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Journal article

Epidemiology of revision hip replacement surgery in the UK over the past 15 years—an analysis from the National Joint Registry

Abstract:
Objectives
To investigate trends in the incidence rate and main indication for revision hip replacement (rHR) over the past 15 years in the UK.
Design
Repeated national cross-sectional study from 2006 to 2020.
Setting/participants
rHR procedures were identified from the National Joint Registry for England, Wales, Northern Ireland, the Isle of Man and the States of Guernsey. Population statistics were obtained from the Office for National Statistics.
Main outcome measures
Crude incidence rates of rHR.
Results
The incidence rate of rHR doubled from 11 per 100 000 adults in 2006 (95% CI 10.7 to 11.3) to a peak of 22 per 100 000 adults (95% CI 22 to 23) in 2012, before falling to 17 per 100 000 adults in 2019 (95% CI 16 to 17) (24.5% decrease from peak). The incidence rate of rHR reduced by 39% in 2020 compared with 2019 (during the COVID-19 pandemic). The most frequent indications for rHR between 2006 and 2019 were loosening/lysis (27.8%), unexplained pain (15.1%) and dislocation/instability (14.7%). There were incremental increases in the annual number and incidence rates of rHR for fracture, infection, dislocation/instability and a decrease in rHR for aseptic loosening/lysis.
Conclusions
The incidence rate of rHR doubled from 2006 to 2012, likely due to high early failure rates of metal-on-metal hip replacements. The incidence of rHR then decreased by approximately 25% from 2012 to 2019, followed by a large decrease during the COVID-19 pandemic. The decrease in the number of rHR performed for aseptic loosening/lysis may reflect improved wear and implant longevity. Increased healthcare resource will be required to care for the increasing numbers of patients undergoing rHR for fracture and infection.
Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1136/bmjopen-2023-072462

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDORMS
Sub department:
Botnar Research Centre
Oxford college:
Wolfson College
Role:
Author
ORCID:
0000-0003-2401-1372


Publisher:
BMJ Publishing Group
Journal:
BMJ Open More from this journal
Volume:
13
Issue:
10
Article number:
e072462
Publication date:
2023-10-17
Acceptance date:
2023-09-19
DOI:
EISSN:
2044-6055


Language:
English
Keywords:
Pubs id:
1532599
Local pid:
pubs:1532599
Deposit date:
2023-09-19

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