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Why choosing surgeon and hospital for knee replacement : Is important

By Dr. Ramneek Mahajan in Orthopaedics & Joint Replacement

Aug 26 , 2021 | 3 min read

Joint replacement surgery is a frequently performed operation — over 2 lakhs hip and knee replacements are implanted every year in the india,and the results are typically excellent as drastically improves quality of life and takes away debilitating pain. As india is facing knee arthritis epidemic the number of patients requiring knee replacement surgery has grown exponentially.  That said, there are complications that can occur, and sometimes the results can be dramatically worse when they do.

For that reason, patients and surgeons go to great lengths to take whatever necessary steps possible to avoid complications. 

One step that you can take is to identify the right surgeon and the right hospital to perform your procedure. These are some criteria you can use to evaluate when choosing.

Choosing a Surgeon

There are many factors that people will use to identify a surgeon that they trust and have confidence in. One critical aspect is his or her experience.  Experience is less about finding a surgeon who has been doing joint replacements for decades and more about finding a surgeon who commonly performs joint replacement surgery.

There isn't exactly a magic number to aim for, but studies have consistently shown that surgeons with a higher volume of performed surgeries under their belt yield outcomes with fewer complications. Some studies have identified cut-off numbers at 25, others 30,  and others 50 surgeries per year.

You shouldn't feel reluctant to ask your surgeon about their volume. I can assure you that this is not an uncommon question, and surgeons should be perfectly comfortable sharing the stat with potential patients. Sometimes it is easier to ask your surgeon if he or she performs joint replacements every week or every month, rather than asking for the number performed annually.

The number of surgical procedures that an individual performs is just one criterion that you can use to evaluate their experience. Some patients will also compare their surgeons training, their board certifications, and other factors, but these have not been shown to have as much of an impact as the volume of surgical procedures that he or she performs each year.
Lastly, I always encourage people to get to know their surgeon and ensure they have a good relationship and rapport.

Choosing a Hospital

Much like a surgeon's experience is important, a hospital's experience has also been shown to be a critical factor. Studies show that hospitals that perform fewer than 100 joint replacement surgical procedures annually have higher complication rates and cost more than hospitals that perform more than 100 replacements each year. As with surgeon experience, there is no magic number, and some studies use different cut-offs, but looking for a hospital that performs at least 100 joint replacements annually is a good starting point.

Among hospitals that routinely perform joint 

replacement surgery also offer some type of joint replacement program that includes preoperative education and standardized protocols to ensure that patients receive the right care at the right time during and after their hospitalization.

Data You Can Use

There are ways to compare hospital outcomes from joint replacement surgery.  For example, ISHKS Joint registry tracks data for  hip and knee replacement, and these complication rates can be easily investigated online.

Certified Hospitals

NABH  and The Joint Commission international,are  the most prominent hospital certification organization, also provides certification for centers of excellence. In order to achieve this level of certification, hospitals must demonstrate high levels of the organization around their patient care programme.

Specifically, the NABH and  Joint Commission certification is focused on ensuring there are processes and standards in place to ensure effective communication and adherence to evidence-based practices. 

Conclusion:

Choosing the right surgeon and hospital are two of the many decisions that may affect the likelihood of success after undergoing joint replacement surgery. There are many other steps that patients can take to improve their results from  surgery.  By understanding more about joint replacement surgery, the possible complications that can occur, and the steps that you can take to avoid these complications, you will position yourself in  the best way possible to have a long-lasting, pain-free joint replacement.

It is important to understand that there is no single criteria that are most important.  Rather, taking many small steps can help to improve your chances of a successful outcome. Just as you look for the right surgeon and the right hospital, you should be paying attention to your general health, keeping your weight ideal, participating in pre-operative exercises, not smoking, avoiding alcohol, and taking other steps to achieve the highest chance of a successful outcome.