How safe is knee replacement surgery? What kinds of implants will be used in your operation, and how can you be confident about the way they’ll perform? These are important questions for anyone who’s considering joint replacement surgery. But the good news is that there’s plenty of data out there to help answer them. In fact, there’s now so much information available that in some ways the UK tops the table when it comes to scrutiny of joint surgery and implants. As a recent report put by ODEP and Beyond Compliance puts it (see below), British orthopaedics is now seen “as a world leader in the breadth and depth of data that is collected, analysed and then used for patient protection and improvement of treatment.” So what are these resources, and how can they give you reassurance about the operations?
National Joint Registry
The National Joint Registry (NJR) is a service that records and monitors joint replacement operations (knees, hips, ankles, shoulders and elbows) across England and Wales. First launched by the government in 2002, it’s now the biggest registry of its kind in the world, with well over 3 million records in the database. All kinds of facts and figures go into the Registry – the type of implant and surgery approach used, the hospitals where they were performed, the longevity of implants, the ages and BMIs of patients, the outcomes of surgery by doctor and hospital, and much more. What does all this achieve? The simple answer is that it helps to drive up standards. With more clarity around the who-what-where-and-how of replacements, the quality and outcomes should keep rising. The Registry also acts as an early-warning sign for any implant type that might be performing badly for patients. Each year the NJR releases a report with its findings, and they even publish data for individual surgeons; here’s Mr Bailey’s page, for example.
One of the great things about replacement surgery is that the technologies are developing all the time. But as new or modified joint products enter the market, they also need to be closely watched and interrogated – are they working as well as we’d expect? How would we know if they aren’t? Beyond Compliance is a service that was set up in 2014 to do just that. Among other things, it collects data on patients who have surgery with new devices, and their recoveries afterwards. A panel of experts then scours the results to check for safety concerns, and to suggest improvements for areas like surgeon training or surgical techniques. In extreme cases, it’s there to flag up poor performance at an early stage so a failing product could be swiftly removed. Products and devices are entered into an online library, with a performance rating from the Orthopaedic Data Evaluation Panel (ODEP). You can find out more about those ratings here.
Online, independent review sites
You can read a review for almost any product and service these days, perhaps not surprising when surveys suggest over 90% of us like to check feedback from fellow customers before we make a purchase. Doctors are no exception; two prominent ones are IWantGreatCare and Doctify, where you can see patients’ honest assessments of their treatment and overall care, compare ratings for doctors, hospitals, GP practices, medicines and more, and leave your own reviews once you’ve been treated (they can be anonymous if you prefer). Both of those sites explain that they are independent of doctors, which is clearly important, with systems in place to ensure transparency for the reviews. You can check out Mr Bailey’s IWantGreatCare and Doctify feedback here and here.
These three resources can help to provide reassurance about doctors, operations and hospitals. But of course you can also ask questions about your surgeon’s record when you meet face-to-face. For example: how many replacements do they perform each year? What are their revision rates for those operations? What are their outcomes in the National Joint Registry? These are useful questions that can help to build peace of mind about the safety and quality of your operation.