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Author Topic: NHS or Private?  (Read 378 times)

Offline millen

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NHS or Private?
« on: January 01, 2017, 08:05:16 PM »
Hello

I'm about to see my GP to discuss options for TKR, aged 62.  Benefits of arthroscopy and micro-fracture 7 years ago for grade IV OA have worn off and pain is now far worse than it was before that op.

My question is whether people feel private surgery is likely to lead to a 'better' outcome than the 'NHS standard'?  I've emailed a couple of private surgeons who claim that more advanced prostheses, eg BCS Journey II or custom-made ConforMIS, are likely to result in more flexion, less pain, greater durability etc, but arguably "they would say that, wouldn't they". 

I've also spoken to an anaesthetist friend who reckons the quality and experience of the surgeon and medical team is a better predictor than the type of joint and that better outcomes tend to come from specialist knee units.

Any views?  Unfortunately in the UK the NHS does not offer an 'upgrade option' and TKR is an expensive operation privately at typically 9-12k per knee. 

If anyone has a recommendation for a really good surgeon in the South or London that would be much appreciated.

Thanks

Online Vickster

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Re: NHS or Private?
« Reply #1 on: January 01, 2017, 08:32:05 PM »
I've sent you a private message regarding my knee surgeon in SW London who  is expert in TKR at a specialist orthopaedic centre
« Last Edit: January 01, 2017, 09:10:28 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
LK New MRI shows lat & medial meniscus tear & other stuff
RK MRI lat meniscus tear
8/1/15 RK Steroid jab,
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation

Offline millen

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Re: NHS or Private?
« Reply #2 on: January 04, 2017, 08:15:42 PM »
Thanks Vicster for your many suggestions!
Massivly helpful  :D

Offline millen

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Re: NHS or Private?
« Reply #3 on: March 14, 2017, 09:38:48 PM »
Brief update: the GP referred me for x-rays and then to see an NHS consultant who also does private work.  I saw him today.  He agrees I need TKR - I could postpone for perhaps up to two years but there's a high risk that progressive deformity of the joint will mitigate against a good outcome.

So I've started down the pathway for an NHS TKR in early summer and underwent various pre-op tests.

We discussed the private treatment alternative.  Main benefit appears to be there's a wider range of prostheses available - NHS is now restricting patients to just one manufacturer (BFC?) which he says is good but not the best for all patients.  He spoke highly of the Conformis iTotal, which is custom-made to one's specific bone structure but is expensive.  And going private guarantees that I'd be operated on by him and not a junior.  He says the NHS hospital offers computer-guided surgery (to ensure best possible alignment etc) though the equipment is no longer state-of-the-art and isn't always working so the procedure might end up being done entirely manually.

So I'll mull over the private v. NHS option and also see one other private surgeon who has a strong interest in exploring new prostheses for those who want maximum flexibility.

 

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