A hip or knee replacement can offer people with chronic joint pain the chance to return to an active life. The potential promise of being pain-free, in some cases after decades of restricted movement, is a powerful incentive to arthritis sufferers around the world.

I know from direct observation that not all joint replacements result in the patient returning to the dance floor, or the jogging track, or even the walking path. My dad had a hip replacement in 1996 that inserted the wrong appliance, leading to 18 dislocations in the ensuing three years. The issue was finally resolved with yet another surgery, paid for by Medicare and my father’s supplemental insurance. This was a doctor error, not an appliance failure.

Imagine my surprise this past Saturday (April 3, 2010) at this piece in the New York Times, revealing that almost all manufacturers of artificial joints offer no warranty whatsoever to US consumers who wind up with defective products surgically strapped on to their skeletal structure. The dodge is facilitated by the way device manufacturers sell the implants: to the hospital, not to the patient.

The skids on that dodge are further greased by the consulting fees paid to many surgeons by implant makers, giving those surgeons little impetus to bite the hand that feeds them.

Here’s a chart for the visual learners:

NYT 4-3-10 hip replacement warranty stats

US device manufacturers who sell artificial joints overseas offer warranties in the countries outside the US where their implants are used. Why not here? One reason could be our tort-crazy system. Got a consumer complaint? Don’t try to work it out directly – hire a lawyer and sue the bastards.

That does not, however, excuse the failure of medical device makers to offer any kind of warranty on their products. And it’s not excuse for their expectation that we – taxpayers (Medicare and Medicaid), insurers, and patients – foot the bill for their lousy manufacturing processes.

This is another example of why we need what I call “real health care reform” in the US: fully-informed consumers (patients) communicating fully and frankly with health care providers (doctors, hospitals, device manufacturers). Price and outcome disclosures at the outset of every interaction. Both sides held to account on compliance with best practices.

Wow – what a revolution that would be.

That’s my story, and I’m stickin’ to it.

Got comments? Brickbats? Kudos? I welcome all. Bring it on.

The Sad Story About Joint Replacement (in the US, at least)
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