The Australian Orthopaedic Association National Joint Replacement Registry predicts that in the next decade, the number of hip and knee replacements performed per annum in Australia will double. It is fair to say that these figures will be similar across the globe.

Even now, it is nearly impossible for Surgeons to review all their Total Joint Replacement patients on a regular basis without compromising their ability to assess, treat and accommodate the predicted increasing demand for hip and knee replacement.

It is important to be reviewed following your operation to check that everything is going well and to monitor the wear and function of the prosthesis. Joint replacement patients should re-present, after their initial post op. period (3 months) for follow-up once joint function has normalized, which is at one to two years post operation.

Patients who are relatively active should also be assessed at 10 years, then, every second year thereafter. These reviews should include a radiological assessment. Higher risk patients or prostheses may require more frequent review at the Surgeon’s discretion. These include:

• patients with clinical or radiological signs of failure,
• revision replacements,
• previous joint sepsis, and
• new prosthetic designs with limited long term clinical trials.

A painful joint replacement or one that changes in function, should prompt the patient to seek Orthopaedic opinion. However, a few joint replacements can be asymptomatic until catastrophic failure occurs. Radiological follow-up may help to detect the less common scenario of an asymptomatic impending failure.

It is also recognized that Surgeons may vary (increase) from this minimum review recommendation as part of their ongoing Arthroplasty Practice. The patient’s obligation to maintain longer term follow up should be discussed as part of the consenting process for Joint Replacement.

These proposals reflect current practice trends among the Members of The Arthroplasty Society of Australia. http://www.aoa.org.au