NJR 10-year report: Patients can expect long life from joint implants

Issue: November/December 2013

BIRMINGHAM, England — In the 10th report from the National Joint Registry for England, Wales and Northern Ireland, now known worldwide as the NJR, data showed that most patients can expect their knee and hip replacement implants to survive for 10 years.

Patients who undergo total hip replacement (THR) are also still more likely to receive an uncemented prosthesis, based on data found in the report of the world’s largest joint implant registry, Martyn Porter, FRCS, president of the BOA and chairman of the NJR Editorial Board, said.

Porter presented results from the NJR 10th Annual Report at the British Orthopaedic Association (BOA) Annual Congress, here.

"We've reached first base in 10 years," he said.

Discussing the report's key findings, Porter said "hip and knee replacement is successful and it is demonstrated successful. It is also demonstrated that hip and knee replacement is safe looking at mortality."

"Most patients who have hip and knee replacements can expect their joints to last, with at least 95% to 98% lasting 10 years. This is also very good," he said.

Porter stressed, however, that those reading the new report, which has a greater focus on clinical performance reporting, need to carefully assess the data it contains.

"The NJR does not stand up and tell you what to do. It provides information. It requires caution in interpretation," he said.

"Some devices and patients have high failure rates, and we know that," Porter added.

Concerning the findings for THR tracked in the last 10 years, metal-on-metal clearly deteriorated rapidly, he said.

In other trends in this year’s report, patients who undergo total joint replacement are no older or younger than they were a decade ago with 80% of them older than 60 years old. THR 36-mm heads were used most often although more 32-mm heads are now being used, based on information in the report.

Laurel Powers-Freeling, chairman of the NJR Steering Committee, mentioned the inclusion of consultant level data in the new report and that it was not an easy task to deliver, she said.

"It is a bit challenging and I’ll just say a little controversial, but we got there," Powers-Freeling said

With 1-year and 3-year patient reported outcome measures (PROMS) included in the registry report, and shoulder PROMS reporting underway, the plan is to extend the PROMS in the NJR out to 5 years, she said.

"We are now also providing management feedback and clinic performance reporting. That obviously is a help,” she said.

Reference:

Porter M. NJR- Tenth Annual Report. 10th annual report – Keynote findings.

Powers-Freeling L. Opening remarks. Both presented at: British Orthopaedic Association Congress. Oct.1-4, 2013. Birmingham, England.

Disclosure: Porter’s department at Wrightington, Wigan and Leigh NHS Trust received financial support from DePuy International Ltd for clinical and RSA studies for Elite Plus femoral stem and C-Stem. He acted as a consultant to DePuy International Ltd in relation to the development of a hip femoral stem (C-Stem AMT) and received royalties on this hip stem. Orthopaedics Today Europe could not confirm Powers-Freeling’s relevant financial disclosures.