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Should I have a hip replacement according to the statistics?

Q) I’m 85 and have painful hip osteoarthritis. I have to make a decision on whether to have replacement. The latest report from the National Joint Registry gives a death rate of 1.17% within 30 days of the operation for men aged 80+. This is out of 18,918 in this group, who a month earlier were presumably declared medically fit enough for a major elective operation. I find this very daunting. I wouldn’t fly an aircraft type which had a record of one crash in 100 flights, no matter how idyllic the destination! Any comments please, or have I misunderstood the statistics?
G K, Hatfield (Summer 2013)

A) Try looking at it a different way – there is a 99% chance of surviving the operation for people of your age. Any operation carries a risk of death whatever the operation and whatever the age. Major operations, such as replacement of a hip, carry a higher risk, and increasing age carries a higher risk, no matter how fit you are beforehand. Having said that the statistic you quote is for all cases, and some people will have more risk than others, and some operations are not as smooth as others (those done in an emergency, after a hip fracture for example). But they are lumped together statistically. Your surgeon will consult the anaesthetist if there is any doubt about your fitness for the operation. And if there are other problems, such as lung or heart disease, they may not operate, or operate under spinal anaesthesia to minimise the risks. Some people are put off by the surgeon spelling out the potential risks, but it all has to be put in context – how much improvement in quality of life will you gain by having the operation?

This answer was provided by Dr Philip Helliwell for the Summer 2013 edition of our magazine, Arthritis Today, and was correct at the time of publication.

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