The ONE THING You MUST Know When Choosing the Right Surgeon for Total Hip Replacement

• December 6, 2021

We’ve all heard it before, “I trust the doctor.” In particular when the doctor is an orthopedic surgeon. Because they are all good. If they were not, they would not be orthopedic surgeons. Right?
Wrong.
A botched total hip replacement surgery is a total disaster. Search Facebook for botched hip replacement surgery stories to see for yourself. Instead of the relief you went in for, you could end up in worse pain every day for the rest of your life. You could get a hospital infection that spreads to your bones, takes months of antibiotics to clean up, and never gets totally better. Or your surgeon may not use the robot or check their work during surgery with x-ray, and you end up with the wrong implants, and a year or more of painful physical therapy that may or may not ever work.

Not all orthopedic surgeons are the same.

Australia tracks every person who has surgery in the country each year in a registry. They have been doing it for 20 years, and there are over a million cases in the registry. The chart below shows the Australian Registry data on patient satisfaction with total hip replacement surgery for the last year. In this chart the higher the dot the higher the patient satisfaction. Each dot represents the average satisfaction of all the patients who saw the same doctor. The horizontal green line is the average; so, any surgeon (dot) below the green line has patients who rank them as below average; whereas any surgeon (dot) above the green line patients rank above average. Look:

Some surgeons’ patients give them much higher marks than others.

A lot higher. I drew a blue arrow at the dot for the surgeon whose patient gives them the worst grades in all of Australia. That surgeon may be very cordial, did an excellent job on your cousin/wife/friend/pastor’s hip, has been practicing for a long time, runs a great office, and is a pillar in the community. However, their patients are a signifigantly less satisfied after hip replacements than any other surgeon in the whole country.
Do not go to them. Run away. It is your hip, not your cousin’s. If you end up with a result that’s not what you hoped, then how do you explain that to yourself? The stakes are just too high, and consequences of error are too scary to take a chance on any surgeon you do not think is the best.
There is another lesson that is clear from this data that you can use in choosing your own surgeon. All the surgeons with below average patient satisfaction did less than seventy hip replacement surgeries the year before. I drew the black arrow below the dots (surgeons) who had below average results but did the most hip replacements. Every surgeon (dot) to the right of the arrow is at or above average.
True! There are a lot of surgeons (dots) above average who did less than seventy hips; but you do not know who they are. And all the below average surgeons did less than seventy surgeries. So, to be certain you do not end up with a below average surgeon:

DO NOT GO to a surgeon who did less than 70 hip replacement surgeries last year.

 
So, there is an enormous difference between the outcomes patients report for their surgeons, and you want to be sure your surgeon has done at least 70 hips last year. What else is important? We do not have strong data, but I would go to a surgeon who:
• Consistently uses a minimally invasive approach
• Uses implants that are proven by registry to be the best
• Get robotic assistance during surgery, or at least
• Verifies their work by x-ray done in the operating room.
I will go into these issues at great length with you in the future. To learn more about interviewing surgeon for who is the best to operate on you, look here: Finding A Hip Surgeon – Hip Replacement Info (hip-replacement.info). For now, the one thing you must know when choosing a surgeon for total hip replacement surgery is what not to do:

DO NOT GO to a surgeon who did less than 70 hip replacement surgeries with a minimally invasive approach and robotic assistance last year.