Total Hip Arthroplasty: Epidemiology and Causes


Registry (year)


Sweden (1979)


Finland (1980)


Norway (1987)


Denmark (1995)


Australia (1999)


NJR (2002)


THA primaries


267,714


206,379


190,298


149,154


437,863


992,090


THA revisions


24,447


40,649


31,515


23,430


66,467


27,605


Coverage


93%


95%


95%


97.5%


98.8%


97%


Outcomes

      

Revision


X


X


X


X


X


X


Mortality


X


X


X


X


X


X


Infection


X


X

 

X

 

X


Dislocation


X


X

    

Periprosthetic fracture


X

     

PROMs


X

  

X

 

X


Readmission


X


X

 

X

 

X


Reoperation


X


X

 

X

  

Costs


X

    

X


Patients

      

Age


X


X


X


X


X


X


Gender


X


X


X


X


X


X


BMI


X


X

 

X


X


X


Diagnosis


X


X


X


X


X


X


Previous surgery

 

X

   

X


ASA


X


X


X


X


X


X


Charnley


X

  

X

  

Surgery

      

Type of hospital


X

 

X


X


X


X


Volume


X

 

X


X


X


X


Approach


X


X


X


X


X


X


Surg time

 

X


X

 

X


X


Antibiotics

 

X


X


X


X


X


Anticoagulation

 

x


x


x


X


X


Implant details


X


X


X


X


X


X


Fixation


X


X


X


X


X


X


Bearing surface


X

 

X


X


X


X



The “X” indicates which registries collected that variable


NRJ National Joint Registry of England, Wales, and Northern Ireland




Primary diagnosis affects the survivorship of THA. Development hip dysplasia, inflammatory degenerative arthritis, osteonecrosis, and femoral neck fracture show less favorable results than primary osteoarthritis (OA) [21]. Primary OA constitutes the main diagnosis in over 85% of patients who receive a total hip replacement. In OA, the age at the time of the index procedure is the key factor which predicts the lifetime risk of revision [22].


Implant selection plays a crucial role in joint survivorship. New implants have not always shown better results than existing ones. The Orthopedic Data Evaluation Panel provide records of implant survivorship at different times of follow-up, producing 3-, 5-, 7-, and 10-year revision rates. At present, it only provides revision rates pertaining to the constituent parts of the arthroplasty. The National Joint Registry of England, Wales, and Northern Ireland (NJR) found that 27% of hip implants introduced between 2003 and 2007 showed a higher revision rate than existing prostheses [23]. Registries allow the detection of suboptimal performance of new implants during the first years [19]. This monitoring helps prevent implant-related complications and aids the decision-making process when deciding which implant to use. Tables 4.2 and 4.3 summarize the best-performing cemented and uncemented hip implants.


Table 4.2

Cumulative percent of revision of primary total conventional hip replacement with cemented fixation in the NJR and AOANJRR: Revision risk (%) for implants with at least one registry reporting 10-year data







































































Stem-cup

Number

Registry

5 years

10 years

MS-30/low-profile Müller

3534

NJR

0.75 (0.4–1.1)

1.72 (1.1–2.6)

 

721

AOANJRR

1.4 (0.7–2.7)

2.9 (1.7–4.8)


Exeter V40/contemporary

77,380

NJR

1.29 (1.2–1.3)

2.34 (2.1–2.5)

 

5513

AOANJRR

3.6 (3.1–4.2)

6.3 (5.5–7.4)


Charnley/Charnley

4560

NJR

1.74 (1.3–2.1)

3.47 (2.9–4.1)

 

591

AOANJRR

2.2 (1.2–3.8)

6.2 (4.4–8.8)


CPT/ZCA

14,872

NJR

2.02 (1.7–2.3)

3.62 (3.1–4.1)

 

951

AOANJRR

2.8 (1.9–4.2)

5 (3.5–7.2)


Stanmore/Stanmore-Arcom

5382

NJR

1.54 (1.2–1.9)

2.42 (1.9–3)



Only data of stem-cup combinations that did not mix different manufacturers are displayed. The number of implants and revision risks at 5- and 10-year follow-up are presented


NRJ National Joint Registry of England, Wales, and Northern Ireland, AOANJRR Australian Orthopedic Association National Joint Replacement Registry




Table 4.3

Cumulative percent of revision of primary total conventional hip replacement with uncemented fixation in the NJR and AOANJRR: Revision risk (%) for implants with at least one registry reporting 10-year data































































































Stem-cup

Number

Registry

5 years

10 years

Taperloc/Exceed ABT

22,851

NJR

1.83 (1.6–2)

2.16 (1.9–2.4)

 

2270

AOANJRR

2.4 (1.9–3.2)

  

Furlong/CSF

17,173

NJR

2.15 (1.9–2.3)

3.6 (3.3–3.9)


Summit/Pinnacle

4688

AOANJRR

2.3 (1.9–2.8)

3.3 (2.7–4.1)


Corail/Pinnacle

137,857

NJR

2.44 (2.3–2.5)

5.96 (5.7–6.2)

 

42,405

AOANJRR

3.4 (3.2–3.6)

5.6 (5.1–6.4)


Accolade/Trident

26,073

NJR

2.61 (2.4–2.8)

4.46 (4–4.9)

 

9288

AOANJRR

3.8 (3.4–4.2)

5.7 (5.2–6.2)


Synergy/Reflection

7966

AOANJRR

2.7 (2.4–3.1)

4.0 (3.6–4.5)


Alloclassic/Allofit

5791

AOANJRR

3.1 (2.7–3.6)

5.4 (4.8–6.1)


Securfit/Trident

9642

AOANJRR

3.4 (3.1–3.8)

4.6 (4.1–5.1)


SL Plus/Epifit

5402

NJR

3.78 (3.2–4.3)

5.83 (5.1–6.6)

 

2300

AOANJRR

3.5 (2.8–4.3)

5.4 (4.5–6.5)



Only data of stem-cup combinations that did not mix different manufacturers are displayed. The number of implants and revision risk at 5- and 10-year follow-up are presented


NRJ National Joint Registry of England, Wales, and Northern Ireland, AOANJRR Australian Orthopedic Association National Joint Replacement Registry

Only gold members can continue reading. Log In or Register to continue

Related posts:

Default ThumbnailTotal Elbow Arthroplasty: Complications and Results Default ThumbnailTotal Shoulder Arthroplasty: Complications and Results Total Hip Arthroplasty: Complications and Results Total Shoulder Arthroplasty: Epidemiology and Causes Total Hip Arthroplasty: Surgical Technique Total Elbow Arthroplasty: Surgical Technique

Stay updated, free articles. Join our Telegram channel
Tags:
Mar 29, 2020 | Posted by in ORTHOPEDIC | Comments Off on Total Hip Arthroplasty: Epidemiology and Causes

Full access? Get Clinical Tree
Get Clinical Tree app for offline access