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
