QUIZ TO WORK OUT IF YOU NEED AN OP

DO NOT consider joint replacement surgery ‘until you have exhausted all non-surgical management options, taken lifestyle advice, optimised your weight as best you can and been as active as possible’, says Mark Wilkinson, a leading professor of orthopaedics.

But deciding whether joint replacement surgery is for you has never been easier, thanks to an online ‘Joint replacement risk calculator’.

This is based on data from the two million procedures carried out in the Britain the past 15 years (recorded on their National Joint Registry). It has just been launched by a team at the University of Sheffield to help patients make up their minds. It can be found at jointcalc.shef.ac.uk.

By filling in your weight, height, age and gender, and answering a series of multiple-choice questions about your general health and how your hip or knee is affecting you, it’s possible to get a good idea of what improvement you can expect from surgery.

The calculator also considers the risk of the patient needing a repeat operation (revision surgery).

Once it’s clear that surgery is the solution, Professor Wilkinson says it makes no sense to put it off — even if you’re young and fear you may need another replacement years later.

‘If the pain and functional difficulty a patient is experiencing is still severely impairing their quality of life, it doesn’t make any difference if they are 25 or 75,’ he says.

But, says Martyn Porter, a surgeon and medical director of the NJR, ‘it is really important that we don’t offer surgery as a lifestyle treatment.

‘It would be wrong for patients to say “I’m getting a tiny bit of an ache, I can’t do 36 holes of golf, it’s going to fall apart in three to four years, so why don’t I get it done before it fails?” Should it go wrong, they will be in great difficulty.’

The headline news is that for the vast majority of patients, replacement joint surgery is as effective and safe as it is common. We know this thanks to the NJR, which records the majority of joint replacement operations in England, Wales, Northern Ireland and the Isle of Man.

Since the registry was set up 17 years ago, the anonymised details of more than 2.8 million operations have been recorded, making it an unrivalled source of information.

It was thanks to this research and recorded information that in 2010 a brand of replacement hip with a metal ball and metal socket was withdrawn, after it was found to have failed in half of patients, with metal fragments causing blood poisoning and tissue damage in some cases. CHOOSING A SURGEON IT’S important to make sure you are comfortable with the surgeon who is going to operate on you, says Professor Wilkinson. ‘I would ask the consultant how good the implants they use are in terms of their survival rate — how long they last,’ he says. ‘I would also ask if they do a lot of this type of surgery, and what their results are’ — the extent to which patients report improvements in pain and mobility. WHAT’S ‘A LOT’ OF OPS? EACH year the average number of joint replacements carried out per surgeon is: hips and knees, 53; shoulders, 14; ankles, 6; and elbows, 3. It makes sense to opt for a surgeon whose caseload at least matches this.

Make sure you research your surgeon and find out all the information that is available about a hospital’s overall record, including patientreported improvements in pain, mobility and quality of life.

Patients are entitled to be treated in a hospital of their choice. If you’re unhappy with your consultant, then you have every right to seek a second opinion.

But if you change consultant you will be treated as a new referral and go to the bottom of the waiting list.