Australian Joint Registry

Indications

Patient > 70

Gjertsen et al JBJS Am 2010

- 4335 patients > 70 with displaced subcapital fractures

- minimum 1 year follow up

- 1 year mortality same in each group / 25%

- 22% reoperation in ORIF v 3% in hemiarthroplasty

- more pain / higher dissatisfaction / lower quality life in ORIF group

Options

Hemiarthroplasty

- unipolar monoblock

- unipolar modular

Numbers

9 years up to 31 December 2009

- 289 000 TKR

- 80% primary

- 11% primary partial

- 8.5% revision

TKR Revision Rate 

9 year revision rate of 5.1% OA

- 4.5% in RA

Causes

- loosening  30%

- infection   20%

Concept

Femur

- removal of femoral head cartilage

- resurfacing with metal

- cemented / uncemented

Acetabulum

- standard technique

Bearing surface

- metal on metal

Indications

Relatively young man (40 - 50)

OA