Towards a Working Methodology for Using Total Hip and Knee Joint Replacements to Support Identification

Hip and knee prostheses have occasionally been used to support identification of unknown persons along with other medical devices and implants. This paper looks at the specific issues around using hip and knee implants, suggesting a working methodology for their use in supporting identification during and after a post-mortem. The value of Total Knee Replacements (TKR) and Total Hip Replacements (THR) as a means of identification along with other implants is a very recent area of interest in Forensic Science considering the long history of implants. This together with the recent introduction of Joint Replacement Registries means that using hip and knee implants to support identification is likely to become automatic in the future but is not currently automatic. The paper looks at the accumulative collection of evidence as well as the range of issues including; the types and changes in early prostheses, examination of the body for external indications of implants, radiological recording prior to autopsy for confirmation of identification using matching of features with ante-mortem images, actual harvesting and collection of all parts of the joint replacement including cement and any other components, specific differences between TKR and THR. In developing an approach to the problems associated with identifications using TKRs and THRs a stepwise process and the full recording of all of the features associated with the implant as well as manufacturers details and identification numbers is suggested so that the cumulative nature of these features will help to narrow down possibilities towards a more certain identification and confirmation of that identification.