1

Valdoltra Knee Arthroplasty Registry 2002 - 2013

Vesna Levašič

Ingrid Milošev

18th December 2015

2

Primary Hip vs. Primary Knee Joint Replacement

67

122 133 156 162 173

231

349

418 460

583

679 722

767

845

719 734

649 635 673 664

686 724

799

913 908

1041

925 931

852

929 946

883

833

0

200

400

600

800

1000

1200

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

KOLENA KOLKI

3

Total and Partial Knee Joint Replacement

37 21 16 15 10 21 21 24 32 20 22 38 33 38 35 52 99 30

101 117 141 152 152 210

325 386 440

561

641 689

729 810

667 635

0

100

200

300

400

500

600

700

800

900

PARCIAL TOTAL

4

Primary vs. revision knee replacement

173 231

349 418

460

583 679

722 767

845

719 734

10

5

21

19 30

22

26 28

56

49

91 78

0

100

200

300

400

500

600

700

800

900

1000

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

revision

primary

Men Women

2006 67 (40-80) 70 (43-84)

2007 69 (51-87) 71 (27-87)

2008 68 (40-85) 70 (32-87)

2009 68 (43-83) 71 (41-88)

2010 67 (33-86) 69 (40-87)

2011 67 (27-90) 70 (34-90)

2012 67 (41-82) 70 (48-89)

2013 67 (36-87) 70 (47-89)

5

Patient data: age and gender

16 25 21 26 22 26 31 29

40 28 31 33

84 75 79 74 78 76 69 71

60 72 69 67

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

200220032004200520062007200820092010201120122013

% women

% men

BMI of patients in 2013: average 30,8; min 16,5; max 57,1

0

50

100

150

200

250

300

3

65

287

235

107

37

Underweight (<18,4)

Normal (18,5-24,9)

Overweight (25-29,9)

Obese Type I (30-34,9)

Obese Type II (35-39,9)

Obese Type III (>40)

307 297

61 69

0

50

100

150

200

250

300

350

400

Right 50% Left 50%

Bilateral

Unilateral

Side of operated knee

8

Unikondilar Knee Prostheses from 2002 to 2013

3 2

21 16 15 25

8 12

31 25 27

23

48

73

7

7

12 10

4 3

8 10

10

4

25

1 2

1

0

20

40

60

80

100

120

Parcialne kolenske proteze

PFJ Sigma Jo&J

Patellofemoral Nexgen

Uni Parcial NexGen

Preservation Jo&J

Oxford Biomet

PFC Sigma Uni Knee Jo&J

9

Primary TKR in 2013, sum 636

Vstavljena tudi: • patela: 1 • infibuli: 2

258

90 76

56 56

27 22 20 11

5 4 3 3 3 1 1 0

50

100

150

200

250

300

10

Knee replacement by use of cement

54

28

7 1 0 0 0

84 115

103 138

16 67 76 82

22

41

86

130 149 153 213 325

299 324

458 505

710 697 770 614

555

6 3 4 2 0 0 2 3 1 33

59

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

uncemented cemented hybrid

REVISION OPERATIONS OF KNEE JOINT REPLACEMENTS

ln 2013: 78 revisions at 68 patients

11

Reasons for revision knee vs. hips 2002-2013

period 2002-2013 Knee(%) Hips(%)

Deep infection 24,83 11,27

Aseptic loosening 19,08 61,99

Nonalignment, malposition 18,85 0,0

2-stage revision 12,87 5,49

Pain 8,51 2,02

OA of other compartment 6,21 0,00

Other (wear of PE, …) 5,98 3,04

Dislocation 1,38 4,62

Periprosthetic fracture 1,15 6,69

Implant broken 1,15 2,64

Oteolysis 0,00 2,26

12

Reasons for revision TKR from 2005 to 2013 (%)

0,0

5,0

10,0

15,0

20,0

25,0

30,0

35,0

40,0

45,0

2005 2006 2007 2008 2009 2010 2011 2012 2013

Deep infection

Aseptic loosening

2-stage revision

Pain

Nonalignment

Revisions per 100 observed component years

Year

Mean Follow

up period

(years)

Revision

rate

Number

primary

cases

Number

of all

revision

s

Number of first

revisions in

this FU period

Revision rate for

revisions in this

FU period

Observed

component

years

Revisions per

100 observed

component

years

2002 0,46 5,46 173 10 0 0,00 79,81 0,00

2003 0,88 3,58 404 15 0 0,00 354,16 0,00

2004 1,22 4,56 753 36 6 0,76 922,31 0,65

2005 1,60 4,49 1171 55 12 0,98 1873,54 0,64

2006 2,03 4,95 1631 85 21 1,22 3305,12 0,64

2007 2,36 4,61 2214 107 29 1,25 5216,43 0,56

2008 2,69 4,40 2893 133 39 1,29 7771,63 0,50

2009 3,05 4,26 3615 161 54 1,43 11015,85 0,49

2010 3,43 4,72 4382 217 82 1,78 15008,65 0,55

2011 3,79 4,84 5227 266 99 1,80 19818,78 0,50

2012 4,27 5,66 5946 357 136 2,16 25414,18 0,54

2013 4,75 6,11 6680 435 172 2,42 31728,17 0,54

14

REVISION BURDEN – ALL REVISIONS

RB (revision burden) = Nº of

revisions*100/(Nº of primaries+ Nº of

revisions) in %

Nº of revisions for infection*100 / (Nº of primaries+ Nº of revisions) in %

2002 5,46 1,09

2003 2,12 0,00

2004 5,68 0,81

2005 4,35 0,92

2006 6,12 1,22

2007 3,64 1,49

2008 3,69 1,28

2009 3,73 0,93

2010 6,80 1,46

2011 5,48 1,23

2012 11,23 1,98

2013 9,61 1,60

Average Valdotra 5,66 1,17

Norway 09 8,91 1,02

Slovakia 10 13,30 1,39

Revision rate for knee prostheses from 02 to 13

Name Removed All primary implanted % revisions

Uni Parcial NexGen Zimmer 0 60 0,00

Sigma Knee HIBRID Jo&J 0 92 0,00

PFJ Sigma Jo&J 0 3 0,00

Balansys Mathys 0 15 0,00

Sigma Knee Jo&J 1 354 0,28

Vanguard Biomet 2 139 1,44

Solution S&N 20 1152 1,74

Sigma PFC Jo&J 28 1555 1,80

Nexgen Monobloc ZIMMER 14 710 1,97

Preservation Jo&J 1 40 2,50

AGC Biomet 19 747 2,54

Nexgen ZIMMER 36 962 3,74

Advance WRIGHT 15 300 5,00

Nexgen LCCK Zimmer 2 32 6,25

Endomodel LINK 3 42 7,14

Oxford Biomet 25 324 7,72

Genesis S&N 3 33 9,09

16

Acknowledgments to:

the director of Valdoltra Orthopaedic Hospital Radoslav

Marčan, dr. med., spec. ortop.

all the orthopaedic surgeons, who perform knee

arthroplasty in Valdoltra Hospital

all other medical and administrative stuff, who are

involved in the process of registration in Valdoltra

Arthroplasty Registry