The hip replacement surgeon is clearly the central figure in all hip replacement procedures - second only to the patient!
The purpose of this page is to the provide an overview of the types of activity that a hip surgeon will typically be involved in - not just the hip replacement procedure itself but also at various stages throughout the whole hip implant product lifecycle including the hip implant recall process.
The notes below, numbered (1) through (7), summarize in rough chronological order, some of the main activities, functions and inputs undertaken by orthopedic surgeons.
1. Hip Implant Research, Design & Product Development
If I was running the product development function in a hip replacement manufacturing business I would want an experienced hip replacement surgeon on the team - in fact I would probably want a few dozen of these highly skilled professionals directly on the team, supported by a few hundred from whose practices I would want to collect data, insight and consensus of opinion.
The hip surgeon is in the lead role - working daily on the front line with patients in need of hip resurfacing or total hip replacement surgery. No single individual is better placed to provide feedback to manufacturers on precisely what is happening at the coal face.
Orthopedic surgeons specializing in joint and in particular hip replacement provide invaluable insights to hip implant manufacturing organizations on many topics including:
The surgeon may or may not be financially rewarded by the manufacturers for this type of activity.
Once a hip replacement surgeon reaches a certain stage in his career, it is possible that his standing, reputation and opinion will be highly regarded. If he is willing to promote or endorse a particular brand of hip replacement system then through time the product is likely to be more profitable for the manufacturer, all other things being equal.
Accordingly, some hip replacement surgeons will be involved in marketing and product promotion. These activities may or may not be financially rewarded, and any such activity will no doubt be managed fully in accordance with the code of professional and medical ethics to which the surgeon is bound.
3. Hip Implant Product Training & Instruction
Once a new hip replacement system is ready to be introduced to the market, the manufacturer may provide technical training and instruction to any hip replacement surgeon or supporting practice staff that expect to be using the products.
The objective of the training will be to ensure that the hip surgeon and his team become fully conversant with the technical specifications of the product and any related supplies, accessories, consumables, tools, literature and instructions.
The risks, benefits and intended use of the products will be explained to the surgeons during these sessions.
4. Post Market Surveillance Activity
Once a hip replacement system is introduced to the market, the hip replacement surgeon plays an ongoing, pivotal role in assessing the performance of the hip implant devices used within his practice and the quality of clinical outcomes achieved for patients.
The organizations, infrastructure, capabilities, processes and methods for collecting, consolidating and interpreting post market data vary significantly from one country to another.
The hip replacement surgeon is at the front line of insight and data collection, forming professional judgments on a daily basis as to whether a particular hip replacement outcome is as expected. If outcomes are not as expected the surgeon will start to form an opinion as to the possible underlying reasons.
If a surgeon notices an emerging adverse trend in the quality of surgical outcomes, for example a higher than expected revision rate for a particular type of device at a given point in time following primary surgery, then he will feed this information into whatever post market data collection mechanisms exist in the state or country where he practices.
5. Communication in the event of a Product Recall
A patient's hip replacement surgeon plays a critical role in the event of a hip implant product recall. The surgeon's Practice will often be the channel for communication to the patient, informing that the hip implant used in their procedure has been recalled.
6. Supporting patients with advice and Revision Surgery
Again, a patient's hip surgeon is by definition central to managing the patient through what is a potentially stressful experience. First communicating that the medical device implanted has been recalled; then working with the patient to assess how their hip implant is performing and whether any treatment or action is required. This process is complex and unique to each patient and will be very carefully managed by the orthopaedic surgeon and his wider support team.
7. Potential involvement in the Legal Process
Finally, given the themes covered above, it is not surprising that an experienced hip surgeon can sometimes called to give evidence as an expert witness in legal cases arising from hip replacement product recalls.
By-exception, it can be the case that the hip replacement surgeon is the defendant in a medical malpractice legal case, if it is alleged that the surgeon has not carried out his work to the standard which could reasonably be expected of someone with his skills and experience.
The hip replacement surgeons are central to: many activities in the lifecycle of hip implant product development; the practice and development of hip replacement surgery; supporting patients and families in situations where products are recalled.
The overriding priority for all hip surgeons is excellence in patient care and doing everything possible to ensure the very best outcome for each patient.