Sheffield research helping patients make informed decisions about joint replacement

  • Over 5000 people have been assisted to make an informed decision about joint replacement surgery using online tool JointCalc
  • JointCalc uses a patient's personal characteristics to help predict a personalised outcome for surgery
  • The online aid is freely available for anyone considering joint replacement surgery, or GPs during medical appointments
  • Each year in the UK alone, over 250,000 people choose to have a joint replacement

An xray of a person who has had a hip replacement.

Over 5000 people have been helped to make an informed decision about whether to go ahead with joint replacement surgery since the launch of an innovative online aid, JointCalc, nine months ago.

The decision about whether to have joint replacement surgery is a big one, but while surgery is beneficial for some, it’s not always the best option, as some people will experience long-term pain and complications after having hip and knee replacements.

Funded by the National Joint Registry and Versus Arthritis, researchers from the University of Sheffield, partnered with the University of Bristol to lead the way and develop an online decision aid that would empower patients to be active partners in the decision-making process and improve individual outcomes.

JointCalc is freely-available to use by anyone considering joint replacement surgery and has been designed to help people understand the potential risks and benefits of knee or hip replacement surgery tailoring outcomes to a patient's own individual circumstances.

An image from the JointCalc tool, showing questions about patient status.Whilst people considering joint replacement surgery are often engaged in the decision-making process, they are usually dependent on the advice of their clinicians on the risks and benefits of surgery itself and of the type of joint replacement used.

In most instances the surgeon will make a decision using the available evidence from past experience of the procedures in the general population, but individual characteristics can significantly affect the outcome of surgery and risk of complications.

In the research team’s latest paper, published in the International Journal of Medical Informatics, they describe the health information system that was used to make the online tool possible.

Using information from the UK National Joint Registry dataset of around 2.5 million hip and knee operations and personal characteristics (such as age, weight, height, and type of surgery) from the patient, JointCalc gives patients a personalised estimation of pain and function after the operation, risk of dying after the operation, and the risk of needing revision surgery.

Patients can then have more informed conversations with their doctor about their treatment options and make evidence-based choices about treatment that is right for them.

In the last nine months since the JointCalc website was first launched, over 15,000 people have visited the site from 110 countries worldwide, with over 5,000 getting personalised results.

Professor Mark Wilkinson, who has been leading the development of JointCalc at the University of Sheffield said: “We’re delighted to see that patients’ responses frequently indicated that the website helped them reach an informed decision about their surgery.

“We’ve also received feedback that the tool is ‘informative’, ‘helpful’ and ‘easy to use’ and responses show that users find JointCalc user-friendly and relevant to their problem.

“The successful application of this tool is not only improving patient outcomes, but it’s increasing the cost-efficiency of joint replacement surgery and post-operative surveillance for the health service.”

Waiting times for joint replacement surgery are likely to be longer than ever as the NHS recovers from the Covid-19 pandemic, so the researchers hope it will be very helpful for patients to have a better understanding of the risks and benefits to them before requesting a referral from their GP to secondary care.

Dr Wilkinson added: “It can only help all round if people are better informed before seeing a surgeon, and that those who decide to seek secondary care, then choose to go through with the surgery knowing some of the risks and benefits.”

Additional information

The University of Sheffield

With almost 29,000 of the brightest students from over 140 countries, learning alongside over 1,200 of the best academics from across the globe, the University of Sheffield is one of the world’s leading universities.
A member of the UK’s prestigious Russell Group of leading research-led institutions, Sheffield offers world-class teaching and research excellence across a wide range of disciplines.

Unified by the power of discovery and understanding, staff and students at the university are committed to finding new ways to transform the world we live in.

Sheffield is the only university to feature in The Sunday Times 100 Best Not-For-Profit Organisations to Work For 2018 and for the last eight years has been ranked in the top five UK universities for Student Satisfaction by Times Higher Education.

Sheffield has six Nobel Prize winners among former staff and students and its alumni go on to hold positions of great responsibility and influence all over the world, making significant contributions in their chosen fields.

Global research partners and clients include Boeing, Rolls-Royce, Unilever, AstraZeneca, Glaxo SmithKline, Siemens and Airbus, as well as many UK and overseas government agencies and charitable foundations.


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