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Understanding the uptake of new hip replacement implants in the UK: a cohort study using data from the National Joint Registry for England and Wales

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@article{6aa816b485c44999b4946efb7a4de437,
title = "Understanding the uptake of new hip replacement implants in the UK: a cohort study using data from the National Joint Registry for England and Wales",
abstract = "Objectives Primary: describe uptake of new implant components (femoral stem or acetabular cup/shell) for total hip replacements (THRs) in the National Joint Registry for England and Wales (NJR). Secondary: compare the characteristics of: a) surgeons b) patients who used/received new rather than established components.Design Cohort of 618,393 primary THRs performed for osteoarthritis (±other indications) by 4,979 surgeons between 2008-2017 in England and Wales from the NJR. We described the uptake of new (first recorded use >2008, used within 5 years) stems/cups, and variation in uptake by surgeons (primary objectives). We explored surgeon-level and patient-level factors associated with use/receipt of new components with logistic regression models (secondary objectives). Outcomes Primary outcomes: total number of new cups/stems, proportion of operations using new versus established components. Secondary outcomes: odds of: a) a surgeon using a new cup/stem in a calendar-year, b) a patient receiving a new rather than established cup/stem.Results Sixty-eight new cups and 72 new stems were used in 47,606 primary THRs (7.7{\%}) by 2,005 surgeons (40.3{\%}) 2008-2017. Surgeons used a median of one new stem and cup (25{\%}-75{\%}=1-2 both, max=10 cups, max=8 stems). Surgeons performed a median total of 22 THRs (25{\%}-75{\%}=5-124, range=1-3,938) in the period 2008-2017. Surgeons used new stems in a median of 5.0{\%} (25{\%}-75{\%}=1.3-16.1{\%}) and new cups in a median of 9.4{\%} (25{\%}-75{\%}=2.8-26.7{\%}) of their THRs. Patients aged <55 years old versus those 55-80 had higher odds of receiving a new rather than established stem (OR=1.83, 95{\%}CI=1.73-1.93) and cup (OR=1.31, 95{\%}CI=1.25-1.37). Women had lower odds of receiving a new stem (OR=0.87, 95{\%}CI=0.84-0.90), higher odds of receiving a new cup (OR=1.06, 95{\%}CI=1.03-1.09).Conclusions Large numbers of new THR components have been introduced in the NJR since 2008. 40{\%} of surgeons have tried new components, with wide variation in how many types and frequency they have been used.",
keywords = "implant, joint replacement, national joint registry, orthopaedics, patient, surgeon",
author = "Penfold, {Chris M.} and Blom, {Ashley W.} and Adrian Sayers and Wilkinson, {J Mark} and Linda Hunt and Andrew Judge and Whitehouse, {Michael R.}",
year = "2019",
month = "11",
day = "25",
doi = "10.1136/bmjopen-2019-029572",
language = "English",
volume = "9",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "11",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - Understanding the uptake of new hip replacement implants in the UK

T2 - a cohort study using data from the National Joint Registry for England and Wales

AU - Penfold, Chris M.

AU - Blom, Ashley W.

AU - Sayers, Adrian

AU - Wilkinson, J Mark

AU - Hunt, Linda

AU - Judge, Andrew

AU - Whitehouse, Michael R.

PY - 2019/11/25

Y1 - 2019/11/25

N2 - Objectives Primary: describe uptake of new implant components (femoral stem or acetabular cup/shell) for total hip replacements (THRs) in the National Joint Registry for England and Wales (NJR). Secondary: compare the characteristics of: a) surgeons b) patients who used/received new rather than established components.Design Cohort of 618,393 primary THRs performed for osteoarthritis (±other indications) by 4,979 surgeons between 2008-2017 in England and Wales from the NJR. We described the uptake of new (first recorded use >2008, used within 5 years) stems/cups, and variation in uptake by surgeons (primary objectives). We explored surgeon-level and patient-level factors associated with use/receipt of new components with logistic regression models (secondary objectives). Outcomes Primary outcomes: total number of new cups/stems, proportion of operations using new versus established components. Secondary outcomes: odds of: a) a surgeon using a new cup/stem in a calendar-year, b) a patient receiving a new rather than established cup/stem.Results Sixty-eight new cups and 72 new stems were used in 47,606 primary THRs (7.7%) by 2,005 surgeons (40.3%) 2008-2017. Surgeons used a median of one new stem and cup (25%-75%=1-2 both, max=10 cups, max=8 stems). Surgeons performed a median total of 22 THRs (25%-75%=5-124, range=1-3,938) in the period 2008-2017. Surgeons used new stems in a median of 5.0% (25%-75%=1.3-16.1%) and new cups in a median of 9.4% (25%-75%=2.8-26.7%) of their THRs. Patients aged <55 years old versus those 55-80 had higher odds of receiving a new rather than established stem (OR=1.83, 95%CI=1.73-1.93) and cup (OR=1.31, 95%CI=1.25-1.37). Women had lower odds of receiving a new stem (OR=0.87, 95%CI=0.84-0.90), higher odds of receiving a new cup (OR=1.06, 95%CI=1.03-1.09).Conclusions Large numbers of new THR components have been introduced in the NJR since 2008. 40% of surgeons have tried new components, with wide variation in how many types and frequency they have been used.

AB - Objectives Primary: describe uptake of new implant components (femoral stem or acetabular cup/shell) for total hip replacements (THRs) in the National Joint Registry for England and Wales (NJR). Secondary: compare the characteristics of: a) surgeons b) patients who used/received new rather than established components.Design Cohort of 618,393 primary THRs performed for osteoarthritis (±other indications) by 4,979 surgeons between 2008-2017 in England and Wales from the NJR. We described the uptake of new (first recorded use >2008, used within 5 years) stems/cups, and variation in uptake by surgeons (primary objectives). We explored surgeon-level and patient-level factors associated with use/receipt of new components with logistic regression models (secondary objectives). Outcomes Primary outcomes: total number of new cups/stems, proportion of operations using new versus established components. Secondary outcomes: odds of: a) a surgeon using a new cup/stem in a calendar-year, b) a patient receiving a new rather than established cup/stem.Results Sixty-eight new cups and 72 new stems were used in 47,606 primary THRs (7.7%) by 2,005 surgeons (40.3%) 2008-2017. Surgeons used a median of one new stem and cup (25%-75%=1-2 both, max=10 cups, max=8 stems). Surgeons performed a median total of 22 THRs (25%-75%=5-124, range=1-3,938) in the period 2008-2017. Surgeons used new stems in a median of 5.0% (25%-75%=1.3-16.1%) and new cups in a median of 9.4% (25%-75%=2.8-26.7%) of their THRs. Patients aged <55 years old versus those 55-80 had higher odds of receiving a new rather than established stem (OR=1.83, 95%CI=1.73-1.93) and cup (OR=1.31, 95%CI=1.25-1.37). Women had lower odds of receiving a new stem (OR=0.87, 95%CI=0.84-0.90), higher odds of receiving a new cup (OR=1.06, 95%CI=1.03-1.09).Conclusions Large numbers of new THR components have been introduced in the NJR since 2008. 40% of surgeons have tried new components, with wide variation in how many types and frequency they have been used.

KW - implant

KW - joint replacement

KW - national joint registry

KW - orthopaedics

KW - patient

KW - surgeon

UR - http://www.scopus.com/inward/record.url?scp=85075660917&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2019-029572

DO - 10.1136/bmjopen-2019-029572

M3 - Article

C2 - 31772087

AN - SCOPUS:85075660917

VL - 9

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 11

M1 - e029572

ER -