Arthroplasty registries around the world: valuable sources of hip implant revision risk data

National and regional arthroplasty registries have proliferated since the Swedish Knee Arthroplasty Register was started in 1975. Registry reports typically present implant-specific estimates of revision risk and patient- and technique-related factors that can inform clinical decision-making about implants and techniques. However, annual registry reports are long and it is difficult for clinicians to extract comparable revision risk data. Since implants may appear in multiple registry reports, it is even more difficult to gather relevant data for clinical decision-making about implant selection. The purpose of this paper is to briefly describe arthroplasty registry concepts, international registries around the world, US registries, and provide a parsimonious summary of total hip arthroplasty (THA) implant revision risk reports across registries.

Revision risk data for conventional stem/cup combinations reported by the Australian, R.I.P.O. (Italian), Finnish, and Danish registries are summarized here. These registries were selected because they presented 10-year data on revision risk by stem/cup combination. Four tables of revision risk are presented based on fixation: cemented, uncemented, hybrid, and reverse hybrid. Review of these tables show there is wide variation in revision risk across conventional THA implants. It also demonstrates that some cemented implants have better 10-year risk than the best uncemented implants.

Many arthroplasty registries prepare annual reports that include revision risk data for implants and they are posted on the registry websites. Arthroplasty surgeons should stay current with these registry reports on implant performance and potential outliers and keep them in mind when making implant decisions.