Hip and Knee Arthroplasty - Surface Hippy Guide to Hip Resurfacing

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AUSTRALIAN CAPITAL TERRITORY PUBLIC HOSPITALS The Canberra Hospital Helen Boyd/Mary Ann Brook CNS Orthopaedic Theatre Calvary Health Care Milton Jamieson RN Theatre PRIVATE HOSPITALS Calvary John James Hospital Phillippa Parkins/Helen Bustard RN Orthopaedics/CNC Theatre The National Capital Private Hospital Theresa Moran NUM Orthopaedic Theatre Calvary Health Care Milton Jamieson RN Theatre NORTHERN TERRITORY PUBLIC HOSPITALS Alice Springs Hospital Samantha Arbuthnot CNM Op Theatre & Day Proc Unit Royal Darwin Hospital Tanya Anderson NUM Theatre PRIVATE HOSPITALS Darwin Private Hospital Barbara Kulbac RN Theatre FORMERLY PARTICIPATING HOSPITALS THAT HAVE CEASED JOINT REPLACEMENT NEW SOUTH WALES Auburn Health Service Blue Mountains District ANZAC Memorial Hospital MacArthur Private Hospital Mosman Private Hospital Sydney Hospital & Sydney Eye Hospital QUEENSLAND Caboolture Private Hospital Gladstone Hospital Logan Private Hospital Riverview Private Hospital VICTORIA Cabrini Private Hospital Hartwell Private Hospital Repatriation Hospital, Heidelberg TASMANIA Calvary Health Care Tasmania St Vincent’s Campus SOUTH AUSTRALIA Abergeldie Hospital Blackwood Hospital Gawler Health Services Northern Yorke Peninsula WESTERN AUSTRALIA Galliers Private Hospital 14
HIP REPLACEMENT GENERAL INTRODUCTION This report is based on the analysis of 191,673 primary and revision hip replacements received by the Registry with a procedure date up to and including 31 st December 2007. This is an additional 31,333 hip procedures compared to the Annual Report released in 2007. Categories of Hip Replacement The Registry categorises hip replacements as either primary or revision procedures. Primary hip procedures are further categorised as partial or total hip replacements. Partial hips are further sub-categorised depending on the type of prostheses used; these are monoblock, unipolar modular and bipolar procedures. This year partial resurfacing has been included as an additional category of partial hip replacement. Partial resurfacing procedures involve the use of the Hemicap prosthesis, which has recently been introduced to the market in Australia. To the 31 st December 2007, the Registry has recorded the use of this prosthesis in eight hip replacements. Total hip replacements are categorised as either conventional total, total resurfacing or thrust plate procedures. Revision procedures are re-operations of hip arthroplasty. They may be primary partial, primary total or previous revisions and are categorised as major or minor. A major revision involves the removal and/or replacement of a major component, which is defined as a component that interfaces with bone i.e. either the femoral stem or acetabular cup or shell. A minor revision is a revision where a major component has not been removed or replaced. Examples of this include exchange of the femoral head and/or acetabular insert. A re-operation that does not involve removal, replacement or addition of a prosthesis or cable is not regarded as a revision procedure and therefore is not included in the analysis. A complete breakdown of age, gender, primary diagnosis and revision diagnoses for each category of hip replacement is available in a supplementary report on the Registry website www.aoa.org.au/jointregistry_pub.asp. Gender Hip replacements are performed more frequently in females (56.7%) than males. There are also variations in gender depending on the category of hip replacement. Primary partial hips (73.7%) and primary total hips (53.1%) are undertaken more frequently in females. Total resurfacing and thrust plate procedures are undertaken more frequently in males (72.7% and 70.9% respectively). More females have revision procedures (54.1%) (Table HG1). Since 2003 (the first year the Registry had full national coverage) there has been little change in the proportion of females having primary conventional hip replacement. There has however been a decline in females undergoing partial hip replacement (decreased from 75.4% in 2003 to 71.4% in 2007) and total resurfacing procedures (decreased from 28.8% in 2003 to 23.6% in 2007) (Figure HG1). Age The mean age for all hip replacement procedures is 69.9 years with females having a higher mean age compared to males (71.8 years and 67.4 years respectively). Primary partial hips are generally used in individuals much older than those receiving primary total hips (mean age 81.6 years for partials and 67.0 years for totals). Females have a higher mean age for both of these procedures (82.0 years compared to 80.6 years for males for partials, and 68.6 years compared to 65.2 years for males having primary total hips). Total resurfacing and thrust plate procedures are generally undertaken in people younger than those having primary conventional total hip replacement (total resurfacing 53.5 years, thrust plate 56.6 years and conventional 68.1 years). The mean age for revision procedures is 70.8 years (females is 71.5 years and males is 70.1 years). The different types of primary partial hip replacement are rarely undertaken on individuals less than 65 years of age (4.5%) with the exception of partial resurfacing where all procedures were undertaken on individuals less than 55 years of age. Most primary conventional hip replacements are undertaken on individuals 65 years or older but the proportion of younger than 65 years (34.3%) is much higher than for partial hip replacement. Most individuals having the other two types of primary total hip replacement are younger than 65 years (90.3% for total resurfacing procedures 15
Page 1 and 2: Hip and Knee Arthroplasty ANNUAL RE
Page 3: Australian Orthopaedic Association
Page 6 and 7: PRIMARY PARTIAL KNEE REPLACEMENT...
Page 8 and 9: PRIMARY TOTAL HIP REPLACEMENT......
Page 10 and 11: PRIMARY TOTAL KNEE REPLACEMENT ....
Page 12 and 13: viii
Page 14 and 15: RIMARY TOTAL RESURFACING HIP REPLAC
Page 17 and 18: EXECUTIVE SUMMARY This executive su
Page 19 and 20: INTRODUCTION This is the eighth Ann
Page 21 and 22: supply aggregate data and negotiati
Page 23 and 24: PARTICIPATING HOSPITALS & COORDINAT
Page 25 and 26: VICTORIA PUBLIC HOSPITALS Austin He
Page 27 and 28: QUEENSLAND PUBLIC HOSPITALS Bundabe
Page 29: WESTERN AUSTRALIA PUBLIC HOSPITALS
Page 33 and 34: difference is also evident when com
Page 35 and 36: Table HG2: Number of Hip Replacemen
Page 37 and 38: Table HG4: Primary Hip Replacement
Page 39 and 40: Table HG8: Primary Total Resurfacin
Page 41 and 42: The use of monoblock prostheses in
Page 43 and 44: PRIMARY PARTIAL HIP REPLACEMENT 1/9
Page 45 and 46: Table HP2: 10 Most Common Unipolar
Page 47 and 48: Table HP4: 10 Most Common Bipolar H
Page 49 and 50: Table HP6: Primary Partial Hip Repl
Page 51 and 52: Table HP14: Primary Partial Hip Rep
Page 53 and 54: Table HP15: Primary Unipolar Monobl
Page 55 and 56: Table HP19: Primary Bipolar Hip Rep
Page 57 and 58: Table HP24: Primary Unipolar Monobl
Page 61 and 62: Table HP32: Primary Unipolar Modula
Page 65 and 66: Primary Unipolar Modular Hip Replac
Page 67 and 68: Primary Bipolar Hip Replacement Pro
Page 69 and 70: PRIMARY TOTAL HIP REPLACEMENT The a
Page 71 and 72: Effect of Bearing Surface For the f
Page 73 and 74: since 2004. The three total resurfa
Page 75 and 76: combination has been used in 1,649
Page 77 and 78: Table HT2: Primary Conventional Tot
Page 79 and 80: 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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Figure KT5: Trends in Prosthesis Fi
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Table KT10: Primary Total Knee Repl
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Figure KT10: Primary Total Knee Rep
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Table KT23: Yearly Cumulative Perce
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Table KT30: Primary Unicompartmenta
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Figure KT24-KT33: Cumulative Percen
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REVISION KNEE REPLACEMENT This repo
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p
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Figure KR1: Trends in Usage for Rev
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‘Revision of Known Primary’ Kne
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Table KR10: Outcome of ‘Revision
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Table KR14: Outcome of ‘Revision
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CEMENT IN HIP AND KNEE REPLACEMENT
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CEMENT IN HIP AND KNEE REPLACEMENT
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Table C3: Top 10 Cements used in Re
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Table C7: Yearly Cumulative Percent
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Table C11: Yearly Cumulative Percen
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MORTALITY FOLLOWING PRIMARY HIP AND
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Table M5: Mortality following Prima
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Appendices APPENDIX 1 Glossary of S
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APPENDIX 2 Patient Consent and Conf
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INTRODUCTION - about the Registry A
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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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