Are Joint Replacement Registries Associated with Burden of Revision Changes? A Real-world Panel Data Regression Analysis

Overview

Journal BMJ Open

Specialty General Medicine

Date 2023 Jan 13

PMID 36639213

Authors

Charles Ebuka Okafor

Son Nghiem

Joshua Byrnes

Affiliations

Soon will be listed here.

Abstract

Objectives: The association of joint replacement registries with outcomes such as revision burden is uncertain. This study aimed to evaluate whether joint replacement registries are associated with the burden of revision changes while controlling for confounders that could affect the association.

Design: A longitudinal study involving a combination of cross-sectional and time series data from 1980 to 2018. The study was a panel regression analysis using the difference-in-difference method.

Setting: Data from countries with joint replacement registries and countries without joint replacement registries were used. Registry data were obtained from joint replacement registries' annual reports, while non-registry data were obtained from each included country's pooled hospitals' annual revision burden reported in the literature.

Outcome Measures: Changes in revision burden from 1980 to 2018 was the outcome measure. The revision burden in the registry periods of registry countries was compared with the non-registry periods of registry and non-registry countries.

Results: Data were obtained from 12 registry periods and 8 non-registry periods. The average difference in revision burden in the registry periods of registry countries relative to the non-registry periods of registry and non-registry countries was statistically significant for hip, -3.80 (95% CI (-2.50 to -5.10); p<0.001) percentage points and knee, -1.63 (95% CI (-1.00 to -2.30); p<0.001) percentage points. This translates to a 19.30%, and 21.85% reduction in revision burden for hip and knee registries, for the whole sampling period.

Conclusion: Joint replacement registries are associated with a significant reduction in the burden of revision. Although revision burden reduces over time even without the registries, the establishment of joint replacement registries is associated with an increased reduction. The establishment of joint replacement registries in non-registry countries would be a worthwhile decision as it will further improve the outcomes of arthroplasty surgeries.

Citing Articles

Arthroplasty registries at a glance: an initiative of the International Society of Arthroplasty Registries (ISAR) to facilitate access, understanding, and reporting of registry data from an international perspective.

Lubbeke A, Hoogervorst L, Marang-van de Mheen P, Prentice H, Rolfson O, Nelissen R Acta Orthop. 2025; 96:116-126.

PMID: 39881617 PMC: 11760185. DOI: 10.2340/17453674.2024.42706.

Thumb Arthroplasty as Reliable Long-term Solution for Trapeziometacarpal Osteoarthritis: A Minimum of 15 Years of Follow-up.

Van Geel P, Decramer A, Top A, Muermans S, Ryckaert T, Vanmierlo B Hand (N Y). 2024; :15589447241233367.

PMID: 38389259 PMC: 11571489. DOI: 10.1177/15589447241233367.

References

Poon P, Rennie J, Gray D . Review of total hip replacement. The Middlemore Hospital experience, 1980-1991. N Z Med J. 2001; 114(1133):254-6. View

Kumar A, Tsai W, Tan T, Kung P, Chiu L, Ku M . Temporal trends in primary and revision total knee and hip replacement in Taiwan. J Chin Med Assoc. 2015; 78(9):538-44. PMC: 7105048. DOI: 10.1016/j.jcma.2015.06.005. View

Kurtz S, Mowat F, Ong K, Chan N, Lau E, Halpern M . Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am. 2005; 87(7):1487-97. DOI: 10.2106/JBJS.D.02441. View

Ceyhan E, Gursoy S, Akkaya M, Ugurlu M, Koksal I, Bozkurt M . Toward the Turkish National Registry System: A Prevalence Study of Total Knee Arthroplasty in Turkey. J Arthroplasty. 2016; 31(9):1878-84. DOI: 10.1016/j.arth.2016.02.033. View

Pabinger C, Berghold A, Boehler N, Labek G . Revision rates after knee replacement. Cumulative results from worldwide clinical studies versus joint registers. Osteoarthritis Cartilage. 2012; 21(2):263-8. DOI: 10.1016/j.joca.2012.11.014. View

Guerrero-Luduena R, Comas M, Espallargues M, Coll M, Pons M, Sabates S . Predicting the Burden of Revision Knee Arthroplasty: Simulation of a 20-Year Horizon. Value Health. 2016; 19(5):680-7. DOI: 10.1016/j.jval.2016.02.018. View

Giesinger J, Giesinger K, Federico B, Howie C, Hamilton D . Differences in case mix and outcomes between Swiss and Scottish total knee arthroplasty patients. Knee Surg Sports Traumatol Arthrosc. 2019; 28(6):1797-1804. DOI: 10.1007/s00167-019-05597-x. View

Leitner L, Turk S, Heidinger M, Stockl B, Posch F, Maurer-Ertl W . Trends and Economic Impact of Hip and Knee Arthroplasty in Central Europe: Findings from the Austrian National Database. Sci Rep. 2018; 8(1):4707. PMC: 5856851. DOI: 10.1038/s41598-018-23266-w. View

Ingvarsson T, Hagglund G, Jonsson Jr H, Lohmander L . Incidence of total hip replacement for primary osteoarthrosis in Iceland 1982-1996. Acta Orthop Scand. 1999; 70(3):229-33. DOI: 10.3109/17453679908997798. View

10.

Villanueva-Martinez M, Hernandez-Barrera V, Chana-Rodriguez F, Rojo-Manaute J, Rios-Luna A, San Roman Montero J . Trends in incidence and outcomes of revision total hip arthroplasty in Spain: a population based study. BMC Musculoskelet Disord. 2012; 13:37. PMC: 3349558. DOI: 10.1186/1471-2474-13-37. View

11.

Torre M, Romanini E, Zanoli G, Carrani E, Luzi I, Leone L . Monitoring Outcome of Joint Arthroplasty in Italy: Implementation of the National Registry. Joints. 2017; 5(2):70-78. PMC: 5672872. DOI: 10.1055/s-0037-1603899. View

12.

Yoon P, Lee Y, Ahn J, Jang E, Kim Y, Kwak H . Epidemiology of hip replacements in Korea from 2007 to 2011. J Korean Med Sci. 2014; 29(6):852-8. PMC: 4055821. DOI: 10.3346/jkms.2014.29.6.852. View

13.

Koh I, Kim T, Chang C, Cho H, In Y . Trends in use of total knee arthroplasty in Korea from 2001 to 2010. Clin Orthop Relat Res. 2012; 471(5):1441-50. PMC: 3613551. DOI: 10.1007/s11999-012-2622-y. View

14.

Kurtz S, Ong K, Lau E, Widmer M, Maravic M, Gomez-Barrena E . International survey of primary and revision total knee replacement. Int Orthop. 2011; 35(12):1783-9. PMC: 3224613. DOI: 10.1007/s00264-011-1235-5. View

15.

de Carvalho R, Cante J, Lima J, Tavares L, Takano M, Tavares F . Prevalence of knee arthroplasty in the state of São Paulo between 2003 and 2010. Sao Paulo Med J. 2016; 134(5):417-422. PMC: 10871848. DOI: 10.1590/1516-3180.2016.0111300616. View

16.

Wengler A, Nimptsch U, Mansky T . Hip and knee replacement in Germany and the USA: analysis of individual inpatient data from German and US hospitals for the years 2005 to 2011. Dtsch Arztebl Int. 2014; 111(23-24):407-16. PMC: 4078223. DOI: 10.3238/arztebl.2014.0407. View

17.

Dixon T, Shaw M, Ebrahim S, Dieppe P . Trends in hip and knee joint replacement: socioeconomic inequalities and projections of need. Ann Rheum Dis. 2004; 63(7):825-30. PMC: 1755069. DOI: 10.1136/ard.2003.012724. View