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A recent article by Andrew Carr, a professor of orthopaedic surgery at the University of Oxford, has issued a warning that many knee replacements could pose future risk to patients. Andrew Carr has warned that many knee replacements may be unsafe and lead to long-term complications. He shared his concerns in an article in The Lancet.
The problem is due to inadequate regulations in the industry. There are currently over 15 companies manufacturing replacement knees that UK surgeons are using. At the moment it is up to individual surgeons to chose which particular knee replacement should be used.
This warning comes just after the news that many people who have had metal on metal hip replacements will have to undergo regular blood tests as there is a risk of contamination from poorly constructed implants.
A case is cited in Australia of 25 patients who received a faulty knee replacement which resulted in pain and inflammation. Recovery from knee replacement surgery is a painful process already without the added pain of complications.
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No Clinical Testing for Knee Replacements
The pharmaceuticals industry has to carry out thorough clinical testing to determine the safety of medicines. However, replacements do not need to undergo the same level of testing. Not only knee replacements, but also hip replacements and breast implants too, do not need to be tested on individuals inside the body before being issued a kitemark to authorise their use.
“While we don’t want to stifle innovation, it is too easy to put something out in the market without testing it properly. The hip and PIP disasters are making people look at this again.”
However, it is important to remember that for a majority of people who have knee replacements there are no problems and they have a much improved quality of life afterwards with increased health, fitness and mobility.
“Knee-replacement surgery is frequently done and highly successful.” Prof Andrew Carr.
Andrew Carr’s article in The Lancet is certainly not an attack on knee replacements, but simply highlighting the need to improve the quality of care that is provided.
“We also emphasise the need for new strategies to treat early-stage osteoarthritis, which will ultimately reduce the demand for joint-replacement surgery.”
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As the population continues to age and more cases of obesity are reported, it is expected that in time there will be more demand for knee and hip replacements. In 2010 there were almost 82,000 knee joint replacements in England and Wales. It is therefore vital that there is more regulation governing the development and testing of implants before they are used in patients.
Reference
“Knee replacement” by Prof Andrew J Carr Otto Robertsson, Prof Stephen Graves, Prof Andrew J Price FRCS, Prof Nigel K Arden, Andrew Judge, Prof David J Beard. The Lancet, Early Online Publication, 6 March 2012. doi:10.1016/S0140-6736(11)60752-6
“New safety concerns over knee replacements” by Nina Lakhani, The Independent.
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