Orthopaedics – Part 1: hospital negligence and claims
Importance of prosthetics in hospital compensation claims
An increasingly common area of hospital negligence concerns the treatment of orthopaedic injuries and conditions. With an ageing population, many of us will be more active into our twilight years than our ancestors. As a result, our joints will wear out through natural degeneration, arthritis or osteoporosis, necessitating surgery. Some of the more active among us may sustain torn ligaments or bony injuries through playing sports, such as a torn meniscus, ACL or MCL (knee ligaments), which can also be repaired surgically.
Orthopaedic procedures are one of the most common and routinely performed and, for the most part, operations go by without a hitch. However, when things do not go according to plan, the resultant damage can have far-reaching implications for the health and independence of the patient.
In a series of blog posts, we will set out a few of the commonly recurring pitfalls and problems which we have encountered in our practice as medical negligence lawyers.
Part 1: Hip or knee replacements (prosthetics)
First developed in the 1960’s, these are now one of the most frequently performed procedures in patients suffering from arthritis and hip pain. A natural joint wears away with destruction of the cartilage and bony surfaces. A plastic and metal component is inserted to replace the whole or part of the joint.
The vast majority of these procedures are successful and patients enjoy a new lease of life. However, I have investigated many cases where patients have been on the receiving end of an inappropriately sized component (either too big or too small), with the result that they cannot flex the joint properly, weight-bear or mobilise. The consequences are often excessive loading on the opposing limb, altered gait and back pain with reduced mobility and independence – the very thing which surgery was intended to avoid.
The decision as to which size prosthesis to use is down to the treating surgeon who mostly judges by eye. Whilst doctors will take a pre-operative x-ray of the joint and measure the socket and femur, the decision of which size prosthesis to use and how far to drill into the adjoining bone is pure guesswork – it is not an exact science and mistakes are often made.
If a stem is slightly too proud of the femur (thigh bone), the hip joint will sit too high and the result is one leg being longer than the other. It is generally accepted that a leg length discrepancy of up to an inch is a reasonable outcome of surgery. However, if you have been left with a severe limp after hip surgery, you may want to investigate whether or not the prosthesis was the correct size for you, and whether the surgical technique was of an acceptable standard.
Some further common pitfalls of joint replacement include dislocation of the prosthesis (particularly if it has been incorrectly sited within the ball and socket joint), and infection – more to follow in our next post.
Should you require assistance with a claim relating to Orthopaedic surgery or any other medical matter, please contact a member of the medical negligence team on 0800 316 8892.