Vejle Hospital

In the past, having patients go home on the same day they underwent total hip replacement was done rarely and only in select cases. As a hip surgeon, I remember these rare cases because the request or demand to go home on the same day that the surgery was performed never came the surgeon. It always came from the patient, who was typically a younger man whose job involved a leadership position and he expected to be “back in business” the next day.

When we, as orthopaedic surgeons, plan a surgical procedure, we certainly demand that safe implants be used. When a patient accepts to undergo surgery performed by us, he or she expects the implants we use are safe. When the manufacturer produces and delivers implants to us to be used in our patients, they take the implants through a meticulous investigation followed by an evaluation of the products by regulators and notified bodies, before the implant is released for free use on the European market by physicians. In this way, all “stakeholders” expect and desire to do their best to bring about safe implants that are used in surgery for patients, which fulfills patients’ expectations of receiving safe treatment.

As someone who has been in orthopaedic surgery for nearly 4 decades, I certainly welcome both evolution and innovation. However, I also prefer stability in my orthopaedic practice and tend to be patient when it comes to new advances in the specialty. As a hip surgeon, I have reflected on the implants, surgical techniques, pain management and rehabilitation programs used and the attitudes of the surgeons and patients in 1982, when I began my practice.

The European Union Commission has launched a new medical device regulation for devices sold in the European Union that replaces the existing medical device directive. Under the new regulation, devices on the market are classified into one of three levels, with class 3 consisting of high-risk devices that need the strictest regulations.

Another great EFORT Congress just concluded. This one, which was held in Lisbon, was the 20th EFORT Congress. As president of EFORT starting June 2018 and ending immediately after the Congress in Lisbon, it was a special event for me, as might be expected.

Following the November 2018 “storm” that occurred before and immediately after several journalists released The Implant Files Investigation, which contained data they collected about problems with orthopaedic implants, various reactions to this information were published. Among them was a statement from the EFORT leadership. Certainly, orthopaedic surgeons care that the best and safest implants are used in patients. No patient should ever question that. However, we, as surgeons, also must ensure we do some self-examination whenever we begin to use a new product or when the outcome of an implanted product does not meet our expectations.

The vote in favor of the United Kingdom leaving the European Union was a shock to me.

The Cover Story in this issue of Orthopaedics Today Europe includes comments from worldwide orthopaedic experts about 3-D printing in musculoskeletal medicine, some of whom use 3-D printing in their daily practice. It is evident this technology is here to stay in medicine and no doubt will soon be sought out by many surgeons as a tool for the development of custom guides and implants unique to their patients, as well as for providing a better understanding of patients with complex deformities and anatomies.

This year’s American Academy of Orthopaedic Surgeons Annual Meeting was held in Orlando, Fla., USA, for the first time in 16 years. As an international member of the American Academy of Orthopaedic Surgeons, I have attended nearly all its meetings since 1988, only missing one or two.

The government in the United Kingdom has announced that, starting in 2020, 7 days of full service shall be implemented for general practices, as well as hospitals that handle emergency cases and other patients with a need for urgent care. In the Cover Story in this issue of Orthopaedics Today Europe, there is a lengthy discussion of the U.K. decision related to this type of service and it includes comments from orthopaedic surgeons in the United Kingdom, as well as other countries.