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Why some joint replacements fail–and how to avoid it

It’s no secret that knee and hip replacements change lives–just ask one (or more!) of my patients who have undergone a procedure. New joints can get you back into the activities you feared were long gone due to Osteoarthritis or other symptoms of aging. As a result, getting a “new” knee or hip has almost become a rite of passage for seniors.

But what happens when a joint replacement goes wrong? In my office, I see patients who have had a procedure done elsewhere with limited success. They come to me to repair the damage or offer an alternative replacement. In fact, the situation is common enough that I have a dedicated procedure for the occurrence in both knees and hips.

In 2010, The New York Times ran an article discussing replacement failure rates, noting that 7 percent of hips implanted in Medicare patients had to be replaced within seven and a half years–a statistic that seems gigantic when compared with the failure rates of replacements in Sweden, where they are a third of that in the U.S. While the data might be a little dated, the issue remains relevant.

The article lays out some suggestions for patients who are looking to have a joint replaced, whether it’s a knee, hip or both. It advises locating a surgeon with experience, adjusting treatment expectations, choosing the right replacement option, and planning for recovery in advance. And these are all points that I strongly agree with.

My experience with joint replacement procedures is both from research and practice. My clinical appointments include serving as Senior attending in Adult Reconstructive Surgery at the NYU Langone Orthopedic Hospital, and I am the founder and director of  Director of the Laboratory of Advanced Arthroplasty Research for Robotics and Sensors, where we focus on pioneering work in pressure mapping technology allowing embedded sensors to improve the accuracy of balancing of joint replacements.

In practice, I place much emphasis on discussing options with my patients. My ultimate goal is to always give patients the best treatment plan that takes into consideration the extent of their condition and the plans they have for the future. For example, a patient with minimal damage who hopes to run marathons or dance competitively would likely benefit more from a partial replacement than a total. Conversely, a patient suffering from severe pain who plans for more moderate activity, such as gardening and hiking, might be better suited for a full replacement. Each patient is unique–and we develop care plans with that in mind.

Finally, I always want to discuss recovery options with my patients. If you are considering a joint replacement procedure, you need to be well aware of your options and choose the plan that is best for you. Doing so will result in a higher level of satisfaction and help you avoid the need for a repair down the line. If you have questions or concerns, I would love to chat with you.

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