Revision Surgery After Total Joint Arthroplasty: A Complication-Based Analysis Using Worldwide Arthroplasty Registers

Sadoghi, Patrick; Liebensteiner, Michael; Agreiter, Mark; Leithner, Andreas; Böhler, N.; Labek, Gerold

doi:10.1016/j.arth.2013.01.012

Cited by 368 publications

(240 citation statements)

References 21 publications

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“…Worldwide arthroplasty registers are essential to analyse single surgical devices and pooled analyses have successfully served as guidelines in the past [16,17]. However, in order to compare register datasets from different countries a comparable minimal dataset is essential [20].…”

Section: Discussionmentioning

confidence: 99%

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Application and surgical technique of total knee arthroplasties: a systematic comparative analysis using worldwide registers

Vielgut

Kastner

Pichler

et al. 2013

International Orthopaedics (SICOT)

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Purpose The aim of this study was to compare total knee arthroplasty (TKA) procedures between different countries with regard to epidemiological data and surgical technique by reference to the worldwide arthroplasty registers. Methods A systematic search was carried out using the EFORT website to identify the relevant arthroplasty registers. We extracted data with respect to the number of implanted TKAs, patients' age distribution, procedure types, and revision rates. After identification of 28 national arthroplasty registers, 11 offered sufficient data regarding the above mentioned parameters and were therefore included in the final analysis. Results A large variation was found in the annual number of primary TKA implantations per inhabitant with a reported range from 30 to 199 per 100,000 (mean 106). The fixation method varied strongly between the different registers as well, e.g. 90 % of totally cemented TKAs in Sweden, England and Wales, Slovakia, and New Zealand versus 54 % cemented fixation in Australia. Another significant difference between included countries was observed with respect to the use of patellar resurfacing in TKA. Whilst the Danish knee arthroplasty register reports a percentage of 72 % using a patellar button in TKA the register from Norway reports only a minority of 2 %. ConclusionsThe comparison of arthroplasty registers revealed large differences regarding the annual number of primary TKAs per inhabitant and primary TKA procedure types. These variations may be explained by several factors such as patient demographics (prevalence of osteoarthritis) and national conditions such as healthcare systems (insurance status), number or availability of performing surgeons, medical facilities and surgeon-dependent factors such as definition of indications, education, tradition and experience.

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Section: Discussionmentioning

confidence: 99%

“…In addition, we performed a free-hand search using the terms "(arthroplasty register) OR (knee arthroplasty register)" via Google. This method was described in previous studies of our group [16,17].…”

Section: Methodsmentioning

confidence: 99%

Application and surgical technique of total knee arthroplasties: a systematic comparative analysis using worldwide registers

Vielgut

Kastner

Pichler

et al. 2013

International Orthopaedics (SICOT)

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“…Aseptic loosening accounts from 31 to 55 % of TKA failure [84]; the pathogenesis is most of all implant-related [84,85].…”

Section: Aseptic Looseningmentioning

confidence: 99%

Painful knee arthroplasty: current practice

Cottino

Rosso

Pastrone

et al. 2015

Curr Rev Musculoskelet Med

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Primary total knee arthroplasty is the treatment for end-stage arthritis of the knee; in the last years, it is becoming more common and reliable, due to technical and implant improvement. With larger implant rates, the overall complications will increase and pain is the most common sign of implant failure. Pain can be related to a lot of different clinical findings, and the surgeon has to be aware of the various etiologies that can lead to failure. Pain does not always mean revision, and the patient has to be fully evaluated to have a correct diagnosis; if surgery is performed for the wrong reason, this will surely lead to a failure. In this paper, the authors revised the more common causes of failure that can have a painful onset proposing an approach for diagnosis and treatment.

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“…Patients often do not accept these complications as being predestined, which may involve subsequent claims for damages. The event of an implant fracture is generally an unacceptable complication and not reconcilable with satisfactory outcome [3]. Even if implant fractures are commonly considered as rare events, it is worth undertaking every reasonable effort in order to avoid them.…”

Section: Introductionmentioning

confidence: 99%

The incidence of implant fractures after total hip arthroplasty

Sadoghi

Pawelka

Liebensteiner

et al. 2013

International Orthopaedics (SICOT)

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Purpose Implant fractures after total hip arthroplasty (THA) are considered as rare in clinical practice. Nevertheless they are relevant complications for patients, physicians, and the public health system leading to high socioeconomic burdens. The aim of this study was to assess the incidence of fractures after THAs in a comparative analysis of clinical studies and worldwide arthroplasty register datasets. Methods We calculated the pooled incidence of revision operations after fractures of THAs in a comparison of clinical studies published in Medline-listed journals and annual reports of worldwide arthroplasty registers in a structured literature analysis based on a standardised methodology. Results Included clinical studies (sample-based datasets) were mono-centre trials comprising a cumulative number of approximately 70,000 primary implantations whereas worldwide national arthroplasty register datasets referred to 733,000 primary implantations, i.e. approximately ten times as many as samplebased datasets. In general, sample-based datasets presented higher revision rates than register datasets with a maximum deviation of a 14.5 ratio for ceramic heads, respectively. The incidence of implant fractures in total hip arthroplasty in pooled worldwide arthroplasty register datasets is 304 fractures per 100,000 implants. In other words, one out of 323 patients has to undergo revision surgery due to an implant fracture after THA in their lifetime. Conclusions Implant fractures in total hip arthroplasty occur in a relevant number of patients. The authors believe that comprehensive arthroplasty register datasets allow more general evaluations and conclusions on that topic in contrast to clinical studies.

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Revision Surgery After Total Joint Arthroplasty: A Complication-Based Analysis Using Worldwide Arthroplasty Registers

Cited by 368 publications

References 21 publications

Application and surgical technique of total knee arthroplasties: a systematic comparative analysis using worldwide registers

Application and surgical technique of total knee arthroplasties: a systematic comparative analysis using worldwide registers

Painful knee arthroplasty: current practice

The incidence of implant fractures after total hip arthroplasty

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