BACKGROUND Population-level data from national arthroplasty registries enable the use and outcomes of arthroplasty procedures to be monitored over time. This study aimed to describe the demographics, indications, and outcomes (up to 15 years) for radial head arthroplasty (RHA) procedures in Australia, as well as the factors associated with an increased likelihood of revision. METHODS Individual-level deidentified data on demographics and surgery characteristics, including revision surgery, were obtained from the Australian Orthopaedic Association National Joint Replacement Registry for all primary isolated RHA procedures that had been performed from 2007 to 2021. The probability of prosthesis survival was determined using Kaplan-Meier estimates. Cox proportional hazards models were used to calculate hazard ratios (HRs) for revision. RESULTS A total of 3,457 primary RHAs were performed during the study period (mean follow-up, 5.6 years; range, 0 to 15 years). The mean age at the time of RHA was 53 years, with female predominance (n = 2,009, 58%). The most common indication for RHA was fracture or dislocation (n = 3,166, 92%), followed by osteoarthritis (n = 232, 7%). The radial head prostheses that were most commonly used were monopolar (n = 3,378, 98%) with a modular design (n = 3,442, 99.6%) and cementless fixation (n = 3,387, 98%). Both metallic and nonmetallic prostheses were used (52% and 48%, respectively). Of the total cohort, 160 revisions (5%) were performed during the 15-year period; most revisions occurred in the first 5 years. The most common revision indication was prosthesis loosening (n = 62, 39%), and 54% of the revisions (n = 87) involved a change of the radial component. In multivariable analysis, primary procedures for osteoarthritis (HR, 1.65; 95% confidence interval [CI], 1.01 to 2.70) or "other" indications (e.g., inflammatory arthritis, osteonecrosis, or tumor) were revised more frequently (HR, 3.68; 95% CI, 1.14 to 11.91) than procedures for fracture or dislocation. Procedures with nonmetallic prostheses had higher rates of revision (HR, 1.61; 95% CI, 1.17 to 2.22) than those with metallic prostheses. CONCLUSIONS Trauma remained the most prevalent indication for RHA in Australia from 2007 to 2021. Encouragingly, revision rates were low, most notably for RHA that had been performed for fracture or dislocation. The likelihood of revision was highest for RHA procedures performed for osteoarthritis and for an indication other than osteoarthritis or trauma. Nonmetallic prostheses had a higher rate of revision than metallic prostheses. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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桡骨头关节置换术的人口统计、适应症和翻修率：澳大利亚骨科协会国家关节置换登记处数据分析。


背景技术来自国家关节成形术登记处的人口水平数据使得能够随着时间的推移监测关节成形术手术的使用和结果。本研究旨在描述澳大利亚桡骨头关节置换术 (RHA) 手术的人口统计、适应症和结果（长达 15 年），以及与翻修可能性增加相关的因素。方法 从澳大利亚骨科协会国家关节置换登记处获得有关人口统计和手术特征（包括翻修手术）的个人层面的去识别化数据，该数据涉及 2007 年至 2021 年进行的所有初次孤立 RHA 手术。假体存活概率通过以下方法确定：卡普兰-迈耶估计。 Cox 比例风险模型用于计算风险比 (HR) 以供修订。结果 研究期间总共进行了 3,457 例初次 RHA（平均随访时间为 5.6 年；范围为 0 至 15 年）。 RHA 时的平均年龄为 53 岁，其中女性占多数（n = 2,009，58%）。 RHA 最常见的适应症是骨折或脱位（n = 3,166，92%），其次是骨关节炎（n = 232，7%）。最常用的桡骨头假体是单极假体（n = 3,378，98%），采用模块化设计（n = 3,442，99.6%）和非骨水泥固定（n = 3,387，98%）。金属和非金属假体均被使用（分别为 52% 和 48%）。在整个队列中，15 年期间进行了 160 次修正 (5%)；大多数修订发生在前 5 年。最常见的翻修指征是假体松动（n = 62，39%），54% 的翻修（n = 87）涉及桡骨分量的变化。在多变量分析中，骨关节炎的主要手术（HR，1.65；与骨折或骨折手术相比，95%置信区间[CI]，1.01至2.70）或“其他”适应症（例如，炎性关节炎、骨坏死或肿瘤）的修改频率更高（HR，3.68；95% CI，1.14至11.91）错位。使用非金属假体的手术比使用金属假体的手术具有更高的翻修率（HR，1.61；95% CI，1.17 至 2.22）。结论 2007 年至 2021 年，创伤仍然是澳大利亚 RHA 最普遍的适应症。令人鼓舞的是，翻修率较低，尤其是针对骨折或脱位进行的 RHA。对于骨关节炎以及骨关节炎或创伤以外的适应症进行的 RHA 手术，翻修的可能性最高。非金属假体的翻修率高于金属假体。证据级别 治疗级别 III。有关证据级别的完整描述，请参阅作者须知。