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- Talk
- UK
Key Learnings from the Registry: Surgical Approaches: What We Know So Far
Description
In this presentation, Mike Reed discusses surgical approaches for hip and knee replacements, drawing on findings from the National Joint Registry (NJR) and research conducted by the University of Bristol team. The session covers three main aspects: hip replacement methods for osteoarthritis, surgical approaches for hip fractures, and insights from knee replacement procedures using NJR data.
Starting with hip replacements for osteoarthritis, Reed outlines seven common surgical techniques and shares outcomes pertaining to revision rates, patient-reported outcomes (PROMs), complications, and mortality. The posterior approach is noted for having the lowest risk of revision and complications compared to other methods. The analysis reveals strong data: out of almost 800,000 primary hip replacements, only 21,000 were revised, indicating a significant follow-up period of over 13 years for some patients.
Transitioning to hip fracture surgical strategies, Reed highlights a comparative analysis of posterior versus anterolateral approaches across over 18,000 patients, where outcomes such as implant survival rates and intraoperative complications are scrutinized. The findings underscored that the posterior approach is safer, displaying advantages in both intraoperative complications and overall patient survival rates at 30 days, one year, and five years.
Lastly, the discussion shifts to knee replacements, utilizing data from 875,000 patients to analyze 10 surgical methods. Notably, the conventional midvastus approach emerged as having a lower revision rate compared to the standard medial parapatellar technique, suggesting this method might warrant more frequent application.
Overall, Reed emphasizes the need for careful consideration of surgical approaches based on registry data, where the posterior and non-minimally invasive anterior approaches for hip replacements and the midvastus approach for knees are notably advantageous, reinforcing their value in improving patient outcomes in orthopedic surgeries.