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Setting benchmark revision rates for total hip replacement : analysis of registry evidence
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Kandala, Ngianga-Bakwin, Connock, M., Pulikottil-Jacob, Ruth, Sutcliffe, P. (Paul), Crowther, Michael, Grove, Amy L., Mistry, Hema and Clarke, Aileen (2015) Setting benchmark revision rates for total hip replacement : analysis of registry evidence. BMJ (Clinical research ed.), 350 . h756. doi:10.1136/bmj.h756
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Official URL: http://dx.doi.org/10.1136/bmj.h756
Abstract
Objective:
To compare 10 year revision rates for frequently used types of primary total hip replacement to inform setting of a new benchmark rate in England and Wales that will be of international relevance.
Design:
Retrospective cohort study.
Setting:
National Joint Registry.
Participants:
239 000 patient records.
Main outcome measures:
Revision rates for five frequently used types of total hip replacement that differed according to bearing surface and fixation mode, encompassing 62% of all primary total hip replacements in the National Joint Registry for England and Wales. Revision rates were compared using Kaplan-Meier and competing risks analyses, and five and 10 year rates were estimated using well fitting parametric models.
Results:
Estimated revision rates at 10 years were 4% or below for four of the five types of total hip replacement investigated. Rates differed little according to Kaplan-Meier or competing risks analysis, but differences between prosthesis types were more substantial. Cemented prostheses with ceramic-on-polyethylene bearing surfaces had the lowest revision rates (1.88-2.11% at 10 years depending on the method used), and cementless prostheses with ceramic-on-ceramic bearing surfaces had the highest revision rates (3.93-4.33%). Men were more likely to receive revision of total hip replacement than were women, and this difference was statistically significant for four of the five prosthesis types.
Conclusions:
Ten year revision rate estimates were all less than 5%, and in some instances considerably less. The results suggest that the current revision rate benchmark should be at least halved from 10% to less than 5% at 10 years. This has implications for benchmarks internationally.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RD Surgery | ||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Total hip replacement | ||||||
| Journal or Publication Title: | BMJ (Clinical research ed.) | ||||||
| Publisher: | BMJ Group | ||||||
| ISSN: | 0959-8138 | ||||||
| Official Date: | 9 March 2015 | ||||||
| Dates: |
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| Volume: | 350 | ||||||
| Article Number: | h756 | ||||||
| DOI: | 10.1136/bmj.h756 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access |
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