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Hip or Knee Replacement - How do you choose where and who does it
Tuesday 2 May 2017

If you’re thinking about a hip or knee replacement you will have likely been thinking about it for some time, often for many months or even years. Family members will have supported you, encouraged and helped you to decide if and when the time is right to go ahead. You will have thought very carefully about whether the pain you feel every day warrants a major operation and when the time is right to do something about it.

However, we often give less thought to where we go to have our pain assessed and treated, and who provides our treatment.  Traditionally we accept a referral to the local hospital from our GP and operation by the first surgeon we meet. When you think a little more about, in 2016, this is a little strange!

When we buy car insurance, book a holiday, choose a film to watch, a book to read or an album to listen to it’s second nature to compare several choices and read several reviews before making a choice. We pay attention to a product or service with multiple 5 star reviews and ignore something that people before us rated as 2 stars. We live in an age of powerful smart phones, abundant digital information and remarkable innovation that makes information sharing possible and enriches our lives. But healthcare has been slow to adopt modern technology and, in particular, slow to make comparison information available to patients online. Times are, however, changing.

Useful information about hip or knee replacements has been collected for some time and is becoming more available. Information about how long a joint replacement will last, which joint placements produce the best improvements in pain and function and information about hospitals such as length of stay and infection rates are collected by the National Joint Registry (NJR), the National PROMs Programme (NPP) and Hospital Statistics (HES). And this information is useful. For example one design of knee replacement has been shown to improve pain and function by an extra 7% over and above other types of knee replacement. We read in Part IPart II and Part III in this series how pain and function improvements following hip and knee replacement at the Duchy Hospital, Truro are among the best in the country.

The problem is that, as useful as this information is, it’s currently hidden away and not readily available to patients. Patients are often left to make decisions based on word-of-mouth e.g. “I heard John Smith’s knee replacement went well”, rather than seeing real results. Wouldn’t it be better to be able to say “my surgeon uses the best rated knee replacement and the Duchy Hospital has the best pain and function results”.

So, the Private Hospital Information Network (PHIN) has been set up to make this useful information available to patients who want it. Choosing where to have an operation will become easier. By going to www.phin.org.uk  and entering your postcode and operation it will soon be possible to compare results from hospitals in your area. Furthermore, some surgeons are also making their results available online. This new era of transparency will allow patients and their families to make better informed decisions about where to have their treatment and by whom.

Dan H Williams FRCS

Consultant Orthopaedic Surgeon