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Since 2000, every joint replacement done in Australia goes into a central registry, and if further surgery undertaken, it is recorded against the implant. The surgeon is also able to access his own results to compare with other surgeons of Australia. This has had substantial impact not only in Australia, but internationally.

Twenty year results indicate re-operation on 7% of joint replacements where the patients are still alive (the average age for joint replacement is 68). Implants that are no longer available are not included in this. It doesn’t matter if hip, knee or shoulder. Various improvements over the years probably improve these results – highly cross linked polyethylene was not available 20 years ago – and basically doesn’t show wear at 15 years. Vitamin E has been in my hip replacements also reducing oxidation and delamination since 2009.

The old days of annual reviews don’t make sense. There will be special patients that do – but given the average age for joint replacement is 68 in Australia, the likelihood of requiring further surgery is small. Given standard referrals run out at 12 months – following up for six months is probably easiest for all parties, but if there is a reason to follow up long term – so be it !

Mr. David Mitchell
Orthopedic Surgeon