Researchers from the Royal College of Surgeons have just published a study regarding hip and knee replacements, finding that one in 75 patients needed a revision of their prosthesis within three years.

The study, published in PLoS Medicine, reviewed records from the National Joint Registry in England and Wales-the largest national joint registry in the world. The registry covers the patient data, type of prostheses and surgical technique used. Jan van der Meulen and colleagues analyzed the data from April 2003 and September 2006, to compare patient outcomes following hip or knee replacement with the different types of techniques and prostheses available.

Successful hip replacements have been performed since the 1960s and knees since the 1970s, and are some of the most frequently performed surgeries. Conditions such as severe arthritis can be alleviated by either an artificial joint, or by resurfacing. In resurfacing, the diseased surfaces are replaced with metal components, rather than the entire joint, and offer quicker recovery. The techniques for hip and knee replacement can use cement to position the metal implant into the bone (cemented) or without cement (cementless).
The one in 75 revision rate of joint replacement is considered low, and cemented hip or knee prosthesis had the lowest revision rates. Post hip replacement, the highest revision rate was with patients who had undergone hip resurfacing, particularly women. For patients who underwent knee replacement, the highest revision rate was with those who had unicondylar prosthesis.

The authors of the study suggest that consideration should be given to using hip resurfacing only in male patients and unicondylar knee replacement only in elderly patients. Due to the fact the study was observational and the data had substantial differences in patient age and clinical characteristics, different data may surface after a longer follow-up and conclusions are tentative. The study does establish important benchmark data to use for future evaluations.

Citation: Sibanda N, Copley LP, Lewsey JD, Borroff M, Gregg P, et al. (2008) Revision rates after primary hip and knee replacement in England between 2003 and 2006. PLoS Med 5(8): e179. doi:10.1371/journal.pmed.0050179

Read the study.

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