Hip and Knee Arthroplasty - Surface Hippy Guide to Hip Resurfacing

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Knee Replacement Table M7: Mortality following Knee Replacement by Type Type of Knee Replacement Number Deaths Number Patients Cumulative Mortality (% deaths) Standardised Mortality Person Years Rate per 100 Person Years Exact 95% CI Partial Resurfacing 0 81 0.0 0.0 104 0.0 (0.00, 3.54) Unispacer 0 37 0.0 0.0 142 0.0 (0.00, 2.59) Patella/Trochlear 19 832 2.3 0.9 2553 0.7 (0.45, 1.16) Unicompartmental 734 21086 3.5 1.1 73866 1.0 (0.92, 1.07) Bicompartmental 0 30 0.0 0.0 11 0.0 (0.00, 33.54) Primary Total 7017 130536 5.4 8.3 417812 1.7 (1.64, 1.72) Total 7770 152602 5.1 7.8 494489 1.6 (1.54, 1.61) Figure M4: Cumulative Percent Survival of Primary Unicompartmental and Total Knee Replacement Number at Risk 0 Yr 1 Yr 2 Yrs 3 Yrs 4 Yrs 5 Yrs 6 Yrs 7 Yrs Unicompartmental 21086 18329 15363 12180 9044 5672 2486 537 Primary Total 130536 107981 86379 65667 46838 29448 13777 3593 Table M8: Yearly Cumulative Percent Survival of Primary Knee Replacement CPS 1 Yr 2 Yrs 3 Yrs 5 Yrs 7 Yrs Patella/Trochlear 99.9 (99.0, 100.0) 99.3 (98.3, 99.8) 98.6 (97.1, 99.3) 95.7 (92.8, 97.5) 90.8 (81.4, 95.5) Unicompartmental 99.6 (99.5, 99.6) 98.8 (98.6, 98.9) 97.7 (97.4, 97.9) 95.0 (94.6, 95.4) 91.3 (90.3, 92.2) Total Knee 98.9 (98.8, 99.0) 97.5 (97.4, 97.6) 95.9 (95.7, 96.0) 91.6 (91.3, 91.8) 86.3 (85.8, 86.7) 194
Appendices APPENDIX 1 Glossary of Statistical Terms Adjustment: The process of re-estimating a crude measure, such as a rate or rate ratio, to minimise the effects of a difference in the distribution of a characteristic, such as age, between groups being compared on that measure. Adjustment may be carried out in the context of a modelling procedure, for example, linear regression, or by standardising the data set against a reference population with a known age distribution, for example, the World Standard Population or the Australian population defined by the Australian Bureau of Statistics Census in 2001. Censoring: When the outcome of interest is the time to a defined event, for example death or revision of a prosthesis, the event may not occur during the available period of observation. For example, the Registry analyses its data on prosthesis revision for the period ending 31 st December each year, and of course many prostheses will not have been revised by that time. Effectively we do not know the outcome unless the prosthesis was revised before 31 st December. For the majority, we only know that up until 31 st December they had not yet been revised. The times to revision for these prostheses are said to have been censored at 31 st December. Statistical methods exist to ensure that censored data are not ignored in analysis; rather information on survival up until the time of censoring is used to give the best possible estimates of survival or revision probabilities. Chi-Square Test (χ 2 ) Test: Any test whose statistic has a chi-square distribution under the null hypothesis is called a chi-square test. A common example is a test for association between two categorical variables whose data are arrayed in a cross-classification table of counts (Pearson’s chi-square test). This can be generalised to many situations where the distribution of observed data is being compared to an expected, theoretical distribution. Confidence Interval: A set of values for a summary measure, for example a rate or a rate ratio, constructed so that this set has a specified probability of including the true value of the measure. The specified probability is called the confidence level, and the end points of the confidence interval are called the lower and upper confidence limits. 95% confidence intervals are most common. Cox Model or Proportional Hazards Model: A statistical model that relates the hazard for an individual at any time t to an (unspecified) baseline hazard and a set of predictor variables, such as treatment type, age, gender etc. The Cox model produces hazard ratios that allow comparisons between groups of the rate of the event of interest. Cumulative Percent Revision: otherwise known as the “cumulative failure rate”. This is defined as 100 x [1- S(t)] where S(t) is the survivorship probability estimated by the Kaplan-Meier method (see survival curve, below). The cumulative percent revision gives the percent of procedures revised up until time t, and allows for right censoring due to death or closure of the database for analysis. Hazard Rate: A measure of the instantaneous risk of occurrence of an event, for example death, at a point in time, t. It is sometimes called the “force of mortality”. A hazard ratio results from dividing one group’s hazard by another’s to give a comparative measure of the instantaneous risk of experiencing the event of interest. In this report, hazard ratios are adjusted for age and sex as appropriate; Hazard Ratio (adjusted for age and sex) = Adj HR. Incidence Rate: The number of new occurrences of an event divided by a measure of the population at risk of that event over a specified time period. The population at risk is often given in terms of persontime: for example, if 6 persons are each at risk over 4 months, they contribute 6 x 1/3 = 2 person-years to the denominator of the incidence rate. The incidence rate ratio (IRR) is commonly used to compare the incidence rates of two groups. If the two groups incidence rates are the same, an IRR of 1 results. Log Rank Test: A family of statistical tests that compares the survival experience of two or more groups over the entire time of observation (contrast with comparison of survival at a defined time, for example, five-year survival.) 195
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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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Primary Patella/Trochlear Knee Repl
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Figure KP11-14: Cumulative Percent
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decrease in use and now accounts fo
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as having a higher than anticipated
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Table KT2: 10 Most Common Femoral C
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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
Page 191 and 192: ‘Revision of Known Primary’ Kne
Page 193 and 194: Table KR10: Outcome of ‘Revision
Page 195 and 196: Table KR14: Outcome of ‘Revision
Page 197 and 198: CEMENT IN HIP AND KNEE REPLACEMENT
Page 199 and 200: 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: Table M5: Mortality following Prima
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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