Hip and Knee Arthroplasty - Surface Hippy Guide to Hip Resurfacing

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evisions and 92.4% of cemented patellar revisions (Table C4). When considering the ten most frequently used cements, the main difference in the cement types used when femoral and tibial components are cemented is that plain cement is used less often in revision than primary procedures. This difference is not evident when comparing cemented patellar primary and revision procedures. There are three types of plain cement used in the 10 most frequently used cements for both primary and revision knee procedures (Simplex P, CMW 1 Plain and CMW 2 Plain.). These are used in 23.1% of cemented primary and 11.2% of cemented revision femoral components. In cemented tibial procedures these three plain cements are used in 26.8% of cemented primary and 12.5% of the cemented revision procedures. When the patellar component is cemented these three plain cements are used in 25.2% of primary and 22.7% of revisions procedures (Table C4). CMW 1 G is the most frequently used cement in cemented revision procedures for all three components (20.0%, 20.5% and 15.6% respectively) (Table C4). Outcomes of Primary Hip and Knee Replacement The Registry has compared the outcomes of the use of cement with and without antibiotics in primary conventional total hip and total knee replacements. Primary Conventional Total Hip Replacement When cement is used in primary conventional total hip replacement, it may be used for either or both the femoral stem or acetabular cup. The Registry records whether antibiotic or plain cement is used for both the femoral and acetabular component or if a combination of antibiotic or plain cement is used for one or other of the two components (Table C5). There is no significant difference in the risk of revision between antibiotic and plain cement (Tables C6 and C7 and Figure C3). There are however some differences in the reasons for revision. The number of revisions for infection is lower if antibiotic cement is used (0.4%) than if plain cement is used (0.6%), as is the number of revisions for loosening and lysis (0.7% for antibiotic cement and 1.3% for plain). Conversely, there are more revisions for dislocation when antibiotic cement is used (0.8%) than when plain cement is used (0.6%) (Table C8). Table C8 reports the reasons for revision following known primary procedures. The difference in revisions for loosening and lysis for the antibiotic and non-antibiotic groups may be due to a proportion of these being “missed” infections. Due to the follow up time available between primary and revision procedures these diagnoses reflects early and mid term revisions. Aseptic loosening and wear related lysis are uncommon reasons for early and mid term revision. It is possible and perhaps probable that at least some if not most of the revisions undertaken for these two reasons are consequent to undiagnosed infection. The likelihood of this occurring is increased by the fact that Registry data are collected at the time of the operation and any infections subsequently diagnosed may be missed. The Registry is also unlikely to receive late notification of infection if it is subsequently diagnosed. Primary Total Knee Replacement When using cement in primary total knee replacement, plain cement has a significantly higher risk of revision compared to when antibiotic cement is used (hazard ratio (adjusted for age and sex)=1.15; 95% CI (1.04, 1.27) p=0.005) (Tables C9, C10 and C11 and Figure C4). When examining the reasons for revision there is a higher number of revisions for infection when plain cement is used (0.9%) compared to when antibiotic cement is used (0.6%). There is also more revisions for loosening and lysis when using plain cement (1.1%) compared to antibiotic cement (0.6%). 182
CEMENT IN HIP AND KNEE REPLACEMENT 1/9/1999 – 31/12/2007 Figure C1: Trends in Usage of Antibiotic Cement in Primary Conventional Total Hip Replacement by State/Territory and Year 100% 80% 60% 40% 20% 0% 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 AUST NSW VIC QLD WA SA TAS ACT/NT Plain Cement Antibiotic Cement Figure C2: Trends in Usage of Antibiotic Cement in Primary Total Knee Replacement by State/Territory and Year 100% 80% 60% 40% 20% 0% 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 AUST NSW VIC QLD WA SA TAS ACT/NT Plain Cement Antibiotic Cement 183
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Hip and Knee Arthroplasty ANNUAL RE
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Australian Orthopaedic Association
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PRIMARY PARTIAL KNEE REPLACEMENT...
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PRIMARY TOTAL HIP REPLACEMENT......
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PRIMARY TOTAL KNEE REPLACEMENT ....
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viii
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RIMARY TOTAL RESURFACING HIP REPLAC
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EXECUTIVE SUMMARY This executive su
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INTRODUCTION This is the eighth Ann
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supply aggregate data and negotiati
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PARTICIPATING HOSPITALS & COORDINAT
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VICTORIA PUBLIC HOSPITALS Austin He
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QUEENSLAND PUBLIC HOSPITALS Bundabe
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WESTERN AUSTRALIA PUBLIC HOSPITALS
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HIP REPLACEMENT GENERAL INTRODUCTIO
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difference is also evident when com
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Table HG2: Number of Hip Replacemen
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Table HG4: Primary Hip Replacement
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Table HG8: Primary Total Resurfacin
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The use of monoblock prostheses in
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PRIMARY PARTIAL HIP REPLACEMENT 1/9
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Table HP2: 10 Most Common Unipolar
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Table HP4: 10 Most Common Bipolar H
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Table HP6: Primary Partial Hip Repl
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Table HP14: Primary Partial Hip Rep
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Table HP15: Primary Unipolar Monobl
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Table HP19: Primary Bipolar Hip Rep
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Table HP24: Primary Unipolar Monobl
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Table HP32: Primary Unipolar Modula
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Primary Unipolar Modular Hip Replac
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Primary Bipolar Hip Replacement Pro
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PRIMARY TOTAL HIP REPLACEMENT The a
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Effect of Bearing Surface For the f
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since 2004. The three total resurfa
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combination has been used in 1,649
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Table HT2: Primary Conventional Tot
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Table HT6: 10 Most Common Femoral C
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Table HT8: 10 Most Common Femoral C
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Table HT10: 10 Most Common Acetabul
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Table HT12: 10 Most Common Primary
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Primary Conventional Total Hip Repl
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Table HT19: Primary Conventional To
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Figure HT18: Cumulative Percent Rev
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Primary Total Resurfacing Hip Repla
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Table HT39: Primary Total Resurfaci
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Table HT48: Yearly Cumulative Perce
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Figure HT34-43: Cumulative Percent
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Primary Total Resurfacing Hip Repla
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REVISION HIP REPLACEMENT This repor
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REVISION HIP REPLACEMENT 1/9/1999 -
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‘Revision of Known Primary’ Hip
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Table HR10: Outcomes of ‘Revision
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knee increased from 29.4% in 2003 t
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Table KG2: Number of Knee Replaceme
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Table KG4: Primary Knee Replacement
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PRIMARY PARTIAL KNEE REPLACEMENT Th
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Effect of Age and Gender The risk o
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Primary Partial Resurfacing Knee Re
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Table KP6: Primary Patella/Trochlea
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Table KP12: Primary Unicompartmenta
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Page 147 and 148: Table KP22: Primary Unicompartmenta
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Page 161 and 162: Figure KT5: Trends in Prosthesis Fi
Page 163 and 164: Table KT10: Primary Total Knee Repl
Page 165 and 166: Figure KT10: Primary Total Knee Rep
Page 171 and 172: Table KT23: Yearly Cumulative Perce
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Page 183 and 184: Figure KT24-KT33: Cumulative Percen
Page 185 and 186: REVISION KNEE REPLACEMENT This repo
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Page 189 and 190: Figure KR1: Trends in Usage for Rev
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Page 193 and 194: Table KR10: Outcome of ‘Revision
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Page 197: CEMENT IN HIP AND KNEE REPLACEMENT
Page 201 and 202: Table C3: Top 10 Cements used in Re
Page 203 and 204: Table C7: Yearly Cumulative Percent
Page 205 and 206: Table C11: Yearly Cumulative Percen
Page 207 and 208: MORTALITY FOLLOWING PRIMARY HIP AND
Page 209 and 210: Table M5: Mortality following Prima
Page 211 and 212: Appendices APPENDIX 1 Glossary of S
Page 213 and 214: APPENDIX 2 Patient Consent and Conf
Page 215 and 216: INTRODUCTION - about the Registry A
Page 217 and 218: APPENDIX 5 ICD-10-AM Codes PRIMARY
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Hip and Knee Arthroplasty - Surface Hippy Guide to Hip Resurfacing

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