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Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 2001 May;83(3):190–196.

Primary total hip replacement: variations in patient management in Oxford & Anglia, Trent, Yorkshire & Northern 'regions'.

R W Morris 1, R Fitzpatrick 1, S Hajat 1, B C Reeves 1, D W Murray 1, D Hannen 1, M Rigge 1, O Williams 1, P J Gregg 1; National Total Hip Replacement Outcome Study Steering Committee1
PMCID: PMC2503572  PMID: 11432139

Abstract

OBJECTIVES: To examine national practice, and variations in practice, concerning total hip replacement; in particular the choice of prosthesis and the involvement of consultants in NHS operations. DESIGN: Pre-operative survey of patients undergoing total hip replacement. SETTING: Five English regions serving combined population of 16.8 million people. SUBJECTS: 13,343 total hip replacement operations in one year commencing September 1996, either in NHS or private sector. MAIN OUTCOME MEASURES: Prosthesis used for surgery, status of surgeons involved in operation, use of laminar flow operating theatre. RESULTS: Prostheses without well documented 5-year survival were used in 5504 (58%) of 9417 operations for which information was available. The consultant was the operator in 4810 (64%) of 7499 NHS operations. In 1352 trainee-led operations, the consultant was present for only 637 (47%); this figure was 54% for trainees in years 1-4 of their training. Substantial variation between NHS consultant firms occurred both for use of prostheses with well documented survival data, and supervision of trainees by the consultant. CONCLUSIONS: This large study is the first attempt to describe national practice for primary total hip replacement. Substantial variation among consultant firms was observed for all indices of practice reported.

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Selected References

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  1. Collins R., Scrimgeour A., Yusuf S., Peto R. Reduction in fatal pulmonary embolism and venous thrombosis by perioperative administration of subcutaneous heparin. Overview of results of randomized trials in general, orthopedic, and urologic surgery. N Engl J Med. 1988 May 5;318(18):1162–1173. doi: 10.1056/NEJM198805053181805. [DOI] [PubMed] [Google Scholar]
  2. Dikki P. E., Crofts T. J., Nixon S. J., Aitken R. J. Consultant supervision of surgical trainees: an objective assessment of how much actually occurs. Ann R Coll Surg Engl. 1999 Mar;81(2 Suppl):73–75. [PubMed] [Google Scholar]
  3. Fender D., Harper W. M., Thompson J. R., Gregg P. J. Mortality and fatal pulmonary embolism after primary total hip replacement. Results from a regional hip register. J Bone Joint Surg Br. 1997 Nov;79(6):896–899. doi: 10.1302/0301-620x.79b6.7677. [DOI] [PubMed] [Google Scholar]
  4. Hashemi-Nejad A., Birch N. C., Goddard N. J. Current attitudes to cementing techniques in British hip surgery. Ann R Coll Surg Engl. 1994 Nov;76(6):396–400. [PMC free article] [PubMed] [Google Scholar]
  5. Hoffman C. W., Lynskey T. G., Hadlow V. Twenty years of total hip arthroplasty in Taranaki: a survival analysis. Aust N Z J Surg. 1994 Aug;64(8):538–541. doi: 10.1111/j.1445-2197.1994.tb02281.x. [DOI] [PubMed] [Google Scholar]
  6. Imperiale T. F., Speroff T. A meta-analysis of methods to prevent venous thromboembolism following total hip replacement. JAMA. 1994 Jun 8;271(22):1780–1785. [PubMed] [Google Scholar]
  7. Lidwell O. M., Lowbury E. J., Whyte W., Blowers R., Stanley S. J., Lowe D. Effect of ultraclean air in operating rooms on deep sepsis in the joint after total hip or knee replacement: a randomised study. Br Med J (Clin Res Ed) 1982 Jul 3;285(6334):10–14. doi: 10.1136/bmj.285.6334.10. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Malchau H., Herberts P., Ahnfelt L. Prognosis of total hip replacement in Sweden. Follow-up of 92,675 operations performed 1978-1990. Acta Orthop Scand. 1993 Oct;64(5):497–506. doi: 10.3109/17453679308993679. [DOI] [PubMed] [Google Scholar]
  9. Marston R. A., Cobb A. G., Bentley G. Stanmore compared with Charnley total hip replacement. A prospective study of 413 arthroplasties. J Bone Joint Surg Br. 1996 Mar;78(2):178–184. [PubMed] [Google Scholar]
  10. Murray D. W., Britton A. R., Bulstrode C. J. Thromboprophylaxis and death after total hip replacement. J Bone Joint Surg Br. 1996 Nov;78(6):863–870. doi: 10.1302/0301-620x78b6.6714. [DOI] [PubMed] [Google Scholar]
  11. Murray D. W., Carr A. J., Bulstrode C. J. Which primary total hip replacement? J Bone Joint Surg Br. 1995 Jul;77(4):520–527. [PubMed] [Google Scholar]
  12. Sochart D. H., Long A. J., Porter M. L. Joint responsibility: the need for a national arthroplasty register. BMJ. 1996 Jul 13;313(7049):66–67. doi: 10.1136/bmj.313.7049.66. [DOI] [PMC free article] [PubMed] [Google Scholar]

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