Importance of surgical technique

There are many different kinds of hip replacement and most of these require different techniques for their insertion. It is important therefore that your surgeon is familiar with the implant that he/she is using and has been specifically trained in the use of that implant.

If a cemented implant is being used, good cementing technique is critical to the outcome. If the bone surfaces in the socket and thigh bone are not properly cleaned and dried, then the cement can not penetrate adequately in the interstices of the cancellous bone and the risk of early failure is high. Fortunately, however, hip replacement is a forgiving operation and it is easy to achieve a good outcome with a cemented hip replacement in the short-term. The true test of a surgeon’s ability is his/her results beyond 10 years. Very detailed xray studies in Sweden have clearly shown that the long-term success of a hip replacement can be determined within 3 months of the procedure. The fact that this is the case can only be pit down to surgical technique. There are numerous other papers in the literature which clearly show that the outcome is directly related, and complications indirectly related, to the number of hip replacements that a surgeon performs annually. The National Hip Joint Register in Sweden has identified a  ----- fold difference in results between hospitals using the same implant.

With uncemented implants experience is required to understand how hard to hit the components during insertion. There is a fine line between perfect fit and and an implant fractionally too big that will fracture the bone. Further different shaped implants require different degrees of impaction.

It is clear that a patient’s prime concern should be the quality and experience of his/her surgeon and not the fact that ‘choice’ merely allows for an operation to be done sooner for possibly very short-term gain.