Sunday, August 14, 2011

Review of the 2010 Australian Joint Registry Results (1 of x)

This is the most recent study of the Australian joint registry results.  I reviewed the 2009 report so thought I would compare the results of interest to this years report.

1. Yearly cumulative percent revision of primary total conventional hip replacement by bearing surface with primary diagnosis listed as Osteo Arthritis. (I believe the high revision hips are handled outside this section.)


2009 report  (up to 12/2008) 8 years of  cumulative data: year 8
2010 report (up to 12 2009) 9 years of cumulative data: year 9
Number of hips in full report (revised and non revised)
159,706
171,104
Number of   conventional revisions only ?
 ?
 ?
Ceramic on ceramic
3.7%
4.3%
Ceramic on poly
4.3%
5.1%
Metal on metal
4.7%
7.7%
Metal on poly
3.7%
5.2%

2.  Femoral stems with exchangeable femoral necks have twice the risk of revision compared to other femoral stems.

3.  It is now clear that primary total conventional hip replacement using metal on metal bearing surface and head sizes over 28 mm have higher risk of revision compared to other bearing surfaces.

4.  Hip resurfacing procedures vs total hip replacement procedures continue to decline for the forth consecutive year.

5. Top two most used femoral components in primary THA (total hip artheroplasty):
  •  Stryker Exeter V40
  •  Depuy Corail
6.  Top two most used Acetabular components in primary THA:
  • Stryker Trident
  •  Depuy Pinnacle
  • (Depuy's ASR is ranked 10 just as an FYI)
7.  There are 1539 combinations of stems and cups for primary total conventional hip replacement which is 154 more than the 2009 report! 

8.  I have an interest in the Depuy Pinnacle revisions as this is the revision component recommended for me so the rates are as follows.



Revision rates @5 years from the 2009 report
Revision rates @5 years from the 2010 report
 Depuy Corail Pinnacle*
2.6%
2.9%
Depuy S-Rom Pinnacle
3.7%
3.7%
Depuy Summit Pinnacle
1.6%
2.0
Depuy Summit ASR (FYI)

7.1%


*First word above in the chart following depuy is the femoral component.  The word following the femoral component is the acetabular component.)

Another note on this chart:  In the 2009 report, the Depuy Corail ASR had a revision rate of 5.5% in 3 years while the summit ASR’s 3 year rate was 5.5%.  The Corail ASR 3 year rate in the 2010 report is 6.4% while the Summit ASR now has a 5 year rate above.  The ASR was the device recalled in 8/2010 which will likely show up in the 2011 report.
In the next post, I would like to review the 2010 results on the "higher than average revision rate hips".  I think they put this in an addendum this year vs the main report but will locate it and report on it next. 

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