Department for Orthopaedics and Traumatology, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020, Linz, Austria.
Johannes Kepler University Linz, Altenberger Strasse 69, 4040, Linz, Austria.
Knee Surg Sports Traumatol Arthrosc. 2022 Mar;30(3):958-964. doi: 10.1007/s00167-021-06437-7. Epub 2021 Feb 17.
The reported usage of UKA is around 10% in the UK, Australian and New Zealand joint registries. However, some authors recommend that a higher UKA usage of 20%, or a minimum 12 UKA cases per year, would reduce revision rates. The purpose of this study was to analyze the percentage of surgeons performing the recommended thresholds in these 3 registries.
Data from the UK, Australian and New Zealand registry databases was utilized from the time period since their respective introduction until 2017. All primary TKA and UKA performed for the diagnosis of osteoarthritis by surgeons with more than 100 recorded knee arthroplasties in their respective registry were included. The results between the registries were compared and a pooled analysis was performed. The number of surgeons meeting the recommended caseload of > 20% UKA yearly or 12 UKA cases yearly was calculated.
We identified 3037 knee surgeons performing 1,556,440 knee arthroplasties, of which 131,575 were UKA (8.45%). Over 50% of knee surgeons in each registry had a proportion of less than 5% UKA of their knee replacement procedures. After pooling of data, median surgeon UKA usage was 2.0% (IQR 0-9.1%). The percentage of surgeons meeting the proposed caseload criteria was highest in New Zealand, 16.3%, followed by the UK at 12.4% and Australia 11.3% (p = 0.28).
More than 50% of knee surgeons in UK, Australian and New Zealand joint registries perform less than 5% of UKA yearly. The majority of experienced knee surgeons are not meeting the recommended minimum thresholds, which might indicate that the recommended thresholds are not feasible for the vast majority of knee surgeons. The reasons behind this require further research.
Level III retrospective registry study.
英国、澳大利亚和新西兰联合登记处报告的 UKA 使用率约为 10%。然而，一些作者建议 UKA 使用率应提高到 20%，或每年至少进行 12 例 UKA 手术，以降低翻修率。本研究的目的是分析这三个登记处中达到建议阈值的外科医生的比例。
利用英国、澳大利亚和新西兰登记处数据库中的数据，时间范围为各自引入登记处至 2017 年。所有由在各自登记处记录超过 100 例膝关节置换术的外科医生为诊断骨关节炎而进行的初次全膝关节置换术和 UKA 均包括在内。对各登记处之间的结果进行比较，并进行汇总分析。计算出每年 UKA 手术量超过 20%或每年 12 例 UKA 手术的外科医生数量。
我们确定了 3037 名膝关节外科医生进行了 1556440 例膝关节置换术，其中 131575 例为 UKA（8.45%）。每个登记处中超过 50%的膝关节外科医生 UKA 手术量占膝关节置换手术的比例不到 5%。在汇总数据后，外科医生 UKA 使用率的中位数为 2.0%（IQR 0-9.1%）。新西兰的外科医生达到建议手术量标准的比例最高，为 16.3%，其次是英国为 12.4%，澳大利亚为 11.3%（p=0.28）。
英国、澳大利亚和新西兰联合登记处中超过 50%的膝关节外科医生每年进行的 UKA 手术不到 5%。大多数经验丰富的膝关节外科医生没有达到建议的最低门槛，这可能表明建议的门槛对绝大多数膝关节外科医生来说是不可行的。这背后的原因需要进一步研究。
三级回顾性登记研究。
