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https://www.readbyqxmd.com/read/29706598/cost-effectiveness-of-unicompartmental-compared-with-total-knee-replacement-a-population-based-study-using-data-from-the-national-joint-registry-for-england-and-wales
#1
Edward Burn, Alexander D Liddle, Thomas W Hamilton, Andrew Judge, Hemant G Pandit, David W Murray, Rafael Pinedo-Villanueva
OBJECTIVES: To assess the value for money of unicompartmental knee replacement (UKR) compared with total knee replacement (TKR). DESIGN: A lifetime Markov model provided the framework for the analysis. SETTING: Data from the National Joint Registry (NJR) for England and Wales primarily informed the analysis. PARTICIPANTS: Propensity score matched patients in the NJR who received either a UKR or TKR. INTERVENTIONS: UKR is a less invasive alternative to TKR, where only the compartment affected by osteoarthritis is replaced...
April 29, 2018: BMJ Open
https://www.readbyqxmd.com/read/29529653/outcomes-after-metal-on-metal-hip-revision-surgery-depend-on-the-reason-for-failure-a-propensity-score-matched-study
#2
Gulraj S Matharu, Andrew Judge, David W Murray, Hemant G Pandit
BACKGROUND: Metal-on-metal hip replacement (MoMHR) revision surgery for adverse reactions to metal debris (ARMD) has been associated with an increased risk of early complications and reoperation and inferior patient-reported outcome scores compared with non-ARMD revisions. As a result, early revision specifically for ARMD with adoption of a lower surgical threshold has been widely recommended with the goal of improving the subsequent prognosis after ARMD revisions. However, no large cohorts have compared the risk of complications and reoperation after MoMHR revision surgery for ARMD (an unanticipated revision indication) with those after non-ARMD revisions (which represent conventional modes of arthroplasty revision)...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29406339/implications-of-introducing-new-technology-comparative-survivorship-modeling-of-metal-on-metal-hip-replacements-and-contemporary-alternatives-in-the-national-joint-registry
#3
Linda P Hunt, Michael R Whitehouse, Andrew Beswick, Martyn L Porter, Peter Howard, Ashley W Blom
BACKGROUND: New medical technologies are often used widely without adequate supporting data, a practice that can lead to widespread catastrophic failure such as occurred with metal-on-metal (MoM) hip replacements. We determined both how revision rates would have differed if, instead of receiving MoM hip replacements, patients had received existing alternatives and the subsequent cumulative re-revision rates of the patients who did receive MoM hip replacements compared with alternatives...
February 7, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29345170/cemented-total-hip-replacement-in-patients-under-55-years
#4
Manish Kiran, Linda R Johnston, Sankar Sripada, Gordon G Mcleod, Arpit C Jariwala
Background and purpose - About 86,000 total hip replacements (THR) have been registered in patients under 55 years in the National Joint Registry of England and Wales (NJR). The use of uncemented implants has increased, despite their outcomes not having been proven to be significantly better than cemented implants in this registry. We determined the implant survivorship and functional outcomes of cemented THR in patients under 55 years at a minimum follow-up of 22 years. Patients and methods - 104 hips in 100 patients were included in this prospective study...
January 18, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/28861196/patellofemoral-joint-arthroplasty-early-results-and-functional-outcome-of-the-zimmer-gender-solutions-patello-femoral-joint-system
#5
Donald Osarumwense, Farhan Syed, Obi Nzeako, Segun Akilapa, Omer Zubair, Jon Waite
BACKGROUND: Improved knee prosthesis designs have led to an increase in the use of patellofemoral arthroplasty as a primary treatment option in recent times. We report the early results and outcomes of the Zimmer Gender Solutions Patello-Femoral Joint (PFJ) system used to treat isolated patellofemoral osteoarthritis (PFA). METHODS: We retrospectively reviewed and analysed data of patients who underwent PFJ replacement (PFJR) at our institution with a minimum follow-up of 2 years...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28782448/risk-factors-associated-with-intraoperative-complications-in-primary-shoulder-arthroplasty
#6
MULTICENTER STUDY
Paul D Cowling, Philip Holland, Lucksy Kottam, Paul Baker, Amar Rangan
Background and purpose - Increasing numbers of shoulder arthroplasty are performed internationally. The predictors of intraoperative complications when implanting primary shoulder replacements are unknown. We determined the incidence of intraoperative complications during primary shoulder arthroplasty using the National Joint Registry of England, Wales, Northern Ireland and the Isle of Man (NJR), and analyzed the associated risk factors for complications. Patients and methods - NJR data on primary shoulder arthroplasty were scrutinized for intraoperative complications...
December 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28768778/which-factors-influence-the-rate-of-failure-following-metal-on-metal-hip-arthroplasty-revision-surgery-performed-for-adverse-reactions-to-metal-debris-an-analysis-from-the-national-joint-registry-for-england-and-wales
#7
MULTICENTER STUDY
G S Matharu, A Judge, H G Pandit, D W Murray
AIMS: To determine the outcomes following revision surgery of metal-on-metal hip arthroplasties (MoMHA) performed for adverse reactions to metal debris (ARMD), and to identify factors predictive of re-revision. PATIENTS AND METHODS: We performed a retrospective observational study using National Joint Registry (NJR) data on 2535 MoMHAs undergoing revision surgery for ARMD between 2008 and 2014. The outcomes studied following revision were intra-operative complications, mortality and re-revision surgery...
August 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28768777/ceramic-on-ceramic-bearing-fractures-in-total-hip-arthroplasty-an-analysis-of-data-from-the-national-joint-registry
#8
MULTICENTER STUDY
D P Howard, P D H Wall, M A Fernandez, H Parsons, P W Howard
AIMS: Ceramic-on-ceramic (CoC) bearings in total hip arthroplasty (THA) are commonly used, but concerns exist regarding ceramic fracture. This study aims to report the risk of revision for fracture of modern CoC bearings and identify factors that might influence this risk, using data from the National Joint Registry (NJR) for England, Wales, Northern Ireland and the Isle of Man. PATIENTS AND METHODS: We analysed data on 223 362 bearings from 111 681 primary CoC THAs and 182 linked revisions for bearing fracture recorded in the NJR...
August 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28642256/revision-for-prosthetic-joint-infection-following-hip-arthroplasty-evidence-from-the-national-joint-registry
#9
E Lenguerrand, M R Whitehouse, A D Beswick, S A Jones, M L Porter, A W Blom
OBJECTIVES: We used the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR) to investigate the risk of revision due to prosthetic joint infection (PJI) for patients undergoing primary and revision hip arthroplasty, the changes in risk over time, and the overall burden created by PJI. METHODS: We analysed revision total hip arthroplasties (THAs) performed due to a diagnosis of PJI and the linked index procedures recorded in the NJR between 2003 and 2014...
June 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28623650/the-incidence-of-dissociated-liners-in-4-751-consecutive-total-hip-arthroplasties-using-pinnacle-polyethylene-acetabular-liners
#10
Richard J Napier, Owen Diamond, Chris K J O'Neill, Seamus O'Brien, David E Beverland
INTRODUCTION: Acetabular liner dissociation is a complication exclusive to modular designs. We present a single surgeon series of 8 polyethylene liner dissociations with the Pinnacle Acetabular System (DePuy Orthopaedics) from over 4,750 cases. We also present a review of the literature and data from the UK National Joint Registry (NJR) on dissociation in total hip arthroplasty (THA). METHODS: The Pinnacle Acetabular System has been used exclusively by the senior author since April 2003, and to date 5,882 have been implanted (837 ceramic liners, 4,751 polyethylene liners (1,606 Enduron/3,145 Marathon) and 294 metal liners)...
November 21, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28589634/systematic-review-and-meta-analysis-of-the-role-of-metronidazole-in-post-haemorrhoidectomy-pain-relief
#11
REVIEW
N J R Lyons, J B Cornille, S Pathak, P Charters, I R Daniels, N J Smart
AIM: Conventional haemorrhoidectomy is still considered the reference standard for the management of severe or recurrent haemorrhoids. Pain is reported by patients to be the most common postoperative complication. Although the literature lacks a consensus on its effectiveness, metronidazole is often used to reduce postoperative pain. We have performed a meta-analysis of all randomized controlled trials (RCTs) that investigated the use of metronidazole for pain relief after haemorrhoidectomy...
September 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28405220/intraoperative-complications-during-revision-shoulder-arthroplasty-a-study-using-the-national-joint-registry-dataset
#12
Helen M Ingoe, Philip Holland, Paul Cowling, Lucksy Kottam, Paul N Baker, Amar Rangan
BACKGROUND: The surgical options for revision shoulder arthroplasty and the number of procedures performed are increasing. However, little is known about the risk factors for intraoperative complications associated with this complex surgery. METHODS: The National Joint Registry (NJR) is a surgeon reported database recording information on major joint replacements including revision shoulder arthroplasty. Using multivariable binary logistic regression modelling, we analyzed 1445 revision shoulder arthroplasties reported to the NJR between April 2012 and 2015...
April 2017: Shoulder & Elbow
https://www.readbyqxmd.com/read/28326404/comparing-contemporary-revision-burden-among-hip-and-knee-joint-replacement-registries
#13
Brian J McGrory, Caryn D Etkin, David G Lewallen
BACKGROUND: Hip and knee arthroplasties are common and successful procedures, however, success and durability are not guaranteed. The revision burden, defined as the ratio of implant revisions to the total number of arthroplasties in a specific period, is a measure of the steady state of arthroplasty success in a given registry. This study examines the hypothesis that revision burden would be similar among contemporary joint replacement registries and improving over time compared with historic controls...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28167869/bearings-in-hip-arthroplasty-joint-registries-vs-precision-medicine-review-article
#14
REVIEW
Mark J Pearson, Liam M Grover, Janet M Lord, Simon W Jones, Edward T Davis
BACKGROUND: Precision medicine has been adopted in a range of clinical settings where omics data have led to greater characterisation of disease and stratification of patients into subcategories of phenotypes and pathologies. However, in orthopaedics, precision medicine lags behind other disciplines such as cancer. Joint registries have now amassed a huge body of data pertaining to implant performance which can be broken down into performance statistics for different material types in different cohorts of patients...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/27802289/has-metal-on-metal-resurfacing-been-a-cost-effective-intervention-for-health-care-providers-a-registry-based-study
#15
Ruth Pulikottil-Jacob, Martin Connock, Ngianga-Bakwin Kandala, Hema Mistry, Amy Grove, Karoline Freeman, Matthew Costa, Paul Sutcliffe, Aileen Clarke
BACKGROUND: Total hip replacement for end stage arthritis of the hip is currently the most common elective surgical procedure. In 2007 about 7.5% of UK implants were metal-on-metal joint resurfacing (MoM RS) procedures. Due to poor revision performance and concerns about metal debris, the use of RS had declined by 2012 to about a 1% share of UK hip procedures. This study estimated the lifetime cost-effectiveness of metal-on-metal resurfacing (RS) procedures versus commonly employed total hip replacement (THR) methods...
2016: PloS One
https://www.readbyqxmd.com/read/27694588/the-influence-of-cemented-femoral-stem-choice-on-the-incidence-of-revision-for-periprosthetic-fracture-after-primary-total-hip-arthroplasty-an-analysis-of-national-joint-registry-data
#16
MULTICENTER STUDY
J Palan, M C Smith, P Gregg, S Mellon, A Kulkarni, K Tucker, A W Blom, D W Murray, H Pandit
AIMS: Periprosthetic fracture (PF) after primary total hip arthroplasty (THA) is an uncommon but potentially devastating complication. This study aims to investigate the influence of cemented stem designs on the risk of needing a revision for a PF. PATIENTS AND METHODS: We analysed data on 257 202 primary THAs with cemented stems and 390 linked first revisions for PF recorded in the National Joint Registry (NJR) of England, Wales and Northern Ireland to determine if a cemented femoral stem brand was associated with the risk of having revision for a PF after primary THA...
October 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27687918/does-laminar-airflow-make-a-difference-to-the-infection-rates-for-lower-limb-arthroplasty-a-study-using-the-national-joint-registry-and-local-surgical-site-infection-data-for-two-hospitals-with-and-without-laminar-airflow
#17
S Singh, S Reddy, Raj Shrivastava
This study compared the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR) data for total hip replacements (THRs) and total knee replacements (TKRs) from Hospital A [with laminar airflow (LAF)] and Hospital B (without LAF). These hospitals were originally managed by two different trusts that subsequently merged. Consequently, the theatres in Hospital A have always had LAF and those in Hospital B had only conventional ventilation systems. As this merger happened before the establishment of the NJR, it puts us in a unique position, enabling direct comparison of the revision rates for infected hip and knee replacements between the two hospitals that follow similar infection protocols...
February 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27329444/pulmonary-embolism-and-mortality-following-total-ankle-replacement-a-data-linkage-study-using-the-njr-data-set
#18
Razi Zaidi, Alexander MacGregor, Suzie Cro, Andy Goldberg
OBJECTIVE: To determine the mortality rate following total ankle replacement (TAR) and incidence of 90 day pulmonary embolism (PE) along with the associated risk factors. DESIGN: Data-linkage study of the UK National Joint Registry (NJR) data and Hospital Episodes Statistics (HES) database. Linkage was performed in a deterministic fashion. HES episodes 90 days after the index procedure were analysed for PE. Mortality data were obtained pertaining to all the index procedures from the NJR for analysis...
June 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27239301/improving-patient-reported-outcome-measures-proms-in-total-knee-replacement-by-changing-implant-and-preserving-the-infrapatella-fatpad-a-quality-improvement-project
#19
Thomas Partridge, Ian Carluke, Kevin Emmerson, Paul Partington, Mike Reed
Patient reported outcome measures (PROMs) were introduced in 2009 to allow patient perspectives to potentially influence change and improvement. In collaboration with the national joint registry (NJR), PROMs data has been examined on a national basis to compare surgical factors in total knee replacement (TKR). Initial results demonstrated there were statistically significant differences in Oxford Knee Score (OKS) when using different brands of implant. Preservation of the infrapatella fatpad (IFP) has also been shown improve outcomes...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27217286/quality-measures-for-total-ankle-replacement-30-day-readmission-and-reoperation-rates-within-1-year-of-surgery-a-data-linkage-study-using-the-njr-data-set
#20
Razi Zaidi, Alexander J Macgregor, Andy Goldberg
OBJECTIVE: To report on the rate of 30-day readmission and the rate of additional or revision surgery within 12 months following total ankle replacement (TAR). DESIGN: A data-linkage study of the UK National Joint Registry (NJR) data and Hospital Episodes Statistics (HES) database. These two databases were linked in a deterministic fashion. HES episodes 12 months following the index procedure were isolated and analysed. Logistic regression was used to model predictors of reoperation and revision for primary ankle replacement...
May 23, 2016: BMJ Open
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