比较髋关节和膝关节置换登记处的当代翻修负担。
Comparing contemporary revision burden among hip and knee joint replacement registries.
作者信息
McGrory Brian J, Etkin Caryn D, Lewallen David G
机构信息
Maine Joint Replacement Institute, Portland, ME, USA; Tufts University School of Medicine, Boston, MA, USA.
American Joint Replacement Registry, Rosemont, IL, USA.
出版信息
Arthroplast Today. 2016 May 27;2(2):83-86. doi: 10.1016/j.artd.2016.04.003. eCollection 2016 Jun.
BACKGROUND
Hip and knee arthroplasties are common and successful procedures, however, success and durability are not guaranteed. The revision burden, defined as the ratio of implant revisions to the total number of arthroplasties in a specific period, is a measure of the steady state of arthroplasty success in a given registry. This study examines the hypothesis that revision burden would be similar among contemporary joint replacement registries and improving over time compared with historic controls.
METHODS
We evaluated the national joint registries of 5 health systems (Australian Orthopaedic Association National Joint Replacement Registry [AOANJRR]; National Joint Registry of England, Wales, Northern Ireland, and the Isle of Man; New Zealand Joint Registry [NZJR]; Swedish Hip Arthroplasty Register [SHAR] and Swedish Knee Arthroplasty Register [SKAR]; and the American Joint Replacement Registry [AJRR]) for hip and knee revision burden over the past 4 years or since registry inception. Historic controls were obtained from previously published reports.
RESULTS
The 2014 hip revision burden varied from 9.7 percent (NJR) to 11.9 percent (NZJR), and the unweighted average was 10.4 percent. The 2011, 2012, and 2013 mean hip revision burden was 11.9, 11.9, and 11.4 percent. The 2014 knee revision burden varied from to 6.0 percent (NJR) to 8.1 percent (AJRR), and the unweighted average for the 5 registries studied was 7.0 percent. The 2011, 2012, and 2013 mean knee revision burden was 6.9, 7.0, and 7.0 percent. Historically, the observed hip revision burden was 15.8 percent and the knee revision burden 8.0 percent.
CONCLUSIONS
Revision burden has gradually decreased for hip replacements and has remained relatively constant for knee replacements both for the last 4 years and compared to historic controls. Knee revision burden was lower than hip revision burden for each period examined. Revision burden is one measure that may be helpful in following the effect of changes in surgical technique and implant design over time in registry populations and may be a helpful way to compare overall results between registries.
背景
髋关节和膝关节置换术是常见且成功的手术，但手术的成功和耐用性并不能得到保证。翻修负担定义为特定时期内植入物翻修数量与关节置换术总数的比率，是衡量特定登记处关节置换术成功稳态的一项指标。本研究检验了这样一个假设，即当代关节置换登记处之间的翻修负担相似，且与历史对照相比，翻修负担会随时间推移而改善。
方法
我们评估了5个医疗系统的国家关节登记处（澳大利亚骨科协会国家关节置换登记处[AOANJRR]；英格兰、威尔士、北爱尔兰和马恩岛国家关节登记处；新西兰关节登记处[NZJR]；瑞典髋关节置换登记处[SHAR]和瑞典膝关节置换登记处[SKAR]；以及美国关节置换登记处[AJRR]）过去4年或自登记处成立以来的髋关节和膝关节翻修负担情况。历史对照数据来自先前发表的报告。
结果
2014年髋关节翻修负担从9.7%（NJR）到11.9%（NZJR）不等，未加权平均为10.4%。2011年、2012年和2013年的平均髋关节翻修负担分别为11.9%、11.9%和11.4%。2014年膝关节翻修负担从6.0%（NJR）到8.1%（AJRR）不等，所研究的5个登记处的未加权平均为7.0%。2011年、2012年和2013年的平均膝关节翻修负担分别为6.9%、7.0%和7.0%。从历史数据来看，观察到的髋关节翻修负担为15.8%，膝关节翻修负担为8.0%。
结论
无论是在过去4年还是与历史对照相比，髋关节置换的翻修负担都逐渐下降，膝关节置换的翻修负担则保持相对稳定。在所检查的每个时期，膝关节翻修负担均低于髋关节翻修负担。翻修负担是一项指标，可能有助于追踪登记人群中手术技术和植入物设计随时间变化的影响，也可能是比较各登记处总体结果的一种有用方式。
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