Department of Orthopaedic Surgery, Wellington Regional Hospital, Riddiford Street, Newtown, Wellington 6021, New Zealand.
Clin Orthop Relat Res. 2012 Nov;470(11):3003-6. doi: 10.1007/s11999-012-2323-6.
Despite advances in primary THA, dislocation remains a common complication. In New Zealand (NZ), dislocations are reported to the National Joint Registry (NJR) only when prosthetic components are revised in the treatment of a dislocation. Closed reductions of dislocated hips are not recorded by the NJR.
QUESTIONS/PURPOSES: We compared the true dislocation rate for patients receiving primary THA in the Wellington region with the rate reported by the NZ NJR for the same group of patients.
The NZ NJR identified 570 patients undergoing primary THA from January 1, 2008, to December 31, 2009, with addresses in the Wellington region. The mean age was 67.5 years (range, 27-96 years). The minimum followup was 2 years (mean, 3 years; range, 2-4 years).
Six patients required revision of at least one component for dislocation. There was 100% agreement between the hospital database and the NJR. Using the NJR criteria of revision of any component as an end point, the dislocation rate in the Wellington region after primary THA was 1.05%. The hospital database identified a further eight patients who presented with a dislocation of their primary THA and underwent a closed reduction. These patients were not recorded by the NJR. The true rate of all dislocations, which includes closed reductions, was 2.46%.
This article documents the discrepancy between the NZ NJR reported rate of revision for dislocation and the true rate of dislocation in primary THA. We recommend documentation of all dislocations by NJR in their database to allow more accurate comparisons between centers and research outcomes.
Level IV, clinical research study. See Guidelines for Authors for a complete description of levels of evidence.
尽管初次全髋关节置换术取得了进展，但脱位仍是一种常见并发症。在新西兰（NZ），只有在因脱位而对假体部件进行翻修时，才向国家关节登记处（NJR）报告脱位。NJR 不记录脱位髋关节的闭合复位。
问题/目的：我们比较了惠灵顿地区接受初次全髋关节置换术的患者的真实脱位率与 NZ NJR 同期报告的同一组患者的脱位率。
NJR 从 2008 年 1 月 1 日至 2009 年 12 月 31 日确定了惠灵顿地区接受初次全髋关节置换术的 570 名患者，这些患者的地址都在惠灵顿地区。平均年龄为 67.5 岁（范围 27-96 岁）。随访时间至少为 2 年（平均 3 年；范围 2-4 年）。
6 名患者因脱位需要至少对一个部件进行翻修。医院数据库与 NJR 之间有 100%的一致性。使用 NJR 标准，即任何部件的翻修为终点，惠灵顿地区初次全髋关节置换术后的脱位率为 1.05%。医院数据库还发现了另外 8 名因初次全髋关节置换术后脱位并接受闭合复位的患者，但这些患者并未被 NJR 记录。包括闭合复位在内的所有脱位的真实发生率为 2.46%。
本文记录了 NZ NJR 报告的脱位翻修率与初次全髋关节置换术后脱位的真实发生率之间的差异。我们建议 NJR 在其数据库中记录所有脱位，以允许更准确地比较各中心和研究结果。
IV 级，临床研究。欲了解完整的证据水平描述，请参见作者指南。
