Population-based 10-year cumulative revision risks after hip and knee arthroplasty for osteoarthritis to inform patients in clinical practice: a competing risk analysis from the Dutch Arthroplasty Register

Authors

  • Maaike G J Gademan Department of Orthopaedics, Leiden University Medical Center, Leiden; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden
  • Liza N Van Steenbergen Dutch Arthroplasty Register, ‘s Hertogenbosch
  • Suzanne C Cannegieter Department of Clinical Epidemiology, Leiden University Medical Center, Leiden
  • Rob G H H Nelissen Department of Orthopaedics, Leiden University Medical Center, Leiden
  • Perla J Marang-Van De Mheen Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands

DOI:

https://doi.org/10.1080/17453674.2021.1876998

Abstract

Background and purpose — A lifetime perspective on revision risks is needed for optimal timing of arthroplasty in osteoarthritis (OA) patients, weighing the benefit of total hip arthroplasty/total knee arthroplasty (THA/TKA) against the risk of revision, after which outcomes are less favorable. Therefore, we provide population-based 10-year cumulative revision risks stratified by joint, sex, fixation type, and age.

Patients and methods — Data from the Dutch Arthroplasty Register (LROI) was used. Primary THAs and TKAs for OA between 2007 and 2018 were included, except metal- on-metal prostheses or hybrid/reversed hybrid fixation. Revision surgery was defined as any change of 1 or more prosthesis components. The 10-year cumulative revision risks were calculated stratified by joint, age, sex, at primary arthro- plasty, and fixation type (cemented/uncemented), taking into account mortality as a competing risk. We estimated the percentage of potentially avoidable revisions assuming all OA patients aged < 75 received primary THA/TKA 5 years later while keeping age-specific 10-year revision risks constant.

Results — 214,638 primary THAs and 211,099 TKAs were included, of which 31% of THAs and 95% of TKAs were cemented. The 10-year cumulative revision risk varied between 1.6% and 13%, with higher risks in younger age categories. Delaying prosthesis placement by 5 years could potentially avoid 23 (3%) THA and 162 (17%) TKA revi- sions.

Interpretation — Cumulative 10- year revision risk varied considerably by age in both fixation groups, which may be communicated to patients and used to guide timing of surgery.

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Published

2021-01-22

How to Cite

Gademan, . M. G. J., Steenbergen , L. N. V., Cannegieter, S. C., Nelissen, R. G. H. H., & Mheen, P. J. M.-V. D. . . (2021). Population-based 10-year cumulative revision risks after hip and knee arthroplasty for osteoarthritis to inform patients in clinical practice: a competing risk analysis from the Dutch Arthroplasty Register. Acta Orthopaedica, 92(3), 280–284. https://doi.org/10.1080/17453674.2021.1876998