Themistocles Gluck, the man credited with inventing an implantable hip replacement in 1891, has probably never dreamed of how successful his operation would be. Surely the operation has been refined over the past 129 years and has become mainstream surgery by the 1960s. And now more than 450,000 hip replacements are performed in the US every year. The operation also has a high success rate: up to 95% of the patients said they no longer have pain. However, some hip implants fail early and need to be reworked, which means another phase of surgery and rehabilitation. New research from the UK suggests that the type of implant surgeon use may be a better indication of how successful the surgery will be than the skills of the surgeon or the hospital where the surgery will be performed.
The researchers examined the results of over 650,000 hip replacements. They found that one hospital in particular had better survival rates than others and that only one type of artificial joint was used in that facility, the Exeter V40 Femoral Stem. So the researchers looked at other hospitals and their findings, as well as the types of hip joints the surgeons were using. They continued to find positive results in patients who also received the Exeter V40 Femoral Stem, regardless of who performed the surgery or where.
This study should not support the use of any particular implant. The authors wrote, "Although this study focused on a single femoral stem (the Exeter V40 femoral stem), we believe the high survival rates observed would be reproducible with other high-performance implants." The message they are conveying to surgeons, hospital administrators and patients was that it seems important to choose implants with a good track record, even when it seems obvious. “Survival outcomes can be replicated through key treatment decisions like implant selection. These decisions are easier to repeat than technical skills or system factors, ”they concluded.