Outcome of Charnley total hip replacement across a single health region in England

Fender, D.; Harper, W. M.; Gregg, P. J.

doi:10.1302/0301-620x.81b4.9859

Cited by 104 publications

(58 citation statements)

References 14 publications

(16 reference statements)

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“…Results from our register represent a best case situation, as we have only assessed the different revision rates of the implants (Fender et al 1999). Further, the brands with the best results were generally used in smaller numbers of patients and in fewer hospitals than, for example, the Charnley prosthesis.…”

Section: Cemented Hip Prosthesesmentioning

confidence: 99%

The Norwegian Arthroplasty Register: 11 years and 73,000 arthroplasties

Havelin¹,

Engesæter²,

Espehaug³

et al. 2000

Acta Orthopaedica Scandinavica

458

253

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In 1985, the Norwegian Orthopaedic Association decided to establish a national hip register, and the Norwegian Arthroplasty Register was started in 1987. In January 1994, it was extended to include all artificial joints. The main purpose of the register is to detect inferior results of implants as early as possible. All hospitals participate, and the orthopedic surgeons are supposed to report all primary operations and all revisions. Using the patient's unique national social security number, the revision can be linked to the primary operation, and survival analyses of the implants are done. In general, the survival analyses are performed with the Kaplan-Meier method or using Cox multiple regression analysis with adjustment for possible confounding factors such as age, gender, and diagnosis. Survival probabilities can be calculated for each of the prosthetic components. The end-point in the analyses is revision surgery, and we can assess the rate of revision due to specific causes like aseptic loosening, infection, or dislocation. Not only survival, but also pain, function, and satisfaction have been registered for subgroups of patients.We receive reports about more than 95% of the prosthesis operations. The register has detected inferior implants 3 years after their introduction, and several uncemented prostheses were abandoned during the early 1990s due to our documentation of poor performance. Further, our results also contributed to withdrawal of the Boneloc cement. The register has published papers on economy, prophylactic use of antibiotics, patients' satisfaction and function, mortality, and results for different hospital categories.In the analyses presented here, we have compared the results of primary cemented and uncemented hip prostheses in patients less than 60 years of age, with 0-11 years' follow-up. The uncemented circumferentially porous-or hydroxyapatite (HA)-coated femoral stems had better survival rates than the cemented ones. In young patients, we found that cemented cups had better survival than uncemented porous-coated cups, mainly because of higher rates of revision from wear and osteolysis among the latter. The uncemented HA-coated cups with more than 6 years of follow-up had an increased revision rate, compared to cemented cups due to aseptic loosening as well as wear and osteolysis.We now present new findings about the six commonest cemented acetabular and femoral components. Generally, the results were good, with a prosthesis survival of 95% or better at 10 years, and the differences among the prosthesis brands were small.Since the practice of using undocumented implants has not changed, the register will continue to survey these implants. We plan to assess the mid-and long-term results of implants that have so far had good short-term results.n

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Section: Cemented Hip Prosthesesmentioning

confidence: 99%

The Norwegian Arthroplasty Register: 11 years and 73,000 arthroplasties

Havelin¹,

Engesæter²,

Espehaug³

et al. 2000

Acta Orthopaedica Scandinavica

458

253

View full text Add to dashboard Cite

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“…(Fitzpatrick et al 1998). Compared with the other uncemented implants, the Omnifit prosthesis has Bimetric ± cement 2 studies (3.8 and 6 yrs) (Meding et al 1997 and Charnley -DePuy 32 studies (10-25 yrs) (Havelin et al 1995a, Avedikian et al 1996, Birtwistle et al 1996, Engesaeter et al 1996, Neumann et al 1996, Devitt et al 1997, Garcia-Cimbrelo et al 1997b, Hartofilakidis et al 1997a,b, Kobayashi et al 1997a, Lehtimaki et al 1997, Madey et al 1997, Nagano et al 1997, Numair et al 1997, Sochart and Porter 1997b, Soyer et al 1997, Kobayashi et al 1997a, Garcia-Cimbrelo et al 1997a, Sochart and Porter 1997a, Kobayashi et al 1997b, Berry et al 1998, Joshi et al 1998, Sochart and Porter 1998, Lehtimaki et al 1999, Prakash et al 1999, Ritter et al 1999b, Sochart 1999, Wroblewski et al 1999, Ritter 1999a, Callaghan et al 2000, Garcia-Cimbrelo et al 2000, Wroblewski et al 2000 Charnley 1 study (5 yrs) (Fender et al 1999)…”

Section: Uncemented Prosthesesmentioning

confidence: 99%

Documentation of hip prostheses used in NorwayA critical review of the literature from 1996–2000

Aamodt

Nordsletten²,

Havelin

et al. 2004

Acta Orthopaedica Scandinavica

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We have conducted a systematic review of the scientific literature concerning outcome and clinical effectiveness of prostheses used for primary total hip replacement (THR) in Norway. The study is based on two Health Technology Assessment reports from the UK (Faulkner et al. 1998, Fitzpatrick et al. 1998), reviewing the literature from 1980 to 1995. Using a similar search strategy, we have evaluated the literature from 1996 through 2000. We included 129 scientific and medical publications which were assessed according to a specific appraisal protocol. The majority (72%) were observational studies, whereas only 9% were randomized studies. We could not retrieve any peer-reviewed documentation for one third of the implants. The Charnley prosthesis had by far the best and most comprehensive evidence base with better than 90% implant survival after about 10 years. Survival of the Charnley prosthesis declines by about 10% during each of the two following decades. Except for the Charnley and Lubinus IP, no other prosthesis on the market in Norway has given long-term results (> 15 years). 5 other cemented implants have given comparable results at about 10 years of follow-up. Some uncemented stems have shown promising medium-term outcome, but no combination of uncemented cup and stem fulfilled the benchmark criterion of > or = 90% implant survival at 10 years, which we propose as a minimum requirement for unrestricted clinical use for prostheses used in primary THR. New or undocumented implants should be introduced through a four-step model including preclinical testing, small series evaluated by radiosterometry, randomized clinical trial involving comparison with a well-documented prosthesis, and finally, surveillance of clinical use through registers.

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“…Up to 20% of patients with total joint replacement (TJR) will develop radiographic evidence of aseptic loosening (AL) [1][2][3]. AL most likely results from an inflammatory response to billions of wear debris particles shed from the prosthesis during normal use, and the periprosthetic tissue presents an inflammatory membrane containing large numbers of macrophages, fibroblasts, giant cells, and osteoclasts [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%