The results of the Australian Joint Registry as summarised by Dr George Thomas,Consultant Orthopaedic Surgeon, St.Isabel Hopsital, Chennai and also Editor, Indian Journal of Medical Ethics
- It is now clear that primary total conventional hip replacement using metal on metal bearing surface and head sizes over 28mm have a higher risk of revision compared to all other bearing surfaces. The impact of head size is more apparent in head sizes greater than 32mm.
- The increased risk of revision of metal on metal bearing surface is due to higher rates of loosening and metal sensitivity. It is not age related. There is however an interaction between age and head size. The risk of revision for head sizes larger than 32mm is higher regardless of age and this risk is greater the younger the patient.
- The use of primary total resurfacing hip replacement has declined for the fourth consecutive year. There was a 17.6% reduction in primary total resurfacing procedures compared to 2008.
- Posterior stabilised primary total knees are revised more than minimally stabilised knees. The risk of revision in the first nine years is increased if the patella is not resurfaced and this risk is highest if a posterior stabilised prosthesis is used.
- The S-Rom/Duraloc combination has been used in 166 procedures and has a seven year cumulative percent revision of 6.9%. It has two and a half times the risk of revision compared to all other total conventional hip replacement (adj HR=2.46; 95%CI (1.54, 3.91), p<0.001). Seven of the 18 revisions were for loosening and six for lysis.
- The CLS/Trilogy combination and the Anca Fit femoral stem have been previously identified prostheses. This year’s analysis shows no significant difference in the revision rate compared to all other total conventional hip replacement (CLS/Trilogy adj HR=1.90; 95%CI (0.95, 3.80), p=0.070; Anca_Fit adj HR=1.84; 95%CI (0.96, 3.54), p=0.067).
see the whole report at