The decision about whether you opt to have a hip or knee replacement is a big one. It involves taking into consideration the level of pain your hip or knee condition is causing, along with how this is affecting your quality of life. Surgery is an option to consider when non-operative management options have been exhausted. In your decision-making, you may weigh up the benefits of surgery against risks/complications associated with surgery. For some, surgery is not always the best option and patients can experience long-term pain or complications following a hip or knee replacement. As such, it is important that you understand the choices available and make an informed decision.

There are many factors which may influence the outcome and risks of surgery e.g. patient age, sex, medical conditions, surgical technique, type of joint replacement used. Mr Kosuge is a believer in patients being active partners in the decision-making process so that individual outcomes can be improved.

In addition to discussions held between you and Mr Kosuge during out-patient consultations, Mr Kosuge recommends a number of other resources in different formats:

• Patient information booklets

• Online videos - Hip Replacement; Knee Replacement

Another useful patient decision-making tool is JointCalc. This was developed in conjunction with patients and carers. Using personal characteristics (such as age, weight, height, and type of surgery), and data from the National Joint Registry and NHS Digital, the tool 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.

Making an informed decision is in the best interests of patients and Mr Kosuge encourages you to explore the available resources. For further information, please visit the 'Preparing for Surgery’ section on this website.

The NHS Friends and Family test (FTT) was created to help service providers and commissioners understand whether patients are happy with the service provided, or where improvements are needed. It is a quick and anonymous way in which patients can feedback about the care they received. This short film explains what the FFT is in a simple way. Whilst commonly used to assess a hospital or a particular service, it is possible to use the test to assess an individual surgeon.

Mr Kosuge opts to collect this data so that his patients can feedback on the care he provides and on areas where improvement may be required. Out of 895 tests, 822 patients (92%) were ‘extremely likely’ to recommend Mr Kosuge to their Friends and Family. The following are a selection of comments left by patients who completed the test;

• ‘Very clear with wording on diagnosis, very polite, makes you feel at ease and very good at stitching leaving neat tidy scar. Thank you.’

• ‘Made me feel very safe having the hip op. Answered all my questions. Very patient friendly.’

• ‘Dennis put me at ease throughout my experience from my initial meeting with him right up until and during surgery. He took time to explain everything and was interested in how I was feeling about the surgery ensuring that he provided adequate and very detailed responses at all times.’

• ‘At appointments and in surgery, I always felt that Mr Kosuge explained everything in great detail, always happy too answer any questions myself or my husband had. In surgery I was made to feel relaxed and trusted Mr Kosuge fully. If in the future I need further surgery on my other hip or be it knee's, I would hope that Mr Kosuge would be my surgeon yet again. Would like to thank him for everything and hope for a full recovery.’

• ‘Mr Kosuge is a good surgeon, he has done both my knees now and they are fantastic, he listens to you and has time for you.’

• ‘Made to feel very comfortable leading up to procedure and following the operation’

Mr Kosuge is extremely grateful for the feedback. He will continue to improve his clinical practice based on the comments and feedback he receives from his patients.