The Orthopaedic Forum   |    
William J. Maloney, MD1
1 Washington UniversitySchool of MedicineSt. Louis, Missouri
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The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2004 Sep 01;86(9):2079-2080
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Total joint replacement offers patients with end-stage degenerative joint disease a solution to disabling joint pain that results in a marked improvement in quality of life. As with all mechanical devices, failure can and will occur. The survival of the implant is multifactorial. Patient-related factors, surgical technique, and implant design as well as manufacturing all play a role in failure. Despite an extensive investment in research and development by implant manufacturers to improve implant performance, unintended consequences of a change in design may result in premature failure. Regardless of the amount of premarket testing done with any given device, it is important to remember that the final testing ground is in our patients. Only there will all of the factors noted above come into play. With that in mind, it seems a reasonable goal to track outcomes at least at a high level to potentially identify poorly performing designs or surgical techniques at the earliest possible point.
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