Is a Revision a Revision? An Analysis of National Arthroplasty Registries’ Definitions of Revision

Liebs, Thoralf Randolph; Splietker, Farina; Hassenpflug, J.

doi:10.1007/s11999-015-4255-4

Cited by 35 publications

(32 citation statements)

References 17 publications

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“…The cumulative revision rate (10.9%) after 10 years suggests that the device is unlikely to be revised in at least some patients within the average lifespan (81 years) since PROMs did not appear to decline with time, and the minimum period for a UKA to be in situ prior to revision to be considered a successful delay of TKR has yet to be elucidated. Importantly, the cumulative revision rate may not be an ideal indicator of success, with varied definitions of revision used in different registries worldwide 31 a lower threshold of patient symptoms used to justify revision in UKA compared with TKA, and a lack of objectivity with respect to revision as a surgical end point. 32 In this way, the fact that the Repicci II device was designed as a minimally invasive procedure readily converted to TKA may contribute to the revision rate observed and may not reflect the patient-centered success of the procedure.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Inlay Prosthesis Unicompartmental Knee Arthroplasty for the Treatment of Unicompartmental Osteoarthritis: A Prospective Observational Cohort Study with Minimum 2-Year Outcomes and up to 14-Year Survival

Scholes¹,

Ebrahimi²,

Field

et al. 2019

J Knee Surg

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There are limited medium-term outcome data available for the Repicci II device in unicompartmental knee arthroplasty (UKA). The purpose of this study was to report the medium-term (minimum 2 years) patient-reported outcomes and long-term (up to 14 years) procedure survival in a consecutive series of patients undergoing an inlay prosthesis UKA (Repicci II) at an independent orthopaedic clinic. Patients presenting with medially localized unicompartmental knee osteoarthritis and meeting the criteria appropriate for UKA were recruited to a clinical patient registry at the time of presentation. A cemented unicompartmental prosthesis (Repicci II) was implanted using minimally invasive techniques with rapid postoperative mobilization. Patients were asked to complete patient-reported outcomes preoperatively and annually postoperatively. A procedure list was cross-matched with the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), and an analysis of procedure survival was performed with comparison to the national data for UKA. Data from a cohort of 661 primary medial compartment UKA procedures performed in 551 patients over a 15-year period were extracted from the clinical patient registry. Significant improvements were maintained in general health, disease symptoms, pain, and function at an average follow-up of 9 years compared with preoperative data. Threshold analysis revealed that >65% of patients exceeded Patient Acceptable Symptom State at the latest follow-up, with >80% within or exceeding age-matched norms for general health. Cumulative revision rate was significantly lower than that reported for UKA in the AOANJRR at up to 13 years follow-up. This series represents a lower cumulative revision rate than previously reported, with >65% of patients reporting satisfactory functional outcomes at an average of 9 years from surgery. Surgical options for treating unicompartmental knee osteoarthritis could include UKA as a viable alternative; however, clear definitions of procedure success and its overall cost–benefit ratio in the context of ongoing management of knee osteoarthritis remain to be elucidated.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Inlay Prosthesis Unicompartmental Knee Arthroplasty for the Treatment of Unicompartmental Osteoarthritis: A Prospective Observational Cohort Study with Minimum 2-Year Outcomes and up to 14-Year Survival

Scholes¹,

Ebrahimi²,

Field

et al. 2019

J Knee Surg

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“…Intraoperative and postoperative complications were computed, regardless of whether they were related to the surgical procedure, as previously described by Saleh et al 15 Additionally, revision surgery was defined as reoperation performed to correct undesirable sequelae of a previous surgery, with or without addition or removal of implant components. 16 Radiologic evaluation was performed through profound analysis of an anteropos-terior radiograph of the pelvis, a modified Dunn's lateral axial view (hip in 45° flexion, foot in neutral rotation), and a false profile view. The grade of hip dysplasia was determined according to the Hartofilakidis classification, 17 the lateral center-edge angle of Wiberg, 18 and the Crowe classification.…”

Section: Methodsmentioning

confidence: 99%

Long-term Outcome of Unconstrained Primary Total Hip Arthroplasty in Ipsilateral Residual Poliomyelitis

Buttaro¹,

Slullitel²,

García-Mansilla³

et al. 2017

Orthopedics

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Incapacitating articular sequelae in the hip joint have been described for patients with late effects of poliomyelitis. In these patients, total hip arthroplasty (THA) has been associated with a substantial rate of dislocation. This study was conducted to evaluate the long-term clinical and radiologic outcomes of unconstrained THA in this specific group of patients. The study included 6 patients with ipsilateral polio who underwent primary THA between 1985 and 2006. Patients with polio who underwent THA on the nonparalytic limb were excluded. Mean follow-up was 119.5 months (minimum, 84 months). Clinical outcomes were evaluated with the modified Harris Hip Score (mHHS) and the visual analog scale (VAS) pain score. Radiographs were examined to identify the cause of complications and determine the need for revision surgery. All patients showed significantly better functional results when preoperative and postoperative mHHS (67.58 vs 87.33, respectively; P=.002) and VAS pain score (7.66 vs 2, respectively; P=.0003) were compared. Although 2 cases of instability were diagnosed, only 1 patient needed acetabular revision as a result of component malpositioning. None of the patients had component loosening, osteolysis, or infection. Unconstrained THA in the affected limb of patients with poliomyelitis showed favorable long-term clinical results, with improved function and pain relief. Nevertheless, instability may be a more frequent complication in this group of patients compared with the general population. [Orthopedics. 2017; 40(2):e255-e261.].

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“…We also distributed them by anatomical location. We considered a revision surgery as a reoperation performed to correct undesirable sequelae of a previous surgery, with or without an addition or removal of implant components 15 . We defined VCF as pre or postoperative filter and measured time from VCF placement to surgery.…”

Section: Variables and Definitionsmentioning

confidence: 99%

Are there any risk factors for developing complications with the use of retrievable vena cava filters in orthopaedic surgery?

Slullitel

Dilernia²,

Stagnaro³

et al. 2018

Rev Fac Cien Med Univ Nac Cordoba

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<p>Introducción: En pacientes sometidos a cirugía ortopédica y con antecedente de Enfermedad tromboembolica, la profilaxis común suele ser insuficiente para prevenir eventos tromboembólicos. Los filtros de vena cava (FVC) removibles pueden considerarse una alternativa. Objetivos: Estimar la tasa de complicaciones hematológicas, mecánicas y muertes asociadas al uso de FVC removibles en cirugía ortopédica. Métodos: Se diseñó una cohorte retrospectiva de pacientes con historia previa de Enfermedad tromboembolica (ETE) sometidos a procedimientos ortopédicos que requirieron FVC removible, entre el 2006-2014 en el servicio de ortopedia del Hospital Italiano de Buenos Aires. Se definió complicación asociada al FVC a las complicaciones mecánicas, hematológicas (recurrencia de ETE, síndrome postrombotico y sangrado mayor) y muerte. Para estimar la asociación con factores de riesgo, subclasificamos a las cirugías en 5 grupos: 1, artroplastia/no artroplastia; 2, primaria/revisión; 3, electiva/urgente; 4, oncológica/no oncológica; 5, filtro pre/postoperatorio. Resultados: Se incluyeron 68 pacientes, de los cuales 31 presentaron algún tipo de complicación. Las complicaciones mecánicas ostentaron un 16%, precisando de una revisión del filtro. 64% de los filtros revisados fallaron mecánicamente y no pudieron ser extraídos. Las tasas de recurrencia de ETE, síndrome postrombotico y sangrado mayor fueron del 33%, 15% y 4.5%, respectivamente. Las cirugías espinales presentaron un mayor riesgo de recurrencia de ETE. La mortalidad global fue del 28% y 4% asociada a recurrencia de ETE. Conclusiones: Las cirugías ortopédicas exhibieron un riesgo elevado de complicaciones mecánicas y hematológicas luego de usar un FVC removible. Empero, la mortalidad debido a dichas complicaciones fue baja.</p>

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Is a Revision a Revision? An Analysis of National Arthroplasty Registries’ Definitions of Revision

Cited by 35 publications

References 17 publications

Minimally Invasive Inlay Prosthesis Unicompartmental Knee Arthroplasty for the Treatment of Unicompartmental Osteoarthritis: A Prospective Observational Cohort Study with Minimum 2-Year Outcomes and up to 14-Year Survival

Minimally Invasive Inlay Prosthesis Unicompartmental Knee Arthroplasty for the Treatment of Unicompartmental Osteoarthritis: A Prospective Observational Cohort Study with Minimum 2-Year Outcomes and up to 14-Year Survival

Long-term Outcome of Unconstrained Primary Total Hip Arthroplasty in Ipsilateral Residual Poliomyelitis

Are there any risk factors for developing complications with the use of retrievable vena cava filters in orthopaedic surgery?

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