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Revision and complication rates in 654 Exeter total hip replacements, with a maximum follow-up of 20 years.

Franklin J, Robertsson O, Gestsson J, Lohmander LS, Ingvarsson T - BMC Musculoskelet Disord (2003)

Bottom Line: Information was gathered regarding the indication for primary surgery, the reason for revision if needed, as well as that of any complications.We have in this unique 2-20 year study of 654 THRs with no loss to follow-up for the patients, found revision rates that conform with the large Swedish THR registry.Complication rates in general are in agreement with that reported for other comparable patient groups, while infection rates appear lower.

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Affiliation: Department of Orthopedics, Central Hospital, 600 Akureyri, Iceland. Jonas.Franklin@skane.se

ABSTRACT

Background: Iceland's geographical isolation with a stable and small population gives a rare opportunity for follow-up studies of medical interventions. Total hip replacements (THR) have been done at FSA Central Hospital in Akureyri, Iceland since 1982 with the Exeter hip implant being in use from the beginning.

Methods: Hospital records for all patients operated on with THR between 1982 and the end of 1999 were reviewed and the patients were followed until the end of 2001. Information was gathered regarding the indication for primary surgery, the reason for revision if needed, as well as that of any complications. Survival statistics were used to calculate the cumulative revision rate.

Results: The mean age at primary THR was 68.4 years for males and 68.8 years for females. 654 primary THRs were done; of which 571 (87 %) were due to osteoarthritis. 37 of the primary arthroplasties had been revised before the end of year 2001.

Conclusion: We have in this unique 2-20 year study of 654 THRs with no loss to follow-up for the patients, found revision rates that conform with the large Swedish THR registry. Complication rates in general are in agreement with that reported for other comparable patient groups, while infection rates appear lower.

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Cumulative revision rate for the period between 1982 and 2000. Cumulative revision rate due to any cause of primary THR due to OA for operations done between 1982 and 2000. The shadowed area indicates the 95 % confidence interval. Curves were cut off when 40 patients remained for analysis.
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Figure 2: Cumulative revision rate for the period between 1982 and 2000. Cumulative revision rate due to any cause of primary THR due to OA for operations done between 1982 and 2000. The shadowed area indicates the 95 % confidence interval. Curves were cut off when 40 patients remained for analysis.

Mentions: Survival statistics for primary THR for OA using aseptic loosening as an endpoint show that for the whole period the revision rate after 10 years is 6 % and after 16 years 10 % (Fig. 1). For primary OA using all revisions as an endpoint the respective numbers are 8% at 10 years and 13% at 16 years (Fig. 2). After 1990 only the polished Exeter stem and all-poly cup was used and after 1990 modern cementing techniques were implemented. The 10 year survival for primary OA hips were 4% using aseptic loosening as an endpoint and 7% using all revisions as an endpoint. Cox regression comparing the 2 time periods (1982–1990 and 1991–2000) adjusting for gender and age showed no significant difference in risk of revision. The gender did not significantly affect the risk while the risk decreased with increasing age.


Revision and complication rates in 654 Exeter total hip replacements, with a maximum follow-up of 20 years.

Franklin J, Robertsson O, Gestsson J, Lohmander LS, Ingvarsson T - BMC Musculoskelet Disord (2003)

Cumulative revision rate for the period between 1982 and 2000. Cumulative revision rate due to any cause of primary THR due to OA for operations done between 1982 and 2000. The shadowed area indicates the 95 % confidence interval. Curves were cut off when 40 patients remained for analysis.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC153516&req=5

Figure 2: Cumulative revision rate for the period between 1982 and 2000. Cumulative revision rate due to any cause of primary THR due to OA for operations done between 1982 and 2000. The shadowed area indicates the 95 % confidence interval. Curves were cut off when 40 patients remained for analysis.
Mentions: Survival statistics for primary THR for OA using aseptic loosening as an endpoint show that for the whole period the revision rate after 10 years is 6 % and after 16 years 10 % (Fig. 1). For primary OA using all revisions as an endpoint the respective numbers are 8% at 10 years and 13% at 16 years (Fig. 2). After 1990 only the polished Exeter stem and all-poly cup was used and after 1990 modern cementing techniques were implemented. The 10 year survival for primary OA hips were 4% using aseptic loosening as an endpoint and 7% using all revisions as an endpoint. Cox regression comparing the 2 time periods (1982–1990 and 1991–2000) adjusting for gender and age showed no significant difference in risk of revision. The gender did not significantly affect the risk while the risk decreased with increasing age.

Bottom Line: Information was gathered regarding the indication for primary surgery, the reason for revision if needed, as well as that of any complications.We have in this unique 2-20 year study of 654 THRs with no loss to follow-up for the patients, found revision rates that conform with the large Swedish THR registry.Complication rates in general are in agreement with that reported for other comparable patient groups, while infection rates appear lower.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopedics, Central Hospital, 600 Akureyri, Iceland. Jonas.Franklin@skane.se

ABSTRACT

Background: Iceland's geographical isolation with a stable and small population gives a rare opportunity for follow-up studies of medical interventions. Total hip replacements (THR) have been done at FSA Central Hospital in Akureyri, Iceland since 1982 with the Exeter hip implant being in use from the beginning.

Methods: Hospital records for all patients operated on with THR between 1982 and the end of 1999 were reviewed and the patients were followed until the end of 2001. Information was gathered regarding the indication for primary surgery, the reason for revision if needed, as well as that of any complications. Survival statistics were used to calculate the cumulative revision rate.

Results: The mean age at primary THR was 68.4 years for males and 68.8 years for females. 654 primary THRs were done; of which 571 (87 %) were due to osteoarthritis. 37 of the primary arthroplasties had been revised before the end of year 2001.

Conclusion: We have in this unique 2-20 year study of 654 THRs with no loss to follow-up for the patients, found revision rates that conform with the large Swedish THR registry. Complication rates in general are in agreement with that reported for other comparable patient groups, while infection rates appear lower.

Show MeSH
Related in: MedlinePlus