Long-term survivorship and results in lower limb arthroplasty: a registry-based comparison study

Abstract

Introduction: Popularity of joint replacement surgery due to ever aging population surges the demand for a proper national joint registry. Our Chinese University of Hong Kong - Prince of Wales Hospital (CUHK-PWH) joint registry has passed the 30^th year. The aims of this study are 1) summarize our territory-wide joint registry which has passed the 30th year since establishment and 2) compare our statistics with other major joint registries.

Methods: Part 1 was to review the CUHK-PWH registry. Demographic characteristics of our patients who underwent knee and hip replacements had been summarized. Part 2 was a series of comparisons with registries from Sweden, UK, Australia and New Zealand.

Results: CUHK-PWH registry captured 2889 primary total knee replacements (TKR) (110 (3.81%) revision) and 879 primary total hip replacements (THR) (107 (12.17%) revision). Median Surgery time of TKR was shorter than THR. Clinical outcome scores were much improved after surgery in both. Uncemented of hybrid in TKR were most popular in Australia (33.4%) and 40% in Sweden and UK. More than half of TKR and THR patients showed the highest percentage with ASA grade 2. New Zealand reflected the best cumulative percentage survival 20 years after surgery of 92.2%, 76.0%, 84.2% survivorship 20 years after TKR, unicompartmental knee replacement (UKR) and Hip.

Conclusion: A worldwide accepted patient-reported outcome measure (PROM) is recommended to develop to make comparisons among registries and studies feasible. Completeness of registry data is important and useful to improve surgical performance through data comparisons from different regions. Funding from government on sustaining registries is reflected. Registries from Asian countries have yet to be grown and reported.

Keywords: Arthroplasty; Hip; Joint Replacement; Knee; Patient reported outcome measures; Registries.

Fig. 1

Kaplan Meier (KM) curves of cumulative percentage of primary knee implant survival at 1^st, 5^th, 10^th, 15^th, and 20^th year

Fig. 2

Kaplan Meier (KM) curves of cumulative percentage of primary hip implant and patient survival rates at 1^st, 5^th, 10^th, 15^th, and 20^th year

Fig. 3

Mean age of the patients in the corresponding knee or hip registries

Fig. 4

Sex of the patients in the corresponding knee or hip registries

Fig. 5

Joint replacement surgeries (%)

Fig. 6

Cumulative percentage survival (%) corresponding to the number of years after primary joint replacement