2016 CELEBRATING 15 YEARS OF DATA REPORT NATIONAL JOINT REPLACEMENT REGISTRY. Metal and Ceramic Bearing Surface in Total Conventional Hip Arthroplasty

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1 NATIONAL JOINT REPLACEMENT REGISTRY Metal and Ceramic Bearing Surface in Total Conventional Hip Arthroplasty SUPPLEMENTARY REPORT 2016 CELEBRATING 15 YEARS OF DATA

2 Contents INTRODUCTION...3 Commencement Date of Hip and Knee Replacement by State/Territory...3 CERAMIC ON METAL OUTCOMES...4 METAL ON CERAMIC OUTCOMES...6 This supplementary report provides information on total conventional hip replacement performed with ceramic and metal bearing surfaces. There are two sections: the first covers procedures performed with ceramic heads on metal bearings, the second covers procedures performed with metal heads on ceramic bearings. Introduction All hip replacement procedures recorded by the Registry from the commencement date to the 31 December 2015 have been included in this report. The table below shows the commencement date for each state/territory. Implementation was completed nationally by mid The rates of revision, reasons for revision and types of revision for procedures using ceramic head on metal bearing are provided. The numbers of procedures using metal heads on ceramic bearings is very low, so only a summary is provided for this combination. COMMENCEMENT DATE OF HIP AND KNEE REPLACEMENT BY STATE/TERRITORY State/Territory Commencement Date South Australia September 1999 Queensland April 2000 Western Australia April 2000 Victoria July 2000 Tasmania September 2000 Northern Territory October 2000 Australian Capital Territory May 2001 New South Wales June aoa.org.au aoa.org.au 3

3 Ceramic on Metal Outcomes The Registry has information on 316 primary total conventional hip replacement procedures using ceramic head/metal bearings. All have been used with cementless acetabular components and the majority have been used with a head size of 36mm (82.3%). Table CM1 The rate of revision of ceramic head/metal bearing is not different from most other bearings when undertaken for osteoarthritis. The cumulative percent revision at seven years is 8.3% (Table CM1). Cumulative Percent Revision of Primary Total Conventional Hip Replacement using Bearing Surface (Primary Diagnosis OA) Bearing Surface N N Total 1 Yr 3 Yrs 5 Yrs 7 Yrs 10 Yrs 15 Yrs (0.7, 4.0) 3.7 (2.1, 6.6) 4.4 (2.6, 7.4) 8.3 (4.9, 13.9) TOTAL Figure CM1 Cumulative Percent Revision of Primary Total Conventional Hip Replacement using Bearing Surface (Primary Diagnosis OA) Cumulative Percent Revision 12% 10% 8% 6% 4% 2% 0% Years Since Primary Procedure at Risk 0 Yr 1 Yr 3 Yrs 5 Yrs 7 Yrs 10 Yrs 15 Yrs Table CM2 Primary Total Conventional Hip Replacement using Bearing Surface by Primary Diagnosis Total Conventional Primary Diagnosis N Col% Osteoarthritis Fractured Neck Of Femur Osteonecrosis Other Inflammatory Arthritis Rheumatoid Arthritis Developmental Dysplasia TOTAL Table CM4 Table CM3 of Revisions of Primary Total Conventional Hip Replacement using Bearing Surface by Year of Implant Year of Implant Total TOTAL Primary Total Conventional Hip Replacement using Bearing Surface by Reason for Revision Revision Diagnosis % Primaries % Revisions Loosening/Lysis Prosthesis Dislocation Fracture Infection Metal Related Pathology Malposition Pain N Revision N Primary 316 Table CM5 Primary Total Conventional Hip Replacement using Bearing Surface by Type of Revision Type of Revision % Primaries % Revisions Femoral Component Acetabular Component Head/Insert Minor Components THR (Femoral/Acetabular) Cement Spacer N Revision N Primary aoa.org.au aoa.org.au 5

4 Metal on Ceramic Outcomes List of Tables Metal head/ceramic bearing has only been used in a small number of procedures. The Registry has information on ten primary total Table MC1 conventional hip replacement using metal head/ceramic bearings. All have been used with cementless acetabular components. Cumulative Percent Revision of Primary Total Conventional Hip Replacement using Metal/Ceramic Bearing Surface (Primary Diagnosis OA) Bearing Surface N N Total 1 Yr 3 Yrs 5 Yrs 7 Yrs 10 Yrs 15 Yrs Metal/Ceramic (0.0, 0.0) 0.0 (0.0, 0.0) 0.0 (0.0, 0.0) 0.0 (0.0, 0.0) 0.0 (0.0, 0.0) TOTAL 0 10 CERAMIC ON METAL OUTCOMES... 4 Table CM1 CPR of Primary Total Conventional Hip Replacement using Bearing Surface (OA)... 4 Table CM2 Primary Total Conventional Hip Replacement using Bearing Surface by Primary Diagnosis... 5 Table CM3 of Revisions of Primary Total Conventional Hip using CoM Bearing Surface by Year of Implant... 5 Table CM4 Primary Total Conventional Hip Replacement using Bearing Surface by Reason for Revision... 5 Table CM5 Primary Total Conventional Hip Replacement using Bearing Surface by Type of Revision... 5 METAL ON CERAMIC OUTCOMES... 6 Table MC1 CPR of Primary Total Conventional Hip Replacement using Metal/Ceramic Bearing Surface (OA)... 6 Table MC2 Primary Total Conventional Hip Replacement using Metal/Ceramic Bearing Surface by Primary Diagnosis... 6 Table MC3 of Revisions of Primary Total Conventional Hip using MoC Bearing Surface by Year of Implant... 6 List of Figures Table MC2 Primary Total Conventional Hip Replacement using Metal/Ceramic Bearing Surface by Primary Diagnosis Table MC3 of Revisions of Primary Total Conventional Hip Replacement using Metal on Ceramic Bearing Surface by Year of Implant CERAMIC ON METAL OUTCOMES... 4 Figure CM1 CPR of Primary Total Conventional Hip Replacement using Bearing Surface (OA)... 4 METAL ON CERAMIC OUTCOMES... 6 Total Conventional Primary Diagnosis N Col% Osteoarthritis TOTAL Year of Implant Total TOTAL aoa.org.au aoa.org.au 7

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