Implant Files: How patients can protect themselves from faulty implants
Under the heading “Implant Files”, leading media all over the world are currently reporting on defective implants, including hip endoprostheses. An important topic, according to Priv.-Doz. Dr. med. habil. Johannes Schauwecker of the Orthopedic Center Munich East (OZMO). The orthopedic specialist is an experienced specialist in minimally invasive joint replacement for hip and knee joints and has been a certified main surgeon for joint replacement operations for the past five years.
Dr. Schauwecker, the Süddeutsche Zeitung and other leading international media have used the collective term “Implant Files” to refer to defective implants. Rightly?
Dr. Schauwecker: “Medical devices can perform almost biblical miracles,’ writes the Süddeutsche Zeitung, for example, and is absolutely right. However, and here I also agree: ‘This medical high tech also has a dangerous side if it is developed sloppily and controlled carelessly.I therefore very much welcome the fact that the issue of the safety of medical devices is now being widely discussed.
It has been known for years that when implants are used, their suitability and safety cannot automatically be assumed. Here the patient must trust his treating physician to the extent that he himself has sufficiently checked such properties of an implant.
And because implant costs are usually part of the flat rate per case and are not billed separately, there is unfortunately also an incentive to increase the total revenue of an operation by using more favorable implants.
However, the subject of implant safety has long been given importance in the field of orthopedics and trauma surgery. Among other things, the German Endoprosthesis Register was founded in 2010 on the initiative of the German Society for Orthopedics and Orthopedic Surgery in response to the prosthesis scandal involving metal-on-metal bearing couples.”
As a patient, how can I protect myself from receiving a defective implant??
Dr. Schauwecker: “The use of an implant is usually an operation that can be planned. So the patient has time to gather information and ask, for example, who the manufacturer is and what kind of implant it is. Subsequently, the patient should seek a second specialist opinion before agreeing to a scheduled surgery.
This can clarify whether the surgery makes sense at all and whether the implant is suitable and meets the necessary standard. Of course, a second medical opinion is only worthwhile if the second doctor has a great deal of experience in the relevant specialist field.
But then it can avoid an unnecessary operation or unsuitable implant, or by confirming the indication, it can remove doubts from the patient and make him feel more secure.”
Are there really implants that are of dubious quality?
Dr. Watchwatch: “I only use implants that I myself have previously checked for a sufficient study situation, that have already been used over a longer period of time and that also have the strict American FDA approval and are continuously monitored.
Based on my many years of experience with joint replacement operations and my work as a TÜV expert, I am aware that there are inadequately tested implants such as e.B. there are cheap replicas from low-wage countries on the market.
Patients who do not want to take this risk should ask their attending physician for the exact designation, i.e. manufacturer and type, of the intended implant before an operation.”
According to expert estimates, one in three orthopedic operations in Germany is actually unnecessary. Artificial joints are inserted too often and too quickly, especially at the knee and hip. How does this happen??
Dr. Schauwecker: “Often, decisions are made and surgery is advised based only on the X-ray image. On the pictures the doctor can recognize the wear and tear of the joint, but the decisive criterion for a plannable surgery is always the suffering of the patient.
If the level of suffering is not that high or if non-surgical therapy options have not yet been exhausted, surgery may be too hasty and therefore unnecessary. Therefore, it is important to take time for a detailed discussion and a comprehensive examination of the patient and to make the recommendation for surgery for each patient individually.”
As a patient, how can I tell whether the doctor has the appropriate expertise??
Dr. Schauwecker: “In general, every patient has the free choice of which doctor to choose. A patient should therefore ask exactly what experience the surgeon has and how many times per year he performs the surgery in question.
It is advantageous if the doctor is an Endocert-certified main surgeon, i.e. can demonstrate the corresponding routine and competence as well as the required infrastructure. This also assures the patient that both the surgeon and the clinic adhere to strict guidelines and standards.”
As a patient, do I have to expect extra costs if I get a second opinion?
Dr. Schauwecker: “Patients who seek a professional second opinion usually do not have to undergo all examinations again, but bring their initial examination results with them. Since the Healthcare Strengthening Act passed by the Bundestag in 2015, every patient has the right to have all documents and results of the initial findings handed over to him.
Costs do not arise for the patient, since these are taken over by the health insurance companies – which is also in their interest, since thereby possibly an operation can be prevented.”
About Priv.-Doz. Dr. med. habil. Johannes Schauwecker
Dr. Johannes Schauwecker is an experienced specialist in innovative joint-preserving therapy procedures and minimally invasive joint replacement in the hip and knee joints. Dr. Schauwecker studied medicine in Berlin and Munich. In 2003, he began his residency as an orthopedic and trauma surgeon at the University Hospital rechts der Isar, which he continued at the Dachau Clinic and later again at the University Hospital rechts der Isar.
Since 2010, Dr. Schauwecker specialist for orthopedics and trauma surgery. In 2012 he became senior physician and in January 2016 chief physician. Early on, Dr specialized in. Schauwecker on the treatment of hip and knee joints. Especially the holistic view of his patients and the exhaustion of non-surgical therapy measures are important to him.
For this reason, he also successfully completed additional training in manual medicine and chiropractic. Due to his great experience and competence, Dr. Schauwecker has been a certified main surgeon for joint replacement operations for five years.
Dr. Schauwecker has authored numerous scientific publications in national and international journals. Due to his outstanding competence and experience, Dr. Schauwecker for years very much in demand for scientific lectures as well as as a specialized examiner with the Bavarian national medical association active.
After twelve years of work at the University Hospital rechts der Isar and more than 3000 surgeries, Dr. Schauwecker the Orthopedic Center Munich East (OZMO) since October 2017.