Epidemiology of revision hip replacement surgery in the UK over the past 15 years—an analysis from the National Joint Registry

<strong>Objectives <br></strong>To investigate trends in the incidence rate and main indication for revision hip replacement (rHR) over the past 15 years in the UK. <br><strong> Design <br></strong>Repeated national cross-sectional study from 2006 to 2020. &...

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Main Authors: Sabah, S, Knight, R, Nicolson, P, Taylor, A, Kendrick, B, Alvand, A, Petrou, S, Beard, D, Price, A, Palmer, A
פורמט: Journal article
שפה:English
יצא לאור: BMJ Publishing Group 2023
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author Sabah, S
Knight, R
Nicolson, P
Taylor, A
Kendrick, B
Alvand, A
Petrou, S
Beard, D
Price, A
Palmer, A
author_facet Sabah, S
Knight, R
Nicolson, P
Taylor, A
Kendrick, B
Alvand, A
Petrou, S
Beard, D
Price, A
Palmer, A
author_sort Sabah, S
collection OXFORD
description <strong>Objectives <br></strong>To investigate trends in the incidence rate and main indication for revision hip replacement (rHR) over the past 15 years in the UK. <br><strong> Design <br></strong>Repeated national cross-sectional study from 2006 to 2020. <br><strong> Setting/participants <br></strong>rHR procedures were identified from the National Joint Registry for England, Wales, Northern Ireland, the Isle of Man and the States of Guernsey. Population statistics were obtained from the Office for National Statistics. <br><strong> Main outcome measures <br></strong>Crude incidence rates of rHR. <br><strong> Results<br></strong> The incidence rate of rHR doubled from 11 per 100 000 adults in 2006 (95% CI 10.7 to 11.3) to a peak of 22 per 100 000 adults (95% CI 22 to 23) in 2012, before falling to 17 per 100 000 adults in 2019 (95% CI 16 to 17) (24.5% decrease from peak). The incidence rate of rHR reduced by 39% in 2020 compared with 2019 (during the COVID-19 pandemic). The most frequent indications for rHR between 2006 and 2019 were loosening/lysis (27.8%), unexplained pain (15.1%) and dislocation/instability (14.7%). There were incremental increases in the annual number and incidence rates of rHR for fracture, infection, dislocation/instability and a decrease in rHR for aseptic loosening/lysis. <br><strong> Conclusions <br></strong>The incidence rate of rHR doubled from 2006 to 2012, likely due to high early failure rates of metal-on-metal hip replacements. The incidence of rHR then decreased by approximately 25% from 2012 to 2019, followed by a large decrease during the COVID-19 pandemic. The decrease in the number of rHR performed for aseptic loosening/lysis may reflect improved wear and implant longevity. Increased healthcare resource will be required to care for the increasing numbers of patients undergoing rHR for fracture and infection.
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spelling oxford-uuid:d8f5e18a-91aa-4d51-b51d-130d2ca957be2024-03-05T18:02:58ZEpidemiology of revision hip replacement surgery in the UK over the past 15 years—an analysis from the National Joint RegistryJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:d8f5e18a-91aa-4d51-b51d-130d2ca957beEnglishSymplectic ElementsBMJ Publishing Group2023Sabah, SKnight, RNicolson, PTaylor, AKendrick, BAlvand, APetrou, SBeard, DPrice, APalmer, A<strong>Objectives <br></strong>To investigate trends in the incidence rate and main indication for revision hip replacement (rHR) over the past 15 years in the UK. <br><strong> Design <br></strong>Repeated national cross-sectional study from 2006 to 2020. <br><strong> Setting/participants <br></strong>rHR procedures were identified from the National Joint Registry for England, Wales, Northern Ireland, the Isle of Man and the States of Guernsey. Population statistics were obtained from the Office for National Statistics. <br><strong> Main outcome measures <br></strong>Crude incidence rates of rHR. <br><strong> Results<br></strong> The incidence rate of rHR doubled from 11 per 100 000 adults in 2006 (95% CI 10.7 to 11.3) to a peak of 22 per 100 000 adults (95% CI 22 to 23) in 2012, before falling to 17 per 100 000 adults in 2019 (95% CI 16 to 17) (24.5% decrease from peak). The incidence rate of rHR reduced by 39% in 2020 compared with 2019 (during the COVID-19 pandemic). The most frequent indications for rHR between 2006 and 2019 were loosening/lysis (27.8%), unexplained pain (15.1%) and dislocation/instability (14.7%). There were incremental increases in the annual number and incidence rates of rHR for fracture, infection, dislocation/instability and a decrease in rHR for aseptic loosening/lysis. <br><strong> Conclusions <br></strong>The incidence rate of rHR doubled from 2006 to 2012, likely due to high early failure rates of metal-on-metal hip replacements. The incidence of rHR then decreased by approximately 25% from 2012 to 2019, followed by a large decrease during the COVID-19 pandemic. The decrease in the number of rHR performed for aseptic loosening/lysis may reflect improved wear and implant longevity. Increased healthcare resource will be required to care for the increasing numbers of patients undergoing rHR for fracture and infection.
spellingShingle Sabah, S
Knight, R
Nicolson, P
Taylor, A
Kendrick, B
Alvand, A
Petrou, S
Beard, D
Price, A
Palmer, A
Epidemiology of revision hip replacement surgery in the UK over the past 15 years—an analysis from the National Joint Registry
title Epidemiology of revision hip replacement surgery in the UK over the past 15 years—an analysis from the National Joint Registry
title_full Epidemiology of revision hip replacement surgery in the UK over the past 15 years—an analysis from the National Joint Registry
title_fullStr Epidemiology of revision hip replacement surgery in the UK over the past 15 years—an analysis from the National Joint Registry
title_full_unstemmed Epidemiology of revision hip replacement surgery in the UK over the past 15 years—an analysis from the National Joint Registry
title_short Epidemiology of revision hip replacement surgery in the UK over the past 15 years—an analysis from the National Joint Registry
title_sort epidemiology of revision hip replacement surgery in the uk over the past 15 years an analysis from the national joint registry
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