Orthopaedics: Joint replacement procedures
1) Dislocation of artificial hip joint, wrong artificial joint components
A patient underwent hip replacement surgery due to painful arthrosis of the hip. The patient did not recover after the operation in the normal way, as the hip joint was dislocated several times. The patient was radiographically imaged, based on which the stem part of the artificial hip joint was too short. Resurgery was performed, replacing the short artificial joint stem with one of the right length. The dislocation problems ceased after this.
The hip replacement was medically indicated to treat the arthrosis. The level of professional competence for a healthcare professional performing hip replacements was not achieved in the operation, when too short a stem part of the artificial joint was selected in the operation.
The patient was compensated for personal injury caused by the dislocations of the artificial joint and resurgery.
2) Hip replacement, dislocations
A patient underwent hip replacement surgery due to painful arthrosis of the hip. The patient's hip was dislocated soon after the operation. At first, the hip could be pulled back in place, but resurgery became necessary due to repeated dislocations. X-ray imaging and resurgery indicated that the parts of the original artificial joint were appropriate. The hip remained painful even after the repeated operation.
The hip replacement was medically indicated. The technical implementation of the operation was appropriate, and the artificial hip joint components selected were appropriate. The reason for the dislocation of the hip could not be determined with certainty. In this case, it was possibly due to weakened muscle structures in the hip region. The operation, which had been performed appropriately using an acceptable method and damaging only little soft tissues, had contributed to this.
This consequence could not be avoided in spite of the treatment having been performed appropriately. The case did not meet the criteria for an injury compensable under the Patient Injuries Act.
3) Knee pain after joint replacement
A patient underwent knee replacement surgery due to wear and arthrosis of the knee. There was still pain in the knee after the operation in spite of rehabilitation and active physical exercise. More detailed examinations on the patient did not indicate the reason for the knee pain.
The knee replacement surgery on the patient had been medically indicated. Based on the report available, the technical implementation of the operation was appropriate. The continuation of the pains was not probably due to the surgical procedure performed.
Appropriate treatment not achieving the desired outcome is not considered a patient injury. In the case of this patient, a painless outcome was not reached in spite of appropriate treatment. Yet, the case did not meet the criteria for an injury compensable under the Patient Injuries Act.
4) Knee replacement surgery, cement residue in the joint
A patient had developed arthrosis in the knee after a previous traffic accident, and therefore a knee replacement surgery was performed. After the operation, there was still abnormal pain in the knee. More detailed examinations indicated that a piece of cement had remained inside the knee joint. The cement piece was removed in a repeated procedure.
The knee replacement was medically indicated to treat the arthrosis of the knee. The knee can remain sore after knee replacement surgery in spite of the appropriate implementation of the operation. However, the patient's pain was caused at least in part by cement residue remaining in the knee region, and it should have been noticed and removed during the operation.
In this respect, the technical implementation of the operation did not meet the level of professional competence required of a healthcare professional performing joint replacements, so the case constituted a patient injury eligible for compensation.
The patient was compensated for personal injury caused by the resurgery.