Patient satisfaction is the ultimate goal of any orthopaedic surgeon performing a lower limb joint replacement. When the patient is shown to be satisfied with the results of their hip or knee arthroplasty; increased mobility, reduction in pain and consequent improvements in their quality of life, the surgeon can be satisfied that they have improved the life of their patient.
The ultimate objective for an orthopaedic surgeon must be to achieve optimum mobility and a pain-free life for their patient. Pre-operative planning plays a crucial role in achieving optimal outcomes, providing an intra-operative guide for the surgeon to, for example, check resection levels and alignment, as well as the size and position of the implant.
It has recently been reported that financial pressures within the NHS in the UK are leading some CCGs (Clinical Commissioning Groups) to consider limiting joint replacement procedures in the hospitals within their areas by 12% for hip and 19% for knee arthroplasties respectively. They will do this by treating only cases where the “patient’s pain and disability should be sufficiently severe that it interferes with the patient’s daily life and/or ability to sleep”, using the patient’s Oxford Hip Score as a determining factor.
To what extent can success be attributed to planning? As with most things in life it undoubtedly helps, and in orthopaedic surgery there are many good reasons to use digital planning tools for both complex and simple procedures, given that digital images and picture archiving and communication systems (PACS) are now the norm in most hospitals.
Betty and her husband were about to leave on their annual holiday to Spain when they heard the bad news: her husband was terminally ill. The situation only got worse when Betty fell during the holiday and shattered her right elbow. Although she received medical attention, it was impossible to allow the bones to heal properly at a time when her husband needed all her care and attention.
With ever increasing cost-pressure and requirements from regulators to show the efficacy of new arthroplasty (joint replacement) devices, the International Society for Technology in Arthroplasty has become a more relevant conference than ever before. With a mix of orthopedic surgeons, academics and representatives from the industry, the conference was a great opportunity to have fruitful discussions about new and ongoing topics in arthroplasty. We look back at the highlights and the lessons learned.
When Dr. Noble, an orthopaedic surgeon specializing in total joint replacement at Palm Beach Orthopaedic Institute, FL, found himself without hard copy X-rays to plan his hip and knee arthroplasty procedures, he took a leap towards digital pre-operative planning.
Dr. Ola Wiig, an experienced pediatric orthopaedic surgeon, was confronted with a very challenging deformity in a young teenager. Dr Wiig’s patient was suffering from severely reduced mobility as a result of an epiphysiolysis in her proximal femur, which caused her leg to be severely rotated outwards. This wasn’t just causing the patient pain, it was stopping her from being a normal teenager.
In a recent study in the Netherlands, all 12 patients who underwent an acetabular reconstruction of large Paprosky type 3 defects using the Materialise aMace custom acetabular cup, were recorded as being satisfied with the results of their procedure. The study, by Marieke Baauw, MD, Gijs Gerard van Hellemondt, MD and Maarten Spruit, MD, PhD from the Department of Orthopaedic Surgery at Sint-Maartenskliniek in Nijmegen, the Netherlands reported on their use of the aMace as part of an integral approach which included “a detailed approach to defect analysis, including measurement of bone deficiency and bone quality”. As reported in Helio Orthopaedics, the study presents positive results from a follow up of the 12 patients at least 18 months after surgery.