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Rayner my parade! The importance of specialist advice.
Jemma Brimblecombe
How many particular joint replacement surgeries does a surgeon undertake each year? – this may be critical to the chances of problems, such as the need for revision surgery.
A new study published in the British Medical Journal (BMJ) underlines the link between patient outcomes and the number of shoulder replacement procedures undertaken by a surgeon. A higher average volume was found to be associated with ‘a significantly lower risk of reoperations, fewer serious adverse events, and shorter hospital stays’.
Incidence of shoulder replacement surgery is increasingly rapidly, according to the study, with 8,000 such operations undertaken annually in the UK. Given changes in population demographics such as age, sex and obesity, joint replacements generally are increasing but the projected increase in shoulder replacement rates is estimated to outpace even those of hip and knee.
Shoulder replacement surgery explained
Replacement with an artificial joint is usually undertaken as a result of injury or arthritis. The joint can be replaced completely (arthroplasty) or only in part (hemiarthroplasty). Artificial shoulder parts are usually made of metal or plastic or a combination of both.
The shoulder is a ball-and-socket joint - the ball at the top of the upper arm moves smoothly in the socket of the shoulder blade on a lining of cartilage. Damage to the cartilage can make the joint stiff and painful. Replacement can help improve shoulder movement and reduce pain.
Sometimes revision surgery will be required if there is a problem with the implant, for example, if it becomes loose. Such surgery can be complicated with higher risks of bone fracture.
Surgeon volume and adverse outcomes
The study published in the BMJ found there was a significantly increased risk of revision surgery where the volume of shoulder replacement surgeries undertaken by a surgeon was below a threshold of 10.4 annually.
Evidence also suggests that across surgical specialities, including hip and knee, higher surgical volume is aligned with improved patient outcomes. At Kingsley Napley we have our own (anecdotal) experience of learning curve issues - whereby success rates reach a constant plateau after a certain number of cases and adverse event rates decrease significantly over a similar number of cases.
According to the study, avoiding repeat surgeries and complications is crucial to reducing the burden on the health system. It is noted that, despite the increase in shoulder replacement surgery, evidence to guide service provision planning remains insufficient. We hope that this is something that will be tackled.
Medical Negligence
At Kingsley Napley we deal with claims related to joint replacement surgery that has unfortunately led to a poor outcome. However, not all such outcomes will be caused by negligence. Some may result from known risks of surgery. A successful claim for negligence requires proving (through independent expert evidence) that the standard of surgical care fell below a reasonable level. In these circumstances, we are able to obtain the compensation needed to meet the injured person’s needs for the future, which can include private revision surgery, aids and equipment, care and therapies, as well as sums to cover any lost earnings or other financial losses.
If you have suffered a poor outcome from joint replacement surgery and wish to speak to one of our specialist solicitors, then please contact us on 020 7814 1200.
Medical Negligence and Personal Injury Team
We welcome views and opinions about the issues raised in this blog. Should you require specific advice in relation to personal circumstances, please use the form on the contact page.
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