(iii) New trends in total hip replacement: follow-up is it required and who pays?

Ghoz, Ali; MacDonald, David

doi:10.1016/j.cuor.2008.06.002

Cited by 4 publications

(4 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Currently, revision surgery constitutes 12% of all hip arthroplasty procedures in the National Joint Registry, the largest group constituting those undertaken for aseptic loosening or osteolysis (National Joint Registry, 2013). These conditions are often silent at onset and, if undetected, may lead to substantial loss of bone with subsequent peri-prosthetic fracture and a significantly higher cost of revision than for aseptic loosening alone (Haddad et al, 2007;Ghoz and Macdonald, 2008;Huddleston et al, 2010). This situation is more challenging for the orthopaedic surgeon and is associated with a higher risk for the patient (Paprosky et al, 2001;Barrack, 2004;Howard, 2009;Vanhegan et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

A Survey of the Current State of Hip Arthroplasty Surveillance in the United Kingdom

Smith

2014

Musculoskeletal Care

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

A Survey of the Current State of Hip Arthroplasty Surveillance in the United Kingdom

Smith

2014

Musculoskeletal Care

View full text Add to dashboard Cite

“…The incidence of haematogenous prosthetic joint infection has been described as 0.3% for large joint replacements, 2 which equates to 210 of the 70 000 hip replacements carried out annually in the United Kingdom. 3 The presence of bacteraemia is a recognised risk factor in haematogenous seeding of prosthetic joints and, for Staphylococcus aureus bacteraemia, this risk has been shown to be as high as 34%. 4 Common sources for such bacteraemia are the oral cavity, skin and respiratory, gastro-intestinal and urogenital tracts.…”

Section: Discussionmentioning

confidence: 99%

Haematogenous infection of a resurfacing hip replacement after transurethral resection of the prostate

Dabasia

Kokkinakis

El-Guindi

2009

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

A 66-year-old man presented with an infected resurfacing hip replacement in the immediate post-operative period following an uneventful transurethral resection of the prostate. Prophylactic antibiotics had been administered on induction of anaesthesia. The hip prosthesis had been inserted seven years previously and had been hitherto asymptomatic. The hip was washed out and microbiological examination identified Enterococcus faecalis as the infecting micro-organism. Despite current recommendations, clinicians undertaking invasive procedures which can lead to bacteraemia in patients with prosthetic joint replacements should be aware of the risk of haematogenous seeding in such prostheses, which although low, has potentially disastrous consequences.

show abstract

“…orthopaedic team, nurse). 24,139 A study 50 that included 30 patients with knee replacement indicated that the most common reason for not returning for follow-up was that the patient forgot or did not know it was recommended. A recent systematic review 18 found that the impact of long-term follow-up on revision remains unknown and, as a result, it is questionable whether or not long-term follow-up should be recommended for all patients undergoing hip and knee joint replacement.…”

Section: Introductionmentioning

confidence: 99%

Safety of disinvestment in mid- to late-term follow-up post primary hip and knee replacement: the UK SAFE evidence synthesis and recommendations

Kingsbury

Smith

Czoski-Murray

et al. 2022

Health Soc Care Deliv Res

View full text Add to dashboard Cite

Background Joint replacement surgery has revolutionised the management of degenerative joint disease. Increasing demand for surgery and post-surgical reviews has overwhelmed orthopaedic services and, consequently, many centres have reduced or stopped follow-up. Such disinvestment is without an evidence base and raises questions regarding the consequences to patients. Objectives To produce evidence- and consensus-based recommendations as to how, when and on whom follow-up should be conducted. Our research question was ‘Is it safe to disinvest in mid- to late-term follow-up of hip and knee replacement?’. Methods The study comprised three complementary evidence synthesis work packages to inform a final consensus process. Work package 1 was a systematic review of the clinical effectiveness and cost-effectiveness literature. Work package 2 used routine national data sets (i.e. the Clinical Practice Research Datalink–Hospital Episode Statistics, Hospital Episode Statistics–National Joint Registry–patient-reported outcome measures) to identify pre, peri and postoperative predictors of mid- to late-term revision, and prospective data from 560 patients to understand how patients present for revision surgery. Work package 3 used a Markov model to simulate the survival, health-related quality of life and NHS costs of patients following hip or knee replacement surgery. Finally, evidence from work packages 1–3 informed a face-to-face consensus panel, which involved 32 stakeholders. Results Our overarching statements are as follows: (1) these recommendations apply to post primary hip and knee replacement follow-up; (2) the 10-year time point in these recommendations is based on a lack of robust evidence beyond 10 years; and (3) in these recommendations, the term ‘complex cases’ refers to individual patient and surgical factors that may increase the risk of replacement failure. Our recommendations are as follows: for Orthopaedic Data Evaluation Panel 10A* (ODEP-10A*) minimum implants, it is safe to disinvest in routine follow-up from 1 to 10 years post non-complex hip and knee replacement provided that there is rapid access to orthopaedic review; (2) for ODEP-10A* minimum implants in complex cases or non-ODEP-10A* minimum implants, periodic follow-up post hip and knee replacement may be required from 1 to 10 years; (3) at 10 years post hip and knee replacement, clinical and radiographic evaluation is recommended; and (4) after 10 years post hip and knee replacement, frequency of further follow-up should be based on the 10-year assessment (note that ongoing rapid access to orthopaedic review is still required) [Stone M, Smith L, Kingsbury S, Czoski-Murray C, Judge A, Pinedo-Villanueva R, et al. Evidence-based follow-up recommendations following primary hip and knee arthroplasty (UK SAFE). Orthop Proc 2020;102–B:13. https://doi.org/10.1302/1358-992X.2020.5.013]. Limitations The current absence of data beyond 10 years restricted the evidence base. Conclusions For ODEP-10A* prostheses, the UK SAFE programme demonstrated that it is safe to disinvest in routine follow-up in the 1- to 10-year period after non-complex hip and knee replacement. At 10 years, clinical and radiographic review is recommended. Complex cases, implants not meeting the 10A* criteria and follow-up after revision surgery are not covered by this recommendation. Future work The evidence base for follow-up after 10 years requires further evaluation. Further work should establish the most clinically effective and cost-effective model of delivering a rapid access service and evaluate alternative models for follow-up services, such as virtual clinics. Finally, the needs and outcomes of patients who are symptomatic but do not have appropriate follow-up should be investigated. Study registration This study is registered as PROSPERO CRD42017053017. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 16. See the NIHR Journals Library website for further project information.

show abstract

(iii) New trends in total hip replacement: follow-up is it required and who pays?

Cited by 4 publications

References 3 publications

A Survey of the Current State of Hip Arthroplasty Surveillance in the United Kingdom

A Survey of the Current State of Hip Arthroplasty Surveillance in the United Kingdom

Haematogenous infection of a resurfacing hip replacement after transurethral resection of the prostate

Safety of disinvestment in mid- to late-term follow-up post primary hip and knee replacement: the UK SAFE evidence synthesis and recommendations

Contact Info

Product

Resources

About