Hip and Knee Arthroplasty - Surface Hippy Guide to Hip Resurfacing

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Observed Component Years: The cumulative number of years that a procedure is at risk of being revised. This is calculated for each procedure as the number of days from the date of the primary procedure until either the date of revision, date of death or end of study (31/12/2007) whichever happens first. This is then divided by 365.25 to get the number of ‘component years’. Each primary procedure then contributes this calculated number of component years to the overall observed component years for a particular category. For example 1. A primary total hip procedure performed on 1/1/2007 was revised on 1/7/2007. Therefore, the number of days that this procedure is at risk of being revised is 183 days. This patient then contributes 0.5 (183/365.25) component years to the overall number of observed component years for the total hip procedure category. 2. A patient with a primary procedure on 1/1/2007 died without being revised on 1/4/2007. This individual has 0.25 component years. 3. A primary procedure on 1/1/2007 and has not been revised. This individual has 1 component year (as observation time is censored at 31/12/2007). Survival Curve: A plot of the proportion of subjects who have not yet experienced a defined event (for example death, revision of prosthesis) versus time. The Kaplan-Meier method is the one most commonly used. The curve takes account of subjects whose ultimate survival time is not known, a phenomenon called “censoring”. The survival estimate at each time is accompanied by a confidence interval based on the method of Greenwood. An interval is interpretable only at the time for which it was estimated and the sequence of intervals (depicted as shading on the Kaplan-Meier curve) cannot be used to judge the significance of any perceived difference over the entire time course. 196
APPENDIX 2 Patient Consent and Confidentiality Guidelines Patient Consent The Registry obtains consent to include information from individuals undergoing joint replacement. This is done by using the ‘opt off’ approach. The implementation of the new Commonwealth Legislation at the end of 2001 resulted in the Registry meeting the Privacy Commission to ensure that the system used for patient consent is within the privacy guidelines. • Data Management & Analysis Centre Staff including data assistants and data manager, statisticians and programmers. Declaration of the project as a Quality Assurance Activity ensures that Registry and DMAC staff are bound to maintain confidentiality. Confidentiality not only applies to individual patients but also includes surgeons and hospitals. Using this approach, patients are provided with a Patient Information Sheet. This explains clearly what information is required, how it is collected and the avenues to take should an individual not want their information included in the Registry. The information is provided to patients by surgeons and hospitals prior to surgery. To accommodate patients that may wish to opt off, have enquires or wish to discuss any issues a freecall number is available for the Registry. Patient Confidentiality Joint replacement patients will not be contacted directly by the Registry. No individual patient will be identified during analysis or in the reports and publications produced by the Registry. Patient operative and prostheses data will be managed in accordance with the Guidelines for the Protection of Privacy in the Conduct of Medical Research. Personal data collected are for use by the AOA National Joint Replacement Registry only. Further to this the Registry is a Federal Quality Assurance Activity (see below) and all information is protected. Data Management & Confidentiality The Data Management & Analysis Centre, University of Adelaide undertakes data entry, validation and analysis and provides secure data storage. The DMAC was established in 1993. Professor Philip Ryan, Professor in Public Health, heads DMAC. The centre staff includes data managers, database programmers, statisticians and data assistants. It is engaged in an increasing variety of work, including clinical trials, pharmacoepidemiological studies, consultations and cohort studies. The list of personnel with access to identified Registry information is as follows: • Director, Professor Stephen Graves • Deputy Director, Mr David Davidson • Deputy Director, Mr Richard de Steiger • Coordinator, Ms Ann Tomkins DMAC has security systems to restrict access to DMAC and Registry staff only. There are policies and procedures in place as well as software barriers to protect personal information. These include the use of codes, passwords and encryption. The proforma used for data collection is stored in a secure locked room at the DMAC. After a period of time the forms are scanned and electronically stored. As with all data these will be securely stored. All data will be retained in accordance with good scientific practice. Surgeon Confidentiality Surgeon confidentiality is assured. The purpose of the Registry is to provide demographic and outcome information relevant to joint replacement surgery. Surgeon name is not recorded in the Registry database. In addition to this, the AOA Registry Management Committee made a decision in October 1999 to remove surgeon name from Registry forms. The Board of the AOA ratified this decision and consequently Registry staff blackout surgeon name, whether it is hand written or printed on the hospital patient identification, on all forms received by the Registry. It is an important Registry function to provide a service to surgeons that allows them to monitor and audit their own performance. For this reason surgeons have a choice to identify themselves by code which can linked to their procedures. This is optional and there is no requirement to provide the surgeon code. These codes are provided to surgeons by the AOA. The intention is to provide surgeons with access to their own information through secure internet access. As yet the software has not been developed that would allow this to occur. It is important to emphasise that surgeons have the choice of using their code and that surgeon name is not recorded in the database and is permanently removed from Registry forms. 197
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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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Table KT4: 10 Most Common Femoral C
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Page 165 and 166: Figure KT10: Primary Total Knee Rep
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Page 185 and 186: REVISION KNEE REPLACEMENT This repo
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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 and 210: Table M5: Mortality following Prima
Page 211: Appendices APPENDIX 1 Glossary of S
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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