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Title: Lifetime risk of revision hip replacement surgery in Australia remains low: A population-level analysis using national registry data.
Epworth Authors: de Steiger, Richard
Other Authors: Ackerman, Ilana
Busija, Ljoudmila
Lorimer, Michelle
Graves, Stephen
Keywords: Hip Replacement
Hip Arthoplasty
Revision Surgery
Surgical Workforce Planning
Resource Allocation
Metal-Related Pathology
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Jan-2021
Publisher: Wolters Kluwer
Abstract: Background: Well-validated data from arthroplasty registries provide an opportunity to understand contemporary use of revision hip replacement at a national level. Such information can underpin health-care resource allocation and surgical workforce planning. The purposes of the present study were to describe the demographic characteristics of patients managed with revision hip replacement surgery in Australia and to examine changes in the lifetime risk of revision hip replacement over a decade. Methods: Deidentified individual-level data on all revision hip replacement procedures performed in Australia from 2007 to 2017 were obtained from the Australian Orthopaedic Association National Joint Replacement Registry. Life tables and population data were sourced from the Australian Bureau of Statistics. The lifetime risk of revision surgery each year was estimated with use of a standardized approach, with separate calculations for males and females. Results: A total of 46,086 revision hip replacement procedures were performed from 2007 to 2017. The median age at the time of surgery was 72 years (interquartile range, 63 to 80 years). While loosening or lysis became less frequent reasons for revision over time (from 51% in 2007 to 28% in 2017), revision hip replacement for infection became increasingly common (from 14% in 2007 to 25% in 2017). Revisions for metal-related pathology peaked in 2011. Utilization rates were highest for males ≥80 years of age (127.9 procedures per 100,000 population in 2017). Although a small rise was evident in 2011 and 2012 (to 2.39% and 2.22%, respectively), the lifetime risk of revision hip replacement in females decreased from 1.90% (95% confidence interval [CI], 1.82% to 1.99%) in 2007 to 1.74% (95% CI, 1.66% to 1.82%) in 2017. A similar pattern was evident for males; the lifetime risk was 1.78% (95% CI, 1.69% to 1.86%) in 2007 and 1.57% (95% CI, 1.49% to 1.65%) in 2017. Conclusions: These data enable us to understand the epidemiology of revision hip replacement in Australia, including the shifting clinical indications for this procedure. At a population level, the lifetime risk of revision hip replacement remains low at <1 in 50 people in 2017. These methods can be utilized for population-level surveillance of revision burden and to enable between-country benchmarking.
DOI: 10.2106/JBJS.20.01235
PubMed URL:
ISSN: 0021-9355
Journal Title: Journal of Bone and Joint Surgery. American.
Type: Journal Article
Affiliated Organisations: School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia.
The University of Melbourne, Melbourne, Victoria, Australia.
Australian Orthopaedic Association National Joint Replacement Registry, Adelaide, South Australia, Australia.
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Musculoskeletal

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