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Litigation after primary total hip and knee arthroplasties in France: review of legal actions over the past 30 years

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Since the law of March 4, 2002, several modifications have impacted medical practices and their medico-legal implications. In case of an infectious complication not related to a fault of the practitioners (surgeons, anesthetists), the patient has the right to compensation assumed by the care structures. Moreover, the lack of preoperative information is no longer just a failing of the ethical standards but a breach of medical and legal obligations. Then, aims of this study were: (1) to describe the reasons for a lawsuit in France following total primary hip (THA) and total knee (TKA) arthroplasties and (2) to compare litigation characteristics of private and public practices.

Materials and methods

Civil (private practice) and administrative (public practice) court decisions in France between 1990 and 2020 were collected using the two main legal data sources (Legifrance, Doctrine).

Results

Eighty-three TKA and 173 THA cases were identified. Reasons for complaint in primary THA were mainly infection (29%), prosthetic failures (18%), nerves injuries (17%), and leg length discrepancies (11%). The main grounds for complaint in favor of the plaintiff were diagnostic or indication mistakes (100%), infections (80%), especially if a lack of information was recognized (88%). Reasons for complaint following primary TKA were mainly infections (65%) and persistent pain or stiffness (12%). Whatever the reason, the verdict was in favor of the plaintiff in about 2/3 of the cases. THAs were more at risk of appeal in administrative procedures than in civil (p = 0.008). There were more cases of implant failure in civil proceedings (p = 0.008). Indemnities after primary THA was higher in public activity litigation (p = 0.04). There were no differences in verdicts, grounds for complaints, and compensation between public and private practices for primary TKA.

Conclusion

The main complaint about all the arthroplasties in France was a septic complication. The lack of information could be an added pejorative element for the final verdict.

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Acknowledgements

The authors thank the attorney at law Anne-Elisabeth Leduc (Paris Bar) for her contribution.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopedic and Trauma Surgery, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, 47-83 Boulevard de l’Hôpital, 75013, Paris, France

    Grégoire Rougereau

  2. Department of Orthopedic and Trauma Surgery, André Mignot Hospital, University Île-de-France Ouest, 177 Rue de Versailles, 78150, Le Chesnay, France

    Grégoire Rougereau, Nicolas Pujol & Philippe Boisrenoult

  3. Department of Orthopedic and Trauma Surgery, University Hospital Center, 2 Rue de la Milétrie, 86021, Poitiers, France

    Thibaut Marty-Diloy

  4. Department of Pediatric Orthopedics, Hôpital des enfants, Purpan, Université de Toulouse, Toulouse, France

    Tristan Langlais

  5. Department of Pediatric Orthopedics, Hôpital Armand-Trousseau, AP-HP, Sorbonne University, 26 avenue du Dr-Arnold-Netter, 75012, Paris, France

    Tristan Langlais

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  1. Grégoire Rougereau
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  2. Thibaut Marty-Diloy
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  3. Tristan Langlais
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  4. Nicolas Pujol
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  5. Philippe Boisrenoult
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Contributions

GR participated in the study design, data acquisition, data interpretation, and article writing. TM and TL participated in the design of the study design, data acquisition and interpretation. PB and NP participated in the study design and critical review of the manuscript. PB reviewed the article with legal expert oversight. Each author has given final approval of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Grégoire Rougereau.

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Conflict of interest

GR, TL, and TM have nothing to disclose. PB is occasional educational consultant for Smith&Nephew. NP is occasional educational consultant for Smith&Nephew, Lima, ZimmerBiomet, Stryker, outside the scope of this work.

Ethical approval

No ethical approval was needed for this study.

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Rougereau, G., Marty-Diloy, T., Langlais, T. et al. Litigation after primary total hip and knee arthroplasties in France: review of legal actions over the past 30 years. Arch Orthop Trauma Surg 142, 3505–3513 (2022). https://doi.org/10.1007/s00402-021-04228-w

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  • DOI: https://doi.org/10.1007/s00402-021-04228-w

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