OrthoCarolina Hip and Knee Center and Atrium Musculoskeletal Institute, Charlotte, North Carolina.
American Academy of Orthopedic Surgeons, Rosemount, Illinois.
J Arthroplasty. 2024 Sep;39(9S1):S46-S50. doi: 10.1016/j.arth.2024.02.055. Epub 2024 Feb 27.
In collaboration with the Orthopedic Data Evaluation Panel (ODEP), the American Joint Replacement Registry (AJRR) investigated the consistency of hip and knee arthroplasty survivorship results compared to the UK National Joint Registry (NJR).
A total of three primary knee devices and three primary hip devices were selected by AJRR and ODEP with known variation in performance. Implant manufacturers independently produced Kaplan Meier survivorship based on NJR data and submitted to ODEP for comparison. The AJRR mirrored the methodology, and results from both sources were stratified into three cohorts (all-age, < 65, and ≥ 65 years).
There were 42,671 AJRR and 60,439 NJR primary knee cases and 70,169 AJRR and 422,657 NJR primary total hip arthroplasty cases. For TKA, performance between the AJRR and NJR were consistent, showing similar trends for comparatively high and low performing devices. Both PS and CR devices showed statistical agreement in survivorship for all 3 cohorts. Unicompartmental comparison also showed statistical agreement for the Medicare cohort. The all-age and < 65-year-old cohorts showed similar trends and reached statistical agreement through 7 and 6 years. For total hip arthroplasty, performance between the AJRR and NJR were consistent, showing similar trends for comparatively high and low performing devices; 0.18% average difference in survivorship at final follow-up (8 years). One femoral device did not reach statistical agreement but showed only 0.61% difference in survivorship. The remaining acetabular and femoral devices reached statistical agreement in all-ages and through 7 and 8 years in the ≥ 65-year-old cohort.
AJRR and NJR performance trends and survivorship were similar across hip and knee arthroplasty with greatest consistency in the all-age and ≥ 65 cohorts. This focused comparison of survivorship showed encouraging results for reliability of patient outcomes in AJRR compared to the world's largest joint arthroplasty registry which has strong implications for global improvement in patient safety.
在美国关节置换登记处（AJRR）与骨科数据评估小组（ODEP）合作下，对髋关节和膝关节置换术的存活率结果与英国国家关节登记处（NJR）进行了比较。
AJRR 和 ODEP 共同选择了三种主要的膝关节假体和三种主要的髋关节假体，这些假体的性能存在明显差异。植入物制造商根据 NJR 数据独立制作 Kaplan-Meier 存活率，并提交给 ODEP 进行比较。AJRR 采用了相同的方法，来自两个来源的结果分为三个队列（所有年龄段、<65 岁和≥65 岁）。
AJRR 有 42671 例初次膝关节和 60439 例初次全膝关节置换术，NJR 有 60439 例初次膝关节和 422657 例初次全髋关节置换术。对于 TKA，AJRR 和 NJR 的表现一致，表现出高、低性能设备相似的趋势。PS 和 CR 设备在所有 3 个队列的生存率方面均具有统计学一致性。在 Medicare 队列中，单髁置换也具有统计学一致性。所有年龄段和<65 岁的队列显示出相似的趋势，并在 7 年和 6 年内达到统计学一致性。对于全髋关节置换术，AJRR 和 NJR 的表现一致，高、低性能设备的趋势相似；最终随访（8 年）时生存率平均差异为 0.18%。一种股骨假体未达到统计学一致性，但生存率仅相差 0.61%。其余髋臼和股骨假体在所有年龄段和≥65 岁的队列中均达到统计学一致性，且随访时间分别为 7 年和 8 年。
AJRR 和 NJR 在髋关节和膝关节置换术方面的表现趋势和生存率相似，在所有年龄段和≥65 岁的患者中一致性最强。对生存率的这种集中比较显示，AJRR 对患者结果的可靠性令人鼓舞，与世界上最大的关节置换登记处相比，这对全球提高患者安全性具有重要意义。
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