Risk factors for early revision after total hip and knee arthroplasty: National observational study from a surgeon and population perspective

Autor: Mark Loeffler, Sunny Parikh, Alex Bottle, Paul Aylin
Přispěvatelé: National Institute for Health Research, Dr Foster Ltd
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Knee Joint
Arthroplasty
Replacement
Hip
medicine.medical_treatment
Knee replacement
Logistic regression
0302 clinical medicine
Risk Factors
Informed consent
Odds Ratio
LOST
Medicine
030212 general & internal medicine
Arthroplasty
Replacement
Knee
Child
Aged
80 and over
030222 orthopedics
education.field_of_study
Multidisciplinary
Middle Aged
PREVALENCE
Multidisciplinary Sciences
REPLACEMENT
England
Child
Preschool
Science & Technology - Other Topics
Female
BURDEN
Adult
Reoperation
medicine.medical_specialty
Adolescent
General Science & Technology
Joint replacement
Science
Population
UNITED-STATES
PATIENT CHARACTERISTICS
Young Adult
03 medical and health sciences
FAILURES
Humans
education
Aged
Surgeons
Science & Technology
business.industry
Infant
Newborn
Infant
Odds ratio
Arthroplasty
Physical therapy
Observational study
FOLLOW-UP
business
Zdroj: PLoS ONE, Vol 14, Iss 4, p e0214855 (2019)
ISSN: 1932-6203
Popis: AimsTo identify predictors of early revision (within 3 years of the index operation) for hip and knee replacement (HR, KR) from both surgeon and population perspectives.Patients and methodsHierarchical logistic regression on national administrative data for England for index procedures between April 2009 and March 2014.ResultsThere were 315,273 index HR procedures and 374,530 index KR procedures for analysis. Three-year revision rates were 2.1% for HR and 2.2% for KR. The highest odds ratios for HR were for 3+ previous emergency admissions, drug abuse, Parkinson's disease, resurfacing and ages under 60; for KR these were patellofemoral or partial joint replacement, 3+ previous emergency admissions, paralysis and ages under 60. Smaller effects were found for other comorbidities such as obesity (HR) and diabetes (KR). From a population perspective, the only population attributable fractions over 5% were for male gender, uncemented total hip replacements and partial knee or patellofemoral replacements.ConclusionsMeeting the rising demand for revision surgery is a challenge for healthcare leaders and policymakers. Our findings suggest optimising patients pre-operatively and improving patient selection for primary arthroplasty may reduce the burden of early revision of arthroplasty. Our study gives useful information on the additional risks of various comorbidities and procedures, which enables a more informed consent process.Clinical relevanceSurgeons should make patients with certain risk factors such as age and procedure type aware of their higher revision risk as part of shared decision-making.
Databáze: OpenAIRE
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