Finding the right hip implant for patient and surgeon: the Dutch strategy--empowering patients

We describe the implementation process of hip prostheses selection in the Netherlands. The recent problems with large head metal-on-metal hip prostheses resulted in substantial damage to the surgeons' credibility and reputation in the media. This led to a true sense of urgency among orthopaedic surgeons to increase their activities to secure patient safety. The board of the Dutch Orthopaedic Association (NOV) in the Netherlands established a Dutch Hip Task Force (DHTF) with the explicit assignment of formulating criteria to classify the quality of total hip implants on the Dutch market based on survivorship. The aim was to offer unequivocal information enabling a balanced choice of total hip prosthesis. The ultimate goal of the NOV is that all implanted total hip prostheses implanted in the Netherlands are based on reliable clinical evidence. The DHTF decided to adapt the principles of the National Institute for Health and Care Excellence (NICE, UK) (www.nice.org.uk). The taskforce uses data from the registries as well as the Orthopaedic Data Evaluation Panel (ODEP). If the ODEP guidelines had been chosen as standard alone, one quarter of our listed hip components would not have been included. In our view this underlines the strength in the Dutch approach where high quality registry data and ODEP ratings are complementary and result in a list of reliable hip prostheses. Most importantly we offer patients insights into the known quality of the implants by sharing the results of our implant review. This will facilitate shared decision making by empowering patients in their knowledge on available hip arthroplasties.