• Hip replacements. The risk of revision or ‘re-do’ surgery for hip-replacements aged under 55 is much higher than for patients aged over 75. So you should bare this in mind when considering whether to have one as soon as you can.

    The National Joint Registry’s medical director Martyn Porter, an orthopaedic surgeon, said the higher risk of revision hip replacement surgery was presumably a result of greater activity among the under-55s.

    ‘Younger patients should not be denied life-changing surgery but they need to be advised that revision may be two or three times more likely at 10 years compared to less active patients,’ he said.

    ‘If patients under-55 years are most likely to need at least one revision  hip replacement surgery in their lifetime, then we must use the maturing dataset of the NJR to analyse long-term trends and get the first time surgery as right for the patient as possible.’

    Retired orthopaedic therapy team leader, Anthony Morgan, who worked at the James Paget Hospital in Great Yarmouth, said clinicians had always known that hip replacements had a lifespan.

    ‘Physiotherapists should be part of the educational process,’ he said.

    ‘If a patient with an arthritic hip tells us they want a hip replacement we should tell them how long it will last.

    ‘If they are 40 and likely to live another 40 years we have a duty to tell them that their new hip will not last as long as them.

    ‘We also have to consider the fact that a large number of revisions will increase the workload on an already hard-pressed NHS.’.

     

    http://www.csp.org.uk/sites/files/csp/imagecache/main_content_530_wide/njr_diagram.jpg

     

    Meanwhile, a survey has found that current practice on movement precautions and equipment provision does not represent clinicians’ perceptions of best care after total hip replacement (THR).

    Historically, THR patients have been provided with post-surgery precautions and equipment such as raised toilet seats and furniture rises, to reduce the risks of dislocation.

    But this has been questioned recently, with some hospitals opting to change practice and relax these restrictions.