 14

    明白了。還有一個問題，我有私人醫療保險，但我想自費的部分一定也很貴。我需要支付多少差額？是不是住院費、麻醉師和主刀醫生的費用都包括在保險裡？

    I understand. I have one more question. I have private health insurance, but I imagine the out-of-pocket portion will still be very expensive. How much gap payment will I need to pay? Are the hospital charges and the anaesthetist’s and surgeon’s fees all covered by the insurance?

15. Orthopaedic Surgeon · turn 15

    That depends on your level of private health insurance and the agreements your insurer has with the hospital and the doctors involved. There may be a gap payment for my surgical fee, and you may also have separate out-of-pocket expenses for the anaesthetist, hospital excess or other services. My receptionist can provide you with an estimate of my fees, but you should also contact your private health insurer before the operation to confirm exactly what they’ll cover and what you’ll need to pay yourself.

    這取決於你的私人醫療保險級別，以及保險公司與醫院及相關醫生之間的協議。我的手術費可能會有差額，你也可能需要另外支付麻醉師費用、醫院自付額或其他服務的自付費用。 我的接待員可以向你提供我的費用估算，但你也應該在手術前聯絡私人醫療保險公司，確認他們具體承保哪些項目，以及哪些費用需要由你自行支付。

16. Mr Gao · turn 16

    好的，我回去會跟保險公司確認清楚。雖然自費的部分可能不少，但比起金錢，高質量的生活對我來說更重要。這幾年髖關節的問題已經嚴重影響我的生活了。醫生，麻煩你盡快幫我安排手術吧。

    All right. I will confirm the details with my insurer when I get home. Although the out-of-pocket cost may be considerable, a good quality of life is more important to me than money. My hip problem has seriously affected my life over the past few years. Doctor, please arrange the operation for me as soon as possible.

17. Orthopaedic Surgeon · turn 17

    Certainly. Before we schedule the operation, I’ll arrange some pre-operative tests and make sure you’re medically fit for surgery. We’ll also confirm which surgical approach and prosthesis are most appropriate for you. Once those assessments are complete, my receptionist will contact you with a proposed surgery date and further instructions about preparing for your hospital admission.

    當然可以。在安排手術之前，我會安排一些術前檢查，並確保你的身體狀況適合接受手術。我們也會確認哪種手術入路和人工關節最適合你。 完成這些評估後，我的接待員會聯絡你，提供擬定的手術日期，以及有關準備入院的進一步指示。

18. Mr Gao · turn 18

    好的，醫生。謝謝你解釋得這麼詳細。知道手術是怎麼做的、有哪些風險，以及術後要怎麼康復，我現在安心多了。我會按照你們的安排做好術前準備。

    All right, Doctor. Thank you for explaining everything in such detail. Now that I know how the operation is performed, what the risks are and how to rehabilitate afterwards, I feel much more reassured. I will follow your arrangements and prepare properly for the operation.

19. Orthopaedic Surgeon · turn 19

    You’re welcome, Mr Gao. We’ll give you written information about the procedure and your rehabilitation program as well. If you have any further questions before the operation, please contact the clinic.

    不用客氣，高先生。我們也會向你提供有關手術和復康計劃的書面資料。如果你在手術前還有任何問題，請聯絡診所。

20. Mr Gao · turn 20

    好的，謝謝醫生。

    All right. Thank you, Doctor.

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