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 and decide what kind of implant is right for me. 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 key topics relating to joint replacement, the better.

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 popularity means little. Judge a surgeon not by the opinion of his locality or even his hospital, but by the opinion of the medical community.

Also, when choosing a knee or hip replacement surgeon interview each with a list of questions you prepare ahead of time (more info: questions for knee surgeons | questions for hip surgeons).

Let the surgeon, rather than a manufacturer, decide which prostheses (implant) is the most optimal for you.

In your preliminary research, you might have already noticed the mountain of information about different prostheses (more info: hip implants | knee implants). Manufacturers do 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 (more info: hip implant materials | knee implant materials). Each have their own advantages and disadvantages but ultimately these are considerations for your surgeon.

BoneSmart.org advocates the use of ceramic because it is known that particles from plastic liners causes tissue reactions and metal on metal creates ions. But again, this is the opinion of our non-profit organization. Seek the advice of your surgeon.

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

Successful hip and knee replacement surgery procedures have been taking place since the early 1960′s. There is a news report mentioned in our hip replacement forum about a lady who has had her implant for over 40 years.

Most implants/prostheses have also been around for years. Although they have been redesigned and refashioned since then, they are conceptually the same. They have stood the test of time. What makes one operation a success and another less successful is often 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 (statistics show fewer than 1% overall) have problems.

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.

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 for knee replacement surgeons | questions for hip replacement surgeons) and discuss them with your doctor.

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.

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image credit: Zdenko Zivkovic

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