Operation rate is more than double the revision rate for periprosthetic femur fractures

Constantin, Harry; Le, Michael; Steiger, Richard de; Harris, Ian

doi:10.1111/ans.15519

Cited by 5 publications

(8 citation statements)

References 35 publications

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“…Constantin et al . reported twice the operation rate for PPF than the revision rate in a select group of hospitals 33 . This may have led to a comparatively higher reported rate of revision for PPF for the ABG II than other cementless stems.…”

Section: Discussionmentioning

confidence: 95%

“…Constantin et al reported twice the operation rate for PPF than the revision rate in a select group of hospitals. 33 This may have led to a comparatively higher reported rate of revision for PPF for the ABG II than other cementless stems. The Registry does not collect imaging data so we cannot comment if stem position or stem size relative to the bone may have been a contributing factor to the rate of PPF.…”

Section: Discussionmentioning

confidence: 99%

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Periprosthetic fracture as a late mode of failure of the Anatomique Benoist Girard II femoral prosthesis

Mulford

Mathew

Penn

et al. 2022

ANZ Journal of Surgery

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Aim: The Anatomique Benoist Girard (ABG) II femoral implant was a commonly used stem for primary total hip replacement (THR) at our institution (Launceston, Tasmania Australia). We identified peri-prosthetic fracture as the main cause of late failure. Methods: The late periprosthetic fracture rate for ABG II implants was reviewed with national statistics, using Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) data. National revision rates for periprosthetic fracture were used to compare ABG II with all other cementless femoral stems. Result: ABG II stems accounted for 1% (2719 implants) of all femoral stem implants in Australia during the 12-year review period, compared to 23% (587 implants) in Launceston Hospitals. Although the Launceston cumulative percent revision rate for the ABG II stem was lower than the National rate at all time points, the reasons for revision were similar. The most common reason for revision of ABG II was fracture (56.8%), followed by loosening (15.3%). This differs from the reasons for revision in other cementless prostheses (loosening 23.9%, fracture 20.8%, dislocation 18.7%). Cumulative percent revision rates from late periprosthetic fracture, were higher for the ABG II stem than other cementless femoral prostheses. Conclusion: This review of the AOANJRR has confirmed a local and national higher revision rate of the ABG II stem due to late periprosthetic fracture compared with other cementless stems. Stem design must be considered to reduce the risk of late periprosthetic fracture.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Periprosthetic fracture as a late mode of failure of the Anatomique Benoist Girard II femoral prosthesis

Mulford

Mathew

Penn

et al. 2022

ANZ Journal of Surgery

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“…We only included revisions for periprosthetic fracture when a component was removed or added. The registry may not collect all data on periprosthetic fractures when a fracture was internally fixed without revision of a component [3]. We also noted that mortality for the first revision for periprosthetic fracture was higher than for patients undergoing revision for other reasons.…”

Section: Discussionmentioning

confidence: 99%

“…We acknowledge that this a "broad brush" approach to the outcome of first revision procedures, and there are several limitations to this study. Patients who undergo a first revision may have poor outcomes, such as pain or infection, that do not always result in a second revision operation [3]. The cumulative percent second revision is therefore only one measure, and other data, such as patient-reported outcome measures and complications after revision THA, were not collected by the registry during the time period of this study.…”

Section: Limitationsmentioning

confidence: 99%

What Is the Outcome of the First Revision Procedure of Primary THA for Osteoarthritis? A Study From the Australian Orthopaedic Association National Joint Replacement Registry

Steiger

Lewis

Harris

et al. 2022

Clin Orthop Relat Res

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Background Joint arthroplasty registries traditionally report survivorship outcomes mainly on primary joint arthroplasty. The outcome of first revision procedures is less commonly reported, because large numbers of primary procedures are required to analyze a sufficient number of first revision procedures. Additionally, adequate linkage of primary procedures to revisions and mortality is required. When undertaking revision hip surgery, it is important for surgeons to understand the outcomes of these procedures to better inform patients. Questions/purposes Using data from a large national joint registry, we asked: (1) What is the overall rate of revision of the first aseptic revision procedure for a primary THA? (2) Does the rate of revision of the first revision vary by the diagnosis for the first revision? (3) What is the mortality after the first revision, and does it vary by the reason for first revision? Methods The Australian Orthopaedic Association National Joint Replacement Registry longitudinally maintains data on all primary and revision joint arthroplasties, with nearly 100% capture. The analyses for this study were performed on primary THA procedures in patients with a diagnosis of osteoarthritis up to December 31, 2020, who had undergone subsequent revision. We excluded all primary THAs involving metal-on-metal and ceramic-on-metal bearing surfaces and prostheses with exchangeable necks because these designs may have particular issues associated with revisions, such as extensive soft tissue destruction, that are not seen with conventional bearings, making a comparative analysis of the first revision involving these bearing surfaces more complicated. Metal-on-metal bearing surfaces have not been used in Australia since 2017. We identified 17,046 first revision procedures from the above study population and after exclusions, included 13,713 first revision procedures in the analyses. The mean age at the first revision was 71 6 11 years, and 55% (7496 of 13,713) of the patients were Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request.

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“…Notwithstanding, some complications managed without revision, including reoperations, may not be reported. This includes periprosthetic fractures treated with osteosynthesis 11 , prosthetic joint infection managed without component exchange, excisional arthroplasties, amputations, and arthrodeses 12 , and THA dislocation treated by closed reduction, which can underestimate the incidence of dislocation by 50% 13 . Furthermore, data entered and analyzed are assumed to be accurate when they may not be 14 .…”

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confidence: 99%

A Systematic Review of Data Collection by National Joint Replacement Registries

Hoskins,

Bingham,

Vince

2023

JBJS Reviews

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Background: National joint replacement registries assist surgeons and hospitals with guiding decision making and quality of care. The data points collected are essential to interpret and analyze data and to understand confounding variables and other sources of bias, which can impair retrospective observational research. The aim of this study was to review all national joint replacement registries to assess what data points are recorded, and in what manner, for primary and revision total hip arthroplasty (THA) and total knee arthroplasty (TKA) so that improvements can be made to enhance data collection, interpretation, and analysis. Methods: All national registries were identified through Internet and publication search and contacted to invite participation. Data collection forms for both primary and revision THA and TKA were requested. Data collected were entered into an Excel spreadsheet. Results: The study group for primary and revision THA consisted of 28 national registries, with 26 agreeing to participate. The study group for primary TKA consisted of 27 national registries, with 24 agreeing to participate. Patient identification details were recorded uniformly. Only a minority recorded patient details beyond American Society of Anesthesiologists and body mass index. Most registries did not record surgeon variables: who actually performed or assisted the procedure and their level of training. There was variation in the degree of detail recorded for diagnosis, mostly regarding secondary causes of osteoarthritis and fracture. The details regarding case complexity were limited. Half recorded previous operations, and fewer recorded bone defects. The location of knee arthritis, preoperative limb alignment, and deformities were rarely recorded. Surgical approach and technological adjuncts were routinely collected, but few other details on the surgical technique were recorded. Implant details and fixation were uniformly collected, although a minority recorded specific details, including cement antibiotic or cementing technique. It was uncommon to record whether additional or adjunctive procedures were concurrently performed. Approximately half the registries lacked a revision specific form. The majority recorded reoperations in addition to revision procedures. Patient, surgeon, case, and postoperative details were recorded similar to primary procedures. There was variation in the degree of details recorded for the reasons underlying the revision +/− reoperation, with most recording greater detail for infection and fracture. Many included details on case complexity and bone defects, including the severity, classification, and how the defect was managed. The majority recorded the specific revision procedure that was performed (total or partial), the fixation used, and the components removed or revised. Other specific aspects of fixation including acetabular screws, cone or sleeve use, stems, and augments were less commonly recorded. Conclusion: Substantial data are recorded by all registries, although each one is different. Data solicited lack many patient factors, surgeon variables, case complexity, and surgical techniques. Separate revision forms are not universal, and many registries do not record reoperation procedures, specific causes of revision, and the revision construct. Level of Evidence: Level II, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

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Operation rate is more than double the revision rate for periprosthetic femur fractures

Cited by 5 publications

References 35 publications

Periprosthetic fracture as a late mode of failure of the Anatomique Benoist Girard II femoral prosthesis

Periprosthetic fracture as a late mode of failure of the Anatomique Benoist Girard II femoral prosthesis

What Is the Outcome of the First Revision Procedure of Primary THA for Osteoarthritis? A Study From the Australian Orthopaedic Association National Joint Replacement Registry

A Systematic Review of Data Collection by National Joint Replacement Registries

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