Revision hip arthroplasty activity in a single UK health region: an audit of 1265 cases

Revision hip arthroplasty is an operation which is steadily increasing in n umber and can often be technically challenging. We have utilised a regional hip register (the Trent Regional Arthroplasty Study) to analyse the epidem iology of revision hip arthroplasties in a single UK health region. The study shows that of the large number (1265) of procedures performed ove r a 7-year period (1991-1997), the majority were performed by general ortho paedic surgeons, with 91 different surgeons performing the operation and on ly two surgeons performing more than 20 procedures per year. Of more than 100 prosthetic combinations used for the procedure, the Charnl ey prosthesis was the most common (38.3% of acetabular revisions and 37.5% of femoral revisions). The same component was also the most commonly explan ted (43%). There was an even geographical spread across the region with revision hip a rthroplasty being performed in all hospitals with an orthopaedic in-patient facility. Prospective audit of this large and varied cohort is necessary to determine differences in outcome (if any) between 'specialist' hip surgeons and gene ral orthopaedic surgeons.