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全球关节成形术登记处:髋关节植入物翻修风险数据的宝贵来源。

Arthroplasty registries around the world: valuable sources of hip implant revision risk data.

作者信息

Hughes Richard E, Batra Aditi, Hallstrom Brian R

机构信息

Department of Orthopaedic Surgery, University of Michigan, 2003 BSRB, 109 Zina Pitcher Pl, Ann Arbor, MI, 48104, USA.

Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.

出版信息

Curr Rev Musculoskelet Med. 2017 Jun;10(2):240-252. doi: 10.1007/s12178-017-9408-5.

Abstract

PURPOSE OF REVIEW

National and regional arthroplasty registries have proliferated since the Swedish Knee Arthroplasty Register was started in 1975. Registry reports typically present implant-specific estimates of revision risk and patient- and technique-related factors that can inform clinical decision-making about implants and techniques. However, annual registry reports are long and it is difficult for clinicians to extract comparable revision risk data. Since implants may appear in multiple registry reports, it is even more difficult to gather relevant data for clinical decision-making about implant selection. The purpose of this paper is to briefly describe arthroplasty registry concepts, international registries around the world, US registries, and provide a parsimonious summary of total hip arthroplasty (THA) implant revision risk reports across registries.

RECENT FINDINGS

Revision risk data for conventional stem/cup combinations reported by the Australian, R.I.P.O. (Italian), Finnish, and Danish registries are summarized here. These registries were selected because they presented 10-year data on revision risk by stem/cup combination. Four tables of revision risk are presented based on fixation: cemented, uncemented, hybrid, and reverse hybrid. Review of these tables show there is wide variation in revision risk across conventional THA implants. It also demonstrates that some cemented implants have better 10-year risk than the best uncemented implants. Many arthroplasty registries prepare annual reports that include revision risk data for implants and they are posted on the registry websites. Arthroplasty surgeons should stay current with these registry reports on implant performance and potential outliers and keep them in mind when making implant decisions.

摘要

综述目的:自1975年瑞典膝关节置换登记处成立以来,国家和地区的关节置换登记处数量激增。登记处报告通常会提供特定植入物的翻修风险估计值,以及与患者和技术相关的因素,这些信息可为植入物和技术的临床决策提供参考。然而,年度登记处报告篇幅冗长,临床医生难以从中提取具有可比性的翻修风险数据。由于植入物可能会出现在多份登记处报告中,因此收集有关植入物选择的临床决策相关数据变得更加困难。本文旨在简要介绍关节置换登记处的概念、全球范围内的国际登记处、美国的登记处,并对各登记处的全髋关节置换(THA)植入物翻修风险报告进行简洁总结。

最新发现:本文总结了澳大利亚、意大利R.I.P.O.、芬兰和丹麦登记处报告的传统柄/臼组合的翻修风险数据。选择这些登记处是因为它们提供了按柄/臼组合划分的10年翻修风险数据。基于固定方式(骨水泥固定、非骨水泥固定、混合固定和反向混合固定)列出了四张翻修风险表。对这些表格的审查表明,传统THA植入物的翻修风险差异很大。这也表明,一些骨水泥固定植入物的10年风险比最佳的非骨水泥固定植入物还要好。许多关节置换登记处会编制年度报告,其中包括植入物的翻修风险数据,这些报告发布在登记处网站上。关节置换外科医生应及时了解这些关于植入物性能和潜在异常值的登记处报告,并在做出植入物决策时予以考虑。

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