title: The National Register of Joint Replacements of the Czech Republic.
abstract: The National Register of Joint Replacements of the Czech Republic was established as part of the National Health Information System in 2002. The register's administrator is the Institute of Health Information and Statistics of the Czech Republic, the Czech Society for Orthopaedics and Traumatology acts as its guarantor of scientific quality. The register is financed from governmental sources. It was launched into full operation in 2003 and it currently focuses on hip joint replacements. Register of knee and shoulder joint replacements is in the process of preparation. The register provides aggregate epidemiological data and other statistics, including the Revision Rate (RR) and curves of cumulative survival probability (Kaplan-Meier) for the main monitored groups of patients and implants used. In years 2003-2012 there were 101,734 primary implantations and 13,459 revision surgeries registered. In terms of gender distribution there is a predominance of females amounting to 59.4% in primary implantations and to 63.49% in revision surgeries. The age structure covers the entire range of adult population; however, more than 50% of the replacements are being implanted between 60-74 years of age. Most frequent indications for primary implantation are primary coxarthrosis (69.85%), post-fracture conditions (13.41%) and post-dysplasia arthritis (8.73%). The most frequent indications for revision surgery are aseptic loosening of acetabular component (38.15%), aseptic loosening of femoral component (22.01%) and recurrent dislocation (6.5%). 45,450 (44.68%) of primary implantations were cemented, 36,477 (35.86%) uncemented, 16,559 (16.28%) hybrid with cemented femur and 656 (0.64%) hybrid with cemented acetabulum. There were also records of 2,592 cervicocapital prostheses (2.55%). Most commonly used is the classic anterolateral approach 75.86% in primary implantations and 50.06% in revision surgeries. Mini-invasive approaches in primary implantations did not exceed 3.2% of all cases. Bone grafts were used in 23.89% of primary implantations and 39.55% of revisions. Most widely used implants in primary implantations were cemented PE cup type Muller (Aesculap) 14,000 pcs, original Czech cemented steel Stem with conical neck 12/14 AK (Beznoska) 13,433 pcs, from uncemented models Plasmacup SC (Aesculap) 9,762 pcs and Stem SL "Zweymüller Alloclassic" (Zimmer) 4,337 pcs. Generally most widely used implants in revision surgeries are uncemented Czech Oval cup MO (Medin) with titanium & hydroxyapatite porous coat 956 pcs and uncemented Stem SL WAGNER, lateralised, cone 12/14 (Zimmer) 712 pcs. The Revision Rate for primary implants due to infection for period 2003-2012 represented 0.06% at the end of the followup as of June 30, 2013. Cumulative survival probability (Kaplan-Meier) in year 11 of the follow-up is 95.69% in cemented implants, 94.55% in uncemented, 92.90% in hybrids with cemented femur and 84.11% in hybrids with cemented cup.
authors.affiliation: 1st Orthopaedic Clinic 1st Faculty of Medicin, Charles University Prague, (V Úvalu 84, Praha 5, 150 00).
authors.forename: P
authors.initials: P
authors.lastname: Vavřík
authors.forename: I
authors.initials: I
authors.lastname: Landor
authors.forename: S
authors.initials: S
authors.lastname: Popelka
authors.forename: R
authors.initials: R
authors.lastname: Fialka
authors.forename: J
authors.initials: J
authors.lastname: Hach
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000401:mortality / Q000706:statistics & numerical data*; D018153:Czech Republic; D005260:Female; D006622:Hip Prosthesis / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data