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EARLY FAILURE OF TOTAL HIP REPLACEMENTS IMPLANTED AT DISTANT HOSPITALS TO REDUCE WAITING LISTS



Abstract

Introduction and Aims: In the years 1990–1993, in an effort to reduce waiting list time, a small number of patients were sent from Exeter to hospitals in London to undergo elective total hip replacement. No medium- or long-term follow-up was arranged. Our aim was to audit the outcome of these hip replacements.

Method: Review of the records of the referring medical practices, Regional Health Authority, local Orthopaedic Hospital and the distant centres at which the surgery was performed has identified 31 cases. A total of 27 hip replacements in 24 patients were available for clinical and radiological review.

Results: Twelve (44%) hips have so far required revision surgery, at a mean of 6.5 years. Of these, three (11%) have been for deep infection. A further three hips (11%) are radiologically loose and are being closely monitored. Two patients (7%) suffered permanent sciatic nerve palsy.

Conclusion: Patients whose surgery was performed locally over a similar time period have a published failure rate of only 4.6%. The causes for such a difference in outcome were analysed and include surgical technique, implant selection and absence of follow-up. In the light of this evidence, we would like to urge the government to address waiting list problems by investing in the local infrastructure. Expanding those facilities where properly audited and fully accountable surgeons operate must be the way forward.

These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.

None of the authors is receiving any financial benefit or support from any source.