Primary care management of postoperative shoulder, hip, and knee arthroplasty
Nick Aresti, specialist registrar in trauma and orthopaedic surgery Percivall Pott rotation and National Medical Director’s clinical fellow1, Jamila Kassam, physiotherapist and orthopaedic research lead1, Daniel Bartlett, general practitioner2, Satish Kutty, consultant knee and revision hip surgeon and clinical director3Hip Knee
The number of orthopaedic operations is increasing in the UK: the National Joint Registry reported just under 225 000 procedures in the period ending 2015-16.1 This practice pointer aims to inform the readership of the important considerations about arthroplasty of the knee, hip, and shoulder—the most common arthroplasty procedures performed in the UK.
Arthroplasty—what’s changed?
Arthroplasty in now routinely used to treat fractures and rotator cuff arthropathy. In 2015 in the UK over 83 000 primary total hip replacements took place, of which over 3700 were for neck of femur fractures, and over 4200 shoulder arthroplasties were performed for cuff arthropathy, representing around a quarter of all shoulder replacements.1 Enhanced recovery programmes have seen better standardisation of arthroplasty care and are now fully implemented in the NHS. They have been shown to reduce mortality, length of hospital stay, and transfusion requirements.2 They have four main steps, summarised in box 1.
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