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Published on: September 7, 2022
Trends in revision hip and knee arthroplasty observations after implementation of a regional joint replacement
Jas Singh1, Angelos Politis1, Lynda Loucks1
1From the University of Manitoba, Winnipeg, Man. (Singh, Hedden, Bohm); the Royal Orthopaedic Hospital, Birmingham, Birmingham, West Midlands, UK (Politis); the Concordia Joint Replacement Group, Winnipeg, Man. (Loucks); and the George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Man. (Bohm).
Background:
National joint replacement registries outside North America have been effective in reducing revision risk. However, there is little information on the role of smaller regional registries similar to those found in Canada or the United States. We sought to understand trends in total hip (THA) and knee (TKA) arthroplasty revision patterns after implementation of a regional registry.
Methods:
We reviewed our regional joint replacement registry containing all 30 252 cases of primary and revision THA and TKA performed between Jan. 1, 2005, and Dec. 31, 2013. Each revision case was stratified into early (< 2 yr), mid (2-10 yr) or late (> 10 yr), and we determined the primary reason for revision.
Results:
The early revision rate for TKA dropped from 3.0% in 2005 to 1.3% in 2011 (R(2) = 0.84, p = 0.003). Similarly, the early revision rate for THA dropped from 4.2% to 2.1% (R(2) = 0.78, p = 0.008). Despite primary TKA and THA volumes increasing by 35.5% and 39.5%, respectively, there was no concomitant rise in revision volumes. The leading reasons for TKA revision were infection, instability, aseptic loosening and stiffness. The leading reasons for THA revision were infection, instability, aseptic loosening and periprosthetic fracture. There were no discernible trends over time in reasons for early, mid-term or late revision for either TKA or THA.
Conclusion:
After implementation of a regional joint replacement registry we observed a significant reduction in early revision rates. Further work investigating the mechanism by which registry reporting reduces early revision risk is warranted.
