National Joint Registry Revision Hip Replacement Project

We are collaborating with the British Hip Society to jointly fund a research fellowship, based at Newcastle University, into the results of hip revision surgery. Whilst a hip replacement will last many years for the majority of patients, some may run into problems and require ‘re-do’ (revision) surgery such as when an infection develops, the components become loose or when the bone around the implant breaks. This ‘re-do’ surgery is often more complex than the original surgery and has a higher chance of running into problems including requiring further ‘re-do’ surgery. It can affect up to a quarter of patients within a timeframe of 15 to 20 years.

The research will examine where and how the revision surgery is undertaken. In particular, it will analyse the effectiveness of a more networked approach, focused on dedicated centres, rather than a system in which hospitals work independently and some surgical teams undertake revision procedures on a relatively infrequent basis.  The research will analyse available data from the National Joint Registry to establish whether the outcomes from hip revision surgery are better when undertaken by more experienced clinical teams dealing with higher volumes of cases within dedicated centres.  The theory is that high volumes of procedures not only lead to economies of scale but also more experienced clinical teams and better patient outcomes.

The research will be undertaken by Newcastle University PhD student and registrar in orthopaedic surgery, Richard Holleyman, who says: ‘By analysing the available data we aim to deliver a clear message in terms of the relationship between the volume of surgeon’s or centre’s procedures and the outcome for patients.  We will also be analysing the outcomes from different types of revision procedures to hopefully provide an invaluable source of authoritative data for clinical teams and CCGs.’

Professor Tim Board, who is chair of the research committee for the British Hip Society, says: ‘It is great to see that Orthopaedic Research UK is increasing funding for UK-based research.  The primary focus of this research fellowship will be on improving patient outcomes, although the study will inevitably help identify more efficient ways of working.’