Revision Rates after Primary Hip and Knee Replacement in England between 2003 and 2006

Sibanda, Nokuthaba; Copley, Lynn P.; Lewsey, Jim; Borroff, Mick; Gregg, P. J.; Macgregor, Alexander; Pickford, Martin; Porter, Martyn; Tucker, Keith; Meulen, Jan van der; Wales, '

doi:10.1371/journal.pmed.0050179

Cited by 63 publications

(44 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This information fills an important knowledge gap and suggests that revision-free survival may have improved over time. These revision-free survival rates in patients with shoulder hemiarthroplasty are slightly lower than those reported after knee and hip replacement surgeries 1; 10 .…”

Section: Discussionmentioning

confidence: 54%

Risk factors for revision surgery after humeral head replacement: 1,431 shoulders over 3 decades

Singh¹,

Sperling²,

Cofield³

2012

Journal of Shoulder and Elbow Surgery

View full text Add to dashboard Cite

Objective Assess long-term risk of revision surgery and its predictors after undergoing humeral head replacement (HHR). Methods We used prospectively collected data from the Mayo Clinic Total Joint registry and other institutional electronic databases. Revision-free survival for HHR at 5-, 10- and 20-years was calculated using Kaplan-Meier survival analysis. We used univariate and multivariable-adjusted Cox regression analyses to examine the association of age, gender, body mass index (BMI), comorbidity assessed by Deyo-Charlson index, American Society of Anesthesiologist (ASA) class, implant fixation (cemented versus not) and underlying diagnosis with the risk of revision surgery. Hazard ratio with 95% confidence interval (CI) and p-values are presented. Results 1,359 patients underwent 1,431 shoulder HHRs during the study period, 1976–2008. The average age was 63 years, 63% were female, mean BMI was 28 kg/m2 and 60% implants were cemented. 114 HHRs were revised during the follow-up. At 5-, 10- and 20-years, the shoulder implant survival was 93.6% (95% CI, 92.1%–95%), 90% (95% CI, 88%–92%) and 85% (95% CI, 81.8%–88.4%) respectively. In multivariable-adjusted analyses, older age was associated with lower hazard of revision, hazard ratio, 0.97 (95% CI, 0.96–0.99; p-value<0.001) and higher BMI with higher hazard ratio of 1.04 (95% CI, 1.01–1.08; p-value=0.02). Conclusions Long-term survival of HHR at 20-years was excellent. Obesity and younger age are risk factors for higher revision rate after HHR. Further studies should investigate the biologic rationale for these important associations. Surgeons can discuss these differences in revision risk with patients, especially in young obese patients.

show abstract

Section: Discussionmentioning

confidence: 54%

Risk factors for revision surgery after humeral head replacement: 1,431 shoulders over 3 decades

Singh¹,

Sperling²,

Cofield³

2012

Journal of Shoulder and Elbow Surgery

View full text Add to dashboard Cite

show abstract

“…Our results confirm those reported by Vendittoli et al [38], who evaluated blood ion concentrations in patients with MOM Durom hip resurfacing (Zimmer, Winterthur, Switzerland). Concerns have been raised regarding a substantially greater failure rate in females treated with MOM-BHR compared with males [7,32]. Vendittoli et al [38] suggested that female gender contributed to higher metal ion levels with resurfacing implants.…”

Section: Discussionmentioning

confidence: 99%

Do Ion Levels In Hip Resurfacing Differ From Metal-on-metal THA at Midterm?

Moroni

Savarino

Hoque

et al. 2011

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Metal-on-metal Birmingham hip resurfacing (MOM-BHR) is an alternative to metal-on-metal total hip arthroplasty (MOM-THA), especially for young and/or active patients. However, wear resulting in increased serum ion levels is a concern. Questions/purposes We asked whether (1) serum chromium (Cr), cobalt (Co), and molybdenum (Mo) concentrations would differ between patients with either MOM-BHR or MOM-THA at 5 years, (2) confounding factors such as gender would influence ion levels; and (3) ion levels would differ at 2 and 5 years for each implant type. Patients and Methods Ions were measured in two groups with either MOM-BHR (n = 20) or MOM-THA (n = 35) and a mean 5-year followup, and two groups with either MOM-BHR (n = 15) or MOM-THA (n = 25) and a mean 2-year followup. Forty-eight healthy blood donors were recruited for reference values. Results At 5 years, there were no differences in ion levels between patients with MOM-BHR or MOM-THA. Gender was a confounding factor, and in the MOM-BHR group at 5 years, Cr concentrations were greater in females compared with those of males. Mean ion levels were similar in patients with 2 and 5 years of followup for each implant type. Ion levels in patients were sevenfold to 10-fold higher than in controls. Conclusions As the metal ion concentrations in the serum at 5 years were in the range reported in the literature, we do not believe concerns regarding excessive metal ion levels after MOM-BHR are justified. Level of Evidence Level III, therapeutic study. See the Guidelines for Authors for a complete description of level of evidence.

show abstract

“…In contrast to HES these systems normally attract a high level of clinical engagement and some of them have benefited from linkage to HES. 15 However, these data are not comprehensive, leading to a situation where some practitioners have excellent information about their service including the quality of patient care and others have none. The benefit of high-quality clinical data has been demonstrated by the year-on-year improvements in outcome following a cardiac surgery.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Hospital episode statistics: improving the quality and value of hospital data: a national internet e-survey of hospital consultants

Spencer

Davies

2012

BMJ Open

View full text Add to dashboard Cite

HypothesisSenior hospital clinicians are poorly engaged with clinical coding and hospital episode statistics (HES).Aims ▸ To understand the current level of clinical engagement with collection of national data and clinical coding.▸ To gain the views of frontline staff on proposed improvements to hospital statistics.▸ To gain an indication of likely clinical engagement in change.▸ To understand the clinical priority for improvement.DesignInternet e-survey accessible from Academy of Royal Medical College Website.SettingNational Health Service (NHS) Trusts.Participants1081 NHS hospital consultants and two general practitioners who volunteered to take part.Results3.4% of the sample regularly access HES data; 21% are regularly involved in clinical coding and 6.2% meet coding staff at least monthly. 95% would like to access HES data and there was a strong support for using this data for appraisal, revalidation and improving the quality of patient care. In terms of improvements, 91.9% would be prepared to code diagnosis in outpatients given the right tools. The highest priority for improvement is clinical validation of diagnostic data.ConclusionsClinical engagement with coding and access to HES data is poor. However, there is professional support for improvement. Clinical requirements should be considered in all future developments of national data collection to provide the quality and scope of data that is required to deliver the information revolution.

show abstract

Revision Rates after Primary Hip and Knee Replacement in England between 2003 and 2006

Cited by 63 publications

References 17 publications

Risk factors for revision surgery after humeral head replacement: 1,431 shoulders over 3 decades

Risk factors for revision surgery after humeral head replacement: 1,431 shoulders over 3 decades

Do Ion Levels In Hip Resurfacing Differ From Metal-on-metal THA at Midterm?

Hospital episode statistics: improving the quality and value of hospital data: a national internet e-survey of hospital consultants

Contact Info

Product

Resources

About