Your Hip or Knee Operation at James Cook

Our surgeons perform different hip and knee replacements, tailored to suit the needs of their patients.

All procedures and implants are evidence based and aimed at ensuring high levels of patient safety coupled with excellent clinical outcomes.

Approximately 1 in every 100 hip and knee replacements performed in England and Wales is performed by a South Tees Hospitals NHS Foundation Trust surgeon.

All the joint replacements we carry out have a proven track record and are backed by national joint replacement registries and clinical studies.

Hip replacements

Where possible we use a cemented hip replacement (cemented socket and stem) as evidence supports this as being the best choice for the majority of patients. The hip replacement we use has the highest possible rating (ODEP 10a rated) and it has been in use for over 40 years.

It demonstrates excellent results in a number of long term clinical studies and is supported by data from all major national joint replacement registries.

The 10 year survival for this hip implant is greater than 96%. This means no more than 1 in 25 of these hip replacements will need to be revised (removal of the old hip replacement and a new one inserted) in the 10 years following surgery.

Where appropriate we also offer a range of other hip replacement solutions including the use of uncemented hip components and alternative bearings (ceramic).

Metal on metal hip replacement

Following recent concerns about their performance we no longer routinely offer metal on metal hip replacements and have not done so for the last five years.

If patients have had a hip replacement since 2008 at either the James Cook or Friarage hospitals they will not have had a metal on metal hip replacement apart from a small number of patients who underwent the less problematic Birmingham hip resurfacing.

No patient should have had a metal on metal hip replacement at all since summer 2010. All patients who had metal on metal hip replacements before this time should have been contacted by the department and offered a clinical review.

If you have concerns that you have undergone a metal on metal hip replacement within the trust then please do not hesitate to contact us.

Knee replacements

We believe that total knee replacement (replacement of the entire knee joint) is the best operation for the majority of patients who present with pain and functional limitation and evidence of osteoarthritis.

All of the knee replacements we use have a proven track record with 10 years survival rates of around 95%. This mean no more than 1 in 20 of these knee replacements will need to be revised (removal of the old knee replacement and a new one inserted) in the 10 years following surgery.

In certain circumstances it may be suitable to consider a partial knee replacement (replacement of part of the knee joint, usually the inside half of the knee or the patellofemoral (kneecap) joint).

However, we remain concerned that partial joint replacements have a significantly higher rate of failure than total knee replacement without any evidence to suggest they deliver improved outcomes for patients.

Evidence from national joint replacement registries suggests that partial knee replacements have failures rates three to five times greater than those observed for a total knee replacement but do not offer greater improvements in pain relief and functional ability.

One thing that is clear is that the result of partial knee replacement is dependent up on who performs your surgery and in particular how many procedures they perform each year.

For these reasons we have limited the number of surgeons offering partial knee replacements to help maximise expertise and deliver the best outcomes for the small number of patient in whom we believe these procedures would be beneficial.

Pioneering treatment

South Tees has always sought to innovate and progress.

In recent years we have pioneered the use of computer assisted surgery for knee replacement and latterly in the use of patient specific knee replacement utilising state of the art technology for accurate patient tailored component positioning.

We will continue to embrace new technologies that we believe will help us to continue to deliver the best outcomes for our patients in the future