Download PDF
J Knee Surg 2021; 34(12): 1284-1295
DOI: 10.1055/s-0040-1708040
Original Article

Design, Construction, and Early Results of a Formal Local Revision Knee Arthroplasty Registry

Aravinthan Visvanathan
1   Department of Orthopaedics and Trauma Surgery, The Repatriation General Hospital Adelaide (RGH), Daw Park, South Australia, Australia
,
Christopher Wilson
1   Department of Orthopaedics and Trauma Surgery, The Repatriation General Hospital Adelaide (RGH), Daw Park, South Australia, Australia
,
Emma Jackman
2   Department of Orthopaedics, Flinders University Adelaide, Bedford Park, South Australia, Australia
,
Geraldine Wong
2   Department of Orthopaedics, Flinders University Adelaide, Bedford Park, South Australia, Australia
,
Jegan Krishnan
1   Department of Orthopaedics and Trauma Surgery, The Repatriation General Hospital Adelaide (RGH), Daw Park, South Australia, Australia
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

National registries for primary and revision knee arthroplasty in Australia, New Zealand, and Europe have been successful in ensuring quality control and providing information to drive crucial research. However, they face challenges in delivering the granularity of data useful at a local hospital level. Our aim was to address these challenges by designing and initiating a local revision knee arthroplasty registry and combining the data with national figures to better evaluate the types of revisions undertaken, and improve patient outcomes and care. All revision knee arthroplasty cases in our center were analyzed from April 2014 to December 2015 using our standardized diagnostic algorithm. Information such as reason and type of revision was collected. Results were compared with Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) data. Primary outcome was comparison against our center's historical data between January 1999 and December 2013 and secondary outcome was comparison against national data prior to and after our intervention. Between April 2014 and December 2015, our center performed 35 revision knee arthroplasties. When compared with our center's historical data, we observed lower rates of revision knee arthroplasties due to “pain” (14.2 vs. 36.7%) with corresponding lower rates of patella button only revision (8.6 vs. 39.2%). Compared with national data before our intervention, we had lower revision rates from infection (14.2 vs. 22.3%) and loosening/lysis (11.4 vs. 29.2%). We undertook more minor revisions (45.7 vs. 30.5%) and similar total revisions (25.7 vs. 25.3%). Similar trends were seen in comparison to national data after our intervention. Our study shows that a local registry can be designed and successfully implemented for revision knee arthroplasty surgery. Data can be easily compared with historic and current hospital and national registry data trends to assess quality and robustness of revision arthroplasty programs. Our early results suggest our center has succeeded in reducing incidences of major revisions, complications, and the risk of re-revision surgery. This will improve the quality of our service with a significant cost reduction for our local health care budget.

Keywords

revision - registry - knee - arthroplasty


Publication History

Received: 11 June 2018

Accepted: 23 January 2020

Article published online:
15 April 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Graves SE, Davidson D, Ingerson L. et al. The Australian Orthopaedic Association National Joint Replacement Registry. Med J Aust 2004; 180 (S5, Suppl): S31-S34
    CrossrefPubMedGoogle Scholar
  • 2 Huang T, Wang W, George D, Mao X, Graves S. What can we learn from AOANJRR 2014 annual report?. Ann Transl Med 2015; 3 (10) 131
    PubMedGoogle Scholar
  • 3 Ahn H, Court-Brown CM, McQueen MM, Schemitsch EH. The use of hospital registries in orthopaedic surgery. J Bone Joint Surg Am 2009; 91 (suppl 3): 68-72
    CrossrefPubMedGoogle Scholar
  • 4 Mont MA, Elmallah RK, Cherian JJ. The value of national and hospital registries. Am J Orthop 2015; 44 (04) 160-162
    PubMedGoogle Scholar
  • 5 Australian Orthopaedic Association; . National Joint Replacement Registry. Annual Report. Adelaide: AOA; 2014
  • 6 Australian Orthopaedic Association; . National Joint Replacement Registry. Annual Report. Adelaide: AOA; 2015
  • 7 Graves SE. . AOANJRR Ad Hoc Report 1667; 2015
  • 8 Nichols CI, Vose JG. Clinical outcomes and costs within 90 days of primary or revision total joint arthroplasty. J Arthroplasty 2016; 31 (07) 1400-1406.e3
    CrossrefPubMedGoogle Scholar
  • 9 Australian Orthopaedic Association. National Joint Replacement Registry. Revision Hip and Knee Arthroplasty Supplementary Report. Adelaide: AOA; 2015
  • 10 Gunst S, Fessy M-H. The effect of obesity on mechanical failure after total knee arthroplasty. Ann Transl Med 2015; 3 (20) 310
    PubMedGoogle Scholar
  • 11 Wilson CJ, Theodoulou A, Damarell RA, Krishnan J. Knee instability as the primary cause of failure following total knee arthroplasty (TKA): a systematic review on the patient, surgical and implant characteristics of revised TKA patients. Knee 2017; 24 (06) 1271-1281
    CrossrefPubMedGoogle Scholar
  • 12 Pugely AJ, Martin CT, Harwood J, Ong KL, Bozic KJ, Callaghan JJ. Database and registry research in orthopaedic surgery: part 2: clinical registry data. J Bone Joint Surg Am 2015; 97 (21) 1799-1808
    CrossrefPubMedGoogle Scholar