2016 AOANJIRR Summary

[Pat Walter]

Original Complete 2016 AOANJIRR Report Here

Note by Patricia Walter:  This information is only for hip resurfacing in Australia.  Many experienced hip resurfacing surgeons have personal series of HR which are more positive than the results below.
Summary of 2016 AOANJIRR Report by Patricia Walter
PRIMARY TOTAL RESURFACING HIP REPLACEMENT
The Registry has recorded 8,895 total resurfacing hip replacement procedures in patients less than 55 years of age. In this age group, the use of primary total hip resurfacing as a proportion of primary total hip procedures, has declined from a peak of 30.2% in 2004 to 4.3% in 2015. There were 93.1% of patients who had a total resurfacing hip replacement performed for osteoarthritis, compared to 97.8 % for the older age groups. The cumulative percent revision at 15 years for total resurfacing hip replacement for patients less than 55 years of age with a primary diagnosis of osteoarthritis was 13.2% . There was a higher rate of revision for females and for head sizes less than 50mm in this younger age group.
There were 11 primary total resurfacing hip replacement prosthesis combinations recorded by the Registry in patients less than 55 years of age, used with 10 or more procedures. “There was a higher rate of revision for females and for head sizes less than 50mm in this younger age group.”
As the BHR and the Adept are the only resurfacing devices used in 2015, we have performed a separate analysis combining these two prostheses. The cumulative percent revision at 15 years for the BHR and Adept combined is 9.5% . Females had a higher rate of revision. At 10 years the cumulative percent revision for females is 14.5% compared to 3.7% for males.

[karlos.bell]

  Thanks Pat. Awesome. As you have expressed on the note "surgeons have their own studies" Just been fighting the system here in New Zealand  a bit due people are not skilled in "what a resurfaced hip is" due I would really like to get back into a job sometime. That has been massively hard after 8 years on crutches explaining now I can do 1/2 marathons.
Dr Koen De Smet who has done my bilateral coxa profunda or FAI hips has indicated to me this normally is a life time prosthesis.... and it will not wear out...... Now that is pretty powerful stuff indicating that it is not activity that wears out the joint from his experience.
Persons would have to write to him and his research team for his results. Be honest I am going to go with his  results / opinion and keep on having as normal life now as I can.
I reckon it is going to be 3 years for me to get back if at all normal strength in my hips due the FAI made major changes in which the new joints now have to rectify and rebuild tendons - muscles back to normal.
I am half way there!!!!!!!!!    cheers K

[John C]

Hi Pat, thanks for posting this. As you said, the compiled results from all Australian surgeons do not match up well against individual studies published by the top resurfacing specialist. This highlights what is often said on this forum; a person may be better served by looking at the published results of top resurfacing surgeons, rather than just looking at large studies that include results from many surgeons that do not specialize in resurfacing. After looking at the Australian results that you posted, I went to Dr Gross's web site for some comparisons. A few things stood out: 1. The Australian study shows a continuous steady increase in failures over the course of the study going out 14 years with the failure rate for patients less than 55 years of age showing a failure rate of 7% at seven years and 10% at ten years. Dr Gross's results with the Biomet uncemented implants level out after about two years, with the failure rate staying almost flat at about 1% out to eight years. 2. Like most studies, the Australian registry shows poor results with women, with a seven year revision rate of 9.2%, and a ten year rate of 14.5%. Since going to the uncemented device, and after devising a system for adjusting the cup angle for smaller sizes, Dr Gross now shows a revision rate of 2% for women at eight years.
Pat, as you have always said, a person considering a resurfacing should go to a top specialist in resurfacing. The Australian study shows once again that a large number of surgeons grouped into a large study will show results that are not nearly as good.
(P.S. I apologize that some of my comparison studies above are not always an exact match. It was difficult to find studies from both the Australian Registry and Dr Gross's web site that matched exactly for both duration and subjects, so I compared durations that were the closest.)