As consumers, we are used to having a wide variety of choices available when considering any purchase or investment. The same element of choice exists in some of the most surprising settings. For example, many people don’t realise that patients are able to research, discuss and influence the type of implant used when they are undergoing a hip replacement.
This hip implant choice will always be made in close consultation with your orthopaedic surgeon, who will make a recommendation based on their own knowledge and preferences of the prosthetic joints that are available, and this will be coupled with what they learn about your unique circumstances. This will help them select that which would be the best fit for the patient’s body and requirements.
Trusted research sources
For surgeons and their patients, the first place of reference when considering hip implant choice is to look at the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR). This body was set up to assess the effectiveness of the different prosthetic joints that are available, after the high profile failures of some new joint designs.
The reason the NJR was set up was to ensure consistency and medical excellence, and also to assess whether there are any issues that surgeons need to be aware of when selecting prosthetic joints for their patients and to identify poorly performing implants at an earlier stage.
Recently, a large-scale patient study was undertaken to look at the non-inferiority of prosthetic joints. This was not designed to identify the very best performing joints and provide a rank; more it was to look at the performance of different implant combinations when compared with an industry benchmark and to identify those which were performing less well and try and understand why this might be the case.
The report, published in the British Medical Journal (BMJ) concludes: “the information presented here illustrates the variability, frequency and performance of different constructs currently used in clinical practice. This, in turn, should be used to further inform the consenting process between the patient and the surgeon, and facilitate implant selection.”
This demonstrates that there is no ‘once side that fits all’ when it comes to prosthetic joint selection, rather that it is an open market place with many different options to choose from, many of which would yield a satisfactory result.
What this means for joint replacement patients
Most surgeons will only work with one or two types of joint, despite the wide variety that is available. This is because the different implants work very differently from one another and are made from different materials. Here at the Fortius Clinic, Mr Simon Bridle uses the Exeter Stem as his joint prosthesis of choice, which he has favoured for many years; this stem is one of the best performing implants in the assessment of joints made in the non-inferiority study mentioned above. This study provides surgeons with very valuable information to help them choose well-performing implants for their patients and is reassuring for patients to know the implant the surgeon is using is likely to last for a long time.
