How Does the Physician Patient Fare After Primary Total Hip and Knee Arthroplasty?

BACKGROUND

Physician patients requiring surgery present with occupational risks and personality traits that may affect outcomes. This study compared implant survivorship, complications, and clinical outcomes of physicians undergoing primary total hip arthroplasty (THA) or total knee arthroplasty (TKA).

METHODS

A retrospective review of our institutional total joint registry identified 185 physicians undergoing primary THA (n = 94) or TKA (n = 91). Physicians were matched 1:2 with nonphysician controls according to age, sex, body mass index, joint (hip or knee), and surgical year. Physician type (medical, n = 132 vs surgical, n = 53) subanalysis was performed. Implant survivorship was assessed via Kaplan-Meier methods. Clinical outcomes were evaluated by Harris hip scores and Knee Society Scores. Mean follow-up was 5 years.

RESULTS

There was no significant difference in 5-year implant survivorship free of any reoperation ( > .5) or any revision ( > .2) between physician and nonphysician patients after THA and TKA. Similarly, the 90-day complication risk was not significantly different after THA or TKA ( = 1.0 for both). Physicians and nonphysicians demonstrated similar improvement in Harris hip scores ( = .6) and Knee Society Scores ( = .4). When comparing physician types, there was no difference in implant survivorship ( > .4), complications ( > .6), or patient reported outcomes ( > .1).

CONCLUSIONS

Physician patients have similar implant survivorship, complications, and clinical outcomes when compared to nonphysicians after primary THA and TKA. Physicians should feel reassured that their profession does not appear to increase risks when undergoing lower extremity total joint arthroplasty.