You probably compare hotels before booking a holiday.
You may read reviews before buying a £100 appliance.
Yet when considering an operation costing many thousands of pounds, patients sometimes have surprisingly little information about the results achieved by the person who will actually perform it.
Fortunately, joint replacement is one area where patients in the UK have access to unusually rich data.
The National Joint Registry records hip, knee and other joint-replacement procedures across England, Wales, Northern Ireland, the Isle of Man and the Channel Islands. Its public surgeon profiles allow patients to examine recent surgical activity and the hospitals at which consultants operate.
There are three concepts particularly worth understanding.
Volume tells you how frequently a surgeon performs a procedure. It isn’t a guarantee of quality, but it gives useful context about experience.
Revision means another operation is performed to replace or modify an existing joint replacement. The NJR uses risk-adjusted revision data as one of its important clinical outcome measures.
PROMs, or Patient Reported Outcome Measures, look at the result through the patient’s eyes — including changes in pain, function and quality of life after surgery.
No single number tells the whole story.
A surgeon who undertakes particularly complex cases, for example, may treat a very different patient population from somebody performing predominantly straightforward operations. Even the NJR cautions against interpreting revision numbers in isolation.
The best approach is to use the data to start a conversation.
Ask your surgeon about their experience.
Ask them about their outcomes.
Ask what complications they see.
Ask what happens if you experience one.
And, if you are paying for your own treatment, ask one other question that can easily be overlooked:
What would I have to pay if something unexpected happened afterwards?
Good healthcare is not simply about knowing the price of the operation.
It is about understanding the entire journey.
