Choosing the appropriate prosthesis is only one part of the equation for successful hip or knee joint replacement. "The most important factor in joint replacement success is the surgeon," says Greenwald. "The first question I'd ask the surgeon is, 'How many have you done and what are your complications?'"
Jonathan Garino, M.D., agrees. "There are a number of good devices out there," says Garino, an orthopedic surgeon with the University of Pennsylvania Health System. "But even if you have the best technology in the world, it has to be implanted correctly." It falls to the surgeon to put the device in right, but it falls to the patient to take care of the new joint, says Garino. Regular exercise is important, but high-impact activities, such as running and jumping, generally are discouraged.
The independent panel convened by the NIH in December 2003 to study total knee replacements also concluded that proper surgical technique was one of the most important factors leading to successful knee replacement. Studies have found that the more knee replacements a surgeon performs, the lower the rates of complication, according to the panel. Similarly, complication rates fall in hospitals with increasing numbers of operations performed.
"All You Need to Know About Joint Surgery," © 2002, Arthritis Foundation