Joint Replacements in England and Wales – Do I have a Clinical Negligence Claim?

Joint replacements are among the most common and life-changing surgeries performed in England and Wales, with thousands of patients receiving hip and knee replacements each year to alleviate pain, restore mobility, and improve quality of life. While these surgeries are usually successful, complications can arise, some of which may be due to medical negligence.

When a joint replacement fails or complications occur due to negligent care, patients may be entitled to bring a medical negligence claim.

How Many Joint Replacements Are Performed Annually?

In England and Wales, around 100,000 hip replacements and 90,000 knee replacements are performed annually. The majority of these procedures are conducted due to osteoarthritis, which wears down the cartilage that cushions the joints, causing pain and stiffness. As a result, joint replacements become a necessary solution for patients who cannot achieve relief through non-surgical treatments.

The Joint Replacement Procedure

Hip replacement involves removing the damaged portions of the hip joint and replacing them with artificial components, typically made of metal, ceramic, or plastic. Similarly, a knee replacement may involve replacing the entire joint (total knee replacement) or only part of it (unicompartmental knee replacement) depending on the extent of the damage.

The aim of joint replacement surgery is to restore function, reduce pain, and improve mobility. However, these procedures can sometimes lead to complications if not performed with proper care.

When Can a Claim Be Made for a Failed Joint Replacement?

A clinical negligence claim can be brought if a patient or their loved one has suffered from a failed joint replacement due to substandard care. Some of the most common grounds for negligence claims in joint replacement surgeries include:

Inappropriate Surgery: In some cases, a patient may undergo a joint replacement unnecessarily or inappropriately. For instance, where a patient with osteoarthritis could have benefitted from less invasive treatments, opting for surgery prematurely could be considered negligent. This is particularly relevant for younger patients or those with mild osteoarthritis who may not have exhausted conservative treatment options.

Incorrectly Sized Implants: Surgeons must ensure that the artificial joint or implant is of the correct size. Using an implant that is too large or too small can result in misalignment, instability, pain, or even joint failure. This is a form of negligence if the surgeon fails to use appropriate surgical techniques or equipment to ensure the correct fit.

Failure to Diagnose Post-operative Complications: After joint replacement surgery, close monitoring is essential to detect complications such as infections, blood clots, or poor healing. If a surgeon or medical team fails to diagnose and treat these complications promptly, it can lead to further damage and long-term consequences for the patient. Failure to properly manage post-operative care could constitute negligence.

Specific Risks and Negligence in Knee and Hip Replacements

Unicompartmental Knee Replacement (UKR) Complications

Unicompartmental knee replacements (UKRs), also known as partial knee replacements, involve replacing only one section of the knee joint. While they can be beneficial for some patients, UKRs have been associated with higher complication rates compared to total knee replacements. Complications can arise due to incorrect patient selection, where a UKR is performed when the damage is too extensive, leading to pain, instability, or early failure of the replacement.

Additionally, misalignment of the implant or insufficient balancing of the knee joint can result in instability, making it difficult for the patient to walk or bear weight on the leg. In cases where poor surgical technique is responsible for these issues, a clinical negligence claim could be pursued.

Hip Replacement Complications: Misalignment, Dislocation, and Nerve Damage

Hip dislocations after a replacement occur when the ball of the new joint comes out of the socket. This can be due to improper positioning of the implant, making the hip more vulnerable to dislocation. While not every dislocation is due to negligence, multiple dislocations or dislocations resulting from misaligned implants or poor surgical technique may lead to a claim.

Another common issue after hip replacement is a leg length discrepancy, where one leg becomes longer or shorter than the other. This can result from poor pre-operative planning or surgical errors in implant placement. While small differences in leg length can be addressed post-surgery, larger discrepancies causing pain or difficulty walking may indicate negligence, especially if no corrective measures are taken.

Foot drop and sciatic nerve damage are other potential complications following hip replacement surgery. Foot drop occurs when the nerve controlling foot movement is damaged, leading to weakness or paralysis in the foot. This can happen if the sciatic nerve is injured during surgery. Nerve damage is often preventable, and if it occurs due to improper surgical technique or positioning, it may be grounds for a negligence claim.

Do I have a Joint Replacement Negligence Claim?

Several factors can determine whether a joint replacement complication is due to negligence:

Inadequate Pre-operative Planning: If a surgeon fails to properly evaluate a patient’s condition, including choosing the appropriate type and size of implant, this can lead to a failed replacement. Failure to assess key risk factors, such as pre-existing conditions, can also be considered negligent.
Surgical Errors: Misalignment of the implant, incorrect sizing, or poor placement can lead to pain, instability, and joint failure. These errors are preventable if the surgeon follows standard protocols and employs proper techniques.

Lack of Informed Consent: If a patient is not fully informed of the risks of surgery, including the possibility of complications or the need for further treatments, a negligence claim may be valid. Surgeons have a duty to explain all potential outcomes before proceeding with surgery.

Post-operative Care Failures: Proper post-surgical monitoring is crucial for ensuring a successful recovery. If complications are ignored or treated too late, leading to further harm, this can also form the basis of a negligence claim.

Seeking Legal Advice for Medical Negligence Cases

Joint replacements can significantly improve a patient’s quality of life, but they are not without risks. When complications arise due to negligent care—whether from inappropriate surgery, incorrect implants, poor surgical technique, or failure to diagnose and treat post-operative issues—patients may have grounds to bring a clinical negligence claim. If you or a loved one has suffered the consequences of a failed hip or knee replacement, seeking legal advice is crucial to understanding your rights and options. Don’t hesitate to reach out to our team of Medical Negligence Solicitors who are experts in this area.