Hip and Knee Arthroplasty - Surface Hippy Guide to Hip Resurfacing

PRIMARY TOTAL HIP REPLACEMENT
The analysis for this Report is based on 135,799
primary total hip replacements reported to the
Registry up to and including 31 st December 2007.
This is an increase of 22,472 primary total hip
procedures reported in the 2007 Annual Report.
In this category of hip replacement there are
125,004 conventional total hip replacements,
10,623 total resurfacing hip replacements and
172 thrust plate hip replacements.
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.
Diagnosis
Osteoarthritis is the most common diagnosis
associated with primary total hip replacement
(88.8% of all procedures, 88.3% of conventional
total, 94.0% of total resurfacing and 94.2% of
thrust plate procedures). Avascular necrosis
(3.8%), fractured neck of femur (3.0%),
developmental dysplasia (1.5%) and rheumatoid
arthritis (1.4%) account for the majority of other
diagnoses for primary total hip replacement.
There is some variation in the percentage of
these diagnoses depending on the type of
primary total hip replacement. Conventional total
hip replacement is the only primary total hip
procedure used for the treatment of fractured
neck of femur (3.0% of all primary conventional
total hip replacements).
Usage
Conventional primary total hip replacement is the
most common type of primary total hip
replacement and accounts for 92.1% of all
primary total hips recorded by the Registry.
Total resurfacing accounts for 7.8% and thrust
plate for 0.1% of all primary total hip
replacement (Table HT1).
Last year the Registry reported a decrease in the
proportion of total resurfacing procedures from
8.8% of all primary total hip replacements in
2005 to 8.3% in 2006. In 2007 total resurfacing
replacements further declined to 7.4% of all
primary total hip replacements (Figure HT1).
Although there remains considerable regional
variation in the use of total resurfacing
procedures, all states have shown a reduction in
the use of this procedure. Western Australia and
Tasmania remain the states with the lowest use
(1.4% and 1.9% respectively) (Figure HT1).
The number of thrust plate hip replacement
remains small, with an additional 24 procedures
reported to the Registry in 2007.
Primary Conventional Total Hip
Replacement
In the last five years the Exeter V40 stem has
been the most commonly used femoral stem for
primary conventional total hip replacement in
Australia (Table HT6 and Figure HT4). In 2007
the Corail stem had the second highest usage
followed by the Accolade stem. Four of the five
most frequently used femoral stems are
cementless stems. The percentage of procedures
using the top ten femoral stems has increased
from 63.2% in 2003 to 67.4% in 2007. This is
despite an increase in the number of femoral
stems used each year during that period (Table
HT6). The ten most used cemented and
cementless femoral stems are listed separately in
Tables HT7 and HT8.
For the fifth consecutive year the Trident remains
the most frequently used acetabular prosthesis
(Table HT9 and Figure HT7). In 2007 the next
most frequently used acetabular prostheses are
the Reflection, Pinnacle and Trilogy and this has
remained unchanged for the last three years.
The top ten acetabular prostheses were used in
80.9% of all primary conventional total hip
replacement in 2007. There has been no change
in the number of different types of acetabular
prostheses used in 2007 compared to 2006. The
ten most frequently used cemented and
cementless acetabular prostheses are listed
separately in Tables HT10 and HT11.
Primary Total Resurfacing Hip
Replacement
For the second consecutive year the number of
total resurfacing hip replacements has not only
declined as a proportion of all hip procedures but
also in terms of the absolute number. There was
no change in the number of different types of
total resurfacing prostheses used in 2007
compared to 2006. The 10 most frequently used
total resurfacing prostheses were used in 99.7%
of all procedures in 2007.
The BHR remains the most used prosthesis
accounting for 54.5% of all total resurfacing
procedures in 2007. The number of procedures
using this prosthesis has declined in recent years
as a consequence of increased use of other total
resurfacing systems. The Mitch TRH is now the
second most used total resurfacing system and is
one of the few that has increased in usage. The
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