How to Choose a Hip Or Knee Replacement Surgeon and Prosthesis

You've decided you want hip or knee replacement surgery and now it's time to choose a surgeon. Or maybe you're asking the question, "When will I be ready?" Hip or knee replacement surgery requires careful planning, but it is also something that can give you back your vitality and give you back you. The earlier you examine these five key topics relating to joint replacement, the better.

1. Judge a surgeon by the opinion of his professional peers, rather than the opinion of his community of followers.

As patients, we can be easily seduced by the amount of praise surrounding a surgeon. When you're looking for a surgeon, you might hear the phrases, 'Mr. X is highly/well respected in our area' or 'Mr. X is the 'top' surgeon'. Such recommendations are good but they're not everything.

ALL surgeons are 'well respected' and have 'fans'. It comes with the job. But it means little if your hip is botched up and later 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 you prepare ahead of time. The second best thing to do is to judge a surgeon not by the opinion of his locality or even his hospital, but by the opinion of the medical community.

2. Let the surgeon decide which prostheses is the most optimal one for you rather than the manufacturer.

In your preliminary research, you might have already noticed the mountain of information about different prostheses. Manufacturers have websites to promote their own products and they tend to emphasize the positives in their own wares and compare them with the negatives of others.

Metal on plastic has been the benchmark combination of materials since the early sixties. In addition, there is metal on metal, ceramic on plastic and ceramic on ceramic. Each have their own positive and negative aspects but ultimately these are decisions for your surgeon to make.

3. Rest assured hip and knee replacement surgery has been tried and tested over the years.

Hip and knee replacement surgery is not a new phenomenon. Successful procedures were taking place in the early sixties. There is a news report at the head of the BoneSmart.org hip replacement forum about a lady who had hers done in 1966!

Most prostheses have also been around for years. Although they have been 'redesigned' and refashioned from time to time, they are basically the same prosthesis. They have stood the test of time. What makes one operation a success and another less successful is mostly a matter of surgical skill and experience.

In the US, 225,900 primary hip replacements and 431,485 primary knee replacements were carried out in 2004 according to data from the Nationwide Inpatient Sample. In the UK, 27,814 primary hip replacements and 75,629 primary knee replacements were recorded in the National Joint Registry in 2008.

Of these, a very tiny number have problems, statistics show less than 1% overall.

4. Statistics show a growing number of years in the longevity of prostheses.

The official longevity for hip and knee replacement surgery is 10 to 15 years. But professionals believe it to be closer to 15 to 20. If we look at the statistics alone, longevity reflects as much as 20 to 25 years.

Despite the strength of these statistics, many continue to hold off on their surgery. People with knee and hip problems will cut back on 40% or more of the things that make their lives worthwhile.

Ask yourself this: Just how much more disabled do you want to be before you get that hip/knee fixed? Nobody knows what's around the corner. Anything could happen. If you wait another 5 or 10 years, you'll never get those years back.

5. Take a list of questions to ask your prospective doctor.

Posing these questions to your surgeon will help inform your decision on which is the best one for you. We suggest you print these questions off and take them to your doctor.

o How long have you used your current prosthesis and what are your reasons for having selected it?

o How many do you do 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, loosenings, breakages of prosthesis, clicking, clunking, unidentifiable pains, need for manipulations?

Any surgeon worth his salt will not only be willing to discuss these questions but also have the figures ready at hand. If you note any hint of reluctance, offense or waffling, go find yourself another surgeon!

Once you have found a surgeon whose responses you feel comfortable with, accept whatever prosthesis he uses. Trust is an essential ingredient in patient/doctor relations.

All the best in your journey to a new joint!