Posted by Bill Sandweg on 28 September 2020.
One consequence of our lengthening life spans is that we are wearing out our original equipment. Our knees and hips were not intended to last 60 or 70 years. They certainly weren’t intended to support the heavy bodies so many of us now have. Our remote ancestors were lucky to have anything at all to eat. You didn’t find any fatties on the savannas in prehistoric Africa. All of this has made joint replacement, especially hips, an important and lucrative field for orthopedic surgeons.
The hip replacement is a wonderful surgery. It has improved the lives of many people who suffer from degenerative joint disease. I am one of them. I had my hip replacement almost 10 years ago and it is still doing great. The technology and operative techniques continue to improve so expect even better results in the future.
There are a number of risks associated with hip replacement, the greatest of which is infection. Other risks are heart attack, pneumonia, sepsis, shock, blood clots, pulmonary embolism, surgical site bleeding and mechanical problems with the prosthesis. For most patients, the risk of complications, other than infection, are small. Not all hospitals are the same, however. Some do a better job of preventing infection or other complications of hip replacement surgery. If you are a candidate for hip replacement surgery, you can and should look at the data the federal government collects about complications for hip replacement surgery. You can find it here, at Hospital Compare.
According to the Centers for Disease Control, on any given day a hospital patient has a 1 in 31 risk of developing a Hospital Acquired Infection (HAI). Some of these infections will be minor, but some of them will be resistant to antibiotics and may be devastating. Infection rates are also tracked and available for review at Hospital Compare.
Just as all hospitals are not equal when it comes to preventing infection and other complications of hip replacement surgery, not all surgeons are equally skilled in performing the procedure. You can and should investigate the qualifications and record of the surgeon you are going to entrust with one of the most important surgical procedures you may ever have.
You want a surgeon who is well-trained and experienced. Go to the web site of your state medical board and look up your surgeon. Is he or she an orthopedic surgeon? These are the surgeons who have been specifically trained in joint surgery. Is she or he Board Certified? While Board Certification does not guarantee a good result, it does mean that the surgeon is well-trained and experienced and has demonstrated competence to his or her peers. Does the surgeon have a record of discipline with the Medical Board? Discipline is uncommon, even with doctors who are not all that good. If a surgeon has been disciplined by the Medical Board, that should be a giant warning flag.
How often does your surgeon perform hip replacements? As the old adage goes, “Practice makes perfect.” The more often your surgeon and his or her team perform a procedure, the more routine it becomes for them and the better they usually are at doing it.
Plan your procedure for a Tuesday or Wednesday, if possible. You do not want to be in the hospital over the weekend, if you can avoid it. Bad things are more likely to happen at hospitals over the weekend for a number of reasons. Go home before the weekend.
When you get home, you have control over many aspects of your recovery. Even if you had a successful surgery, you can degrade the ultimate result by failing to do what the surgeon and therapists tell you. Follow the orders of your surgeon and therapists. Do your exercises. Avoid weightbearing.
Do these things and you will have done what you can to get the best outcome from your hip replacement surgery.
Good luck. I hope yours turns out as well as mine.