You have decided that you want hip or knee replacement surgery and now is the time to choose a surgeon. Or maybe you are asking yourself the question: “When will I be ready?” Hip or knee replacement surgery requires careful planning, but it is also something that can restore your vitality and bring you back to who you are. The sooner you examine these five key topics related to joint replacement, the better.
1. Judging a surgeon by the opinion of his professional peers, rather than by the opinion of his community of followers.
As patients, we can easily be seduced by the amount of praise that surrounds a surgeon. When looking for a surgeon, you may hear the phrases, ‘Mr. X is highly/highly respected in our area’ or ‘Mr. X is the ‘top’ fool. These recommendations are good, but they are not everything.
ALL surgeons are ‘highly respected’ and have ‘fans’. It comes with the job. But it’s of little use if your hip is blown and then you discover a few others with similar regrets.
The best thing to do when choosing a knee or hip replacement surgeon is to interview each one with a list of questions that you prepare ahead of time. The second best thing you can do is judge a surgeon not by the opinion of your locality or even your hospital, but by the opinion of the medical community.
2. Let the surgeon decide which prosthesis is best for you instead of the manufacturer.
In your preliminary research, you may have already noticed the mountain of information about different prosthetics. Manufacturers have websites to promote their own products and tend to emphasize the positive aspects of their own products and compare them to the negative aspects of others.
Metal on plastic has been the go-to material combination since the early 1960s. In addition, there is metal on metal, ceramic on plastic, and ceramic on ceramic. Each have their own positives and negatives, but ultimately these are decisions for your surgeon to make.
3. Rest assured, hip and knee replacement surgery has been proven for years.
Hip and knee replacement surgery is not a new phenomenon. Successful procedures were taking place in the early 1960s. There’s a news report headlining the BoneSmart.org hip replacement forum about a woman who had hers done in 1966!
Most prosthetics have also been around for years. Although they have been ‘redesigned’ and reshaped from time to time, they are basically the same prosthesis. They have stood the test of time. What makes one operation successful and another less successful is primarily a matter of surgical skill and experience.
In the US, 225,900 primary hip replacements and 431,485 primary knee replacements were performed in 2004, based on data from the national sample of hospitalized patients. In the UK, 27,814 primary hip replacements and 75,629 primary knee replacements were registered on the National Joint Registry in 2008.
Of these, a very small number have problems, statistics showing less than 1% overall.
4. Statistics show an increasing number of years in the longevity of dentures.
The official longevity for hip and knee replacement surgery is 10 to 15 years. But professionals believe that it is closer to 15 to 20 years. If we look at the statistics alone, the longevity reflects as much as 20 to 25 years.
Despite the strength of these statistics, many continue to put off their surgery. People with knee and hip problems will cut out 40% or more of the things that make their lives worth living.
Ask yourself this: how much more disabled do you want to be before you get your hip or knee fixed? Nobody knows what is around the corner. Anything could happen. If you wait another 5 or 10 years, you will never get those years back.
5. Take a list of questions to ask your future doctor.
Asking your surgeon these questions will help inform your decision about which one is best for you. We suggest that you print these questions and take them to your doctor.
o How long have you used your current prosthesis and what are your reasons for choosing it?
o How many does each year? (anything over 50 is good)
o What is your infection rate? (0.5% or less is good)
o What is your incidence of short-term complications: dislocations, wound infections?
o What is your incidence of long-term complications: infections, loosening, denture breakage, clicking, clanking, unidentifiable pain, need for manipulation?
Any self-respecting surgeon will not only be willing to discuss these issues, but will also have the numbers in hand. If you notice any hint of reluctance, offense, or hesitation, find another surgeon!
Once you’ve found a surgeon whose answers you’re comfortable with, accept whatever prosthetics he uses. Trust is an essential ingredient in doctor/patient relationships.
All the best on your journey to a new joint!