School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
South Australian Health and Medical Research Institute, Adelaide, Australia.
Bone Joint J. 2022 May;104-B(5):613-619. doi: 10.1302/0301-620X.104B5.BJJ-2021-1219.R1.
This study aimed to describe the use of revision knee arthroplasty in Australia and examine changes in lifetime risk over a decade.
De-identified individual-level data on all revision knee arthroplasties performed in Australia from 2007 to 2017 were obtained from the Australian Orthopaedic Association National Joint Replacement Registry. Population data and life tables were obtained from the Australian Bureau of Statistics. The lifetime risk of revision surgery was calculated for each year using a standardized formula. Separate calculations were undertaken for males and females.
In total, 43,188 revision knee arthroplasty procedures were performed in Australia during the study period, with a median age at surgery of 69 years (interquartile range (IQR) 62 to 76). In 2017, revision knee arthroplasty rates were highest for males aged 70 to 79 years (102.9 procedures per 100,000 population). Lifetime risk of revision knee arthroplasty for females increased slightly from 1.61% (95% confidence interval (CI) 1.53% to 1.69%) in 2007 to 2.22% (95% CI 2.13% to 2.31%) in 2017. A similar pattern was evident for males, with a lifetime risk of 1.43% (95% CI 1.36% to 1.51%) in 2007 and 2.02% (95% CI 1.93% to 2.11%) in 2017. A decline in procedures performed for loosening/lysis (from 41% in 2007 to 24% in 2017) and pain (from 14% to 9%) was evident, while infection became an increasingly common indication (from 19% in 2007 to 29% in 2017).
Well-validated national registry data can help us understand the epidemiology of revision knee arthroplasty, including changing clinical indications. Despite a small increase over a decade, the lifetime risk of revision knee arthroplasty in Australia is low at one in 45 females and one in 50 males. These methods offer a population-level approach to quantifying revision burden that can be used for ongoing national surveillance and between-country comparisons. Cite this article: 2022;104-B(5):613-619.
本研究旨在描述澳大利亚翻修膝关节置换术的应用情况，并在十年间探讨终生风险的变化。
从澳大利亚矫形协会国家关节置换登记处获取了 2007 年至 2017 年期间澳大利亚所有翻修膝关节置换术的去识别个体水平数据。人口数据和生命表来自澳大利亚统计局。使用标准化公式为每年计算翻修手术的终生风险。分别为男性和女性进行单独的计算。
研究期间，澳大利亚共进行了 43188 例翻修膝关节置换术，手术中位年龄为 69 岁（四分位间距（IQR）62 至 76）。2017 年，70 至 79 岁男性翻修膝关节置换术率最高（每 10 万人中有 102.9 例）。女性翻修膝关节置换术的终生风险从 2007 年的 1.61%（95%置信区间（CI）1.53%至 1.69%）略有增加到 2017 年的 2.22%（95%CI 2.13%至 2.31%）。男性也呈现出类似的模式，2007 年的终生风险为 1.43%（95%CI 1.36%至 1.51%），2017 年为 2.02%（95%CI 1.93%至 2.11%）。可见，松动/松解（从 2007 年的 41%降至 2017 年的 24%）和疼痛（从 14%降至 9%）的手术数量减少，而感染成为越来越常见的适应证（从 2007 年的 19%升至 2017 年的 29%）。
经过充分验证的全国登记处数据可帮助我们了解翻修膝关节置换术的流行病学，包括不断变化的临床适应证。尽管在十年间略有增加，但澳大利亚女性翻修膝关节置换术的终生风险为每 45 人中有 1 人，男性为每 50 人中有 1 人，风险仍然较低。这些方法提供了一种基于人群的量化翻修负担的方法，可用于持续的国家监测和国家间比较。
2022；104-B（5）：613-619。
