Total Elbow Replacement
Conditions
Brief summary
The goal of this observational registry study is to provide detailed descriptions of the patients who are receiving primary total elbow replacement surgery in England. The main questions it aims to answer are: * Who are receiving primary total elbow replacement surgery? * Where and by whom is the total elbow replacement surgery is being performed? * What the current surgical practices for total elbow replacement? Pseudonymous data from the National Joint Registry NJR of all patients with total elbow replacement will be used.
Interventions
DEVICETotal Elbow Replacement
Total elbow replacement is a procedure that involves replacing the elbow joint with an implanted device to alleviate pain and improve function.
Sponsors
The National Joint Registry
The Royal College of Surgeons of England
John Charnley Trust
University of Bristol
University of Manchester
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* All patients aged 18 to 100 years old with a primary TER on the National Joint Registry (NJR) elbow dataset from the start of data collection on the 1st of April 2012 to the 31st of December 2022 will be included.
Exclusion criteria
* Patients are excluded if they did not consent for their data to be used for research purposes, if it is impossible to trace them after surgery, if their ID numbers are invalid, or if the surgery was not performed in England. * Unconfirmed procedures and procedures with inconsistent operative patterns (i.e. a sequence of operations where the primary operation is not the first operation in the sequence or where there are multiple primary operations recorded for the same joint) will be excluded from the analyses.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of total elbow replacement (TER) in England | Yearly (1 year) incidence for a 10 year period | The number and age-sex standardised rate of TER for different sexes, ethnicities, and socioeconomic backgrounds. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Serious adverse events or re-admissions | 30 and 90 days after the index TER | Serious adverse events will be defined as any severe medical complications leading to hospital admission, including pulmonary embolism, myocardial infarction, lower respiratory tract infection, acute kidney injury, urinary tract infection, cerebrovascular events, and all-cause death. |
| Duration of elective wait | Up to 10 years period | The number of days between the decision for total elbow replacement and the actual day of surgery |
| Post-operative duration of stay | Up to 10 years period | The number of days from the time of surgery until discharge from the hospital |
| Surgeon volume | 10 year (2012 to 2022) | Number of TERs performed by a surgeon per year by surgeons in England |
| Hospital volume | 10 year (2012 to 2022) | Number of TERs performed by a hospital per year by surgeons in England |
Other
| Measure | Time frame | Description |
|---|---|---|
| Indication for total elbow replacement | 10 year (2012 to 2022) | Categories: Acute trauma/inflammatory/ Trauma sequelae/Osteoarthritis/ Other |
| Socioeconomic status | 10 year (2012 to 2022) | Categorical: Indices of multiple deprivation quintiles (2015 version) |
| Ethnicity | 10 year (2012 to 2022) | Categorical: Asian, Asian British, or Asian Welsh /Black, Black British, Black Welsh, Caribbean or African/White/Mixed or Multiple ethnic groups/Other ethnic group |
| Co-morbidities | 10 year (2012 to 2022) | Categorical: Acute MI /CHF / PVD/ Cerebrovascular Disease / Dementia/ COPD/ Rheumatoid Disease/ Peptic Ulcer/ Mild liver disease/ Diabetes/ Diabetes + Complications/ Hemiplegia or Paraplegia/ Renal disease/ Cancer/ Moderate/Severe liver disease/ Metastatic Cancer/ AIDS/ Depression/ Anxiety/ Osteoporosis |
| Charlson Comorbidity Index | 10 year (2012 to 2022) | Original Charlson Comorbidity Index |
| If radial head replacement was used | 10 year (2012 to 2022) | Categorical: Yes/No |
| Fixation type | 10 year (2012 to 2022) | Categorical: Cemented/ Uncemented |
| Implant type | 10 year (2012 to 2022) | Categorical: Coonrad-Morrey/ Discovery/ Latitude (Legacy, EV, Mix)/ GSB III/ MUTARS/ Nexel/ IBP |
| Funding | 10 year (2012 to 2022) | Categorical: National Health Services (NHS) /Independent sector |
| Elective admission type | 10 year (2012 to 2022) | Categorical: General admission/ Day case admission |
| Implant classification | 10 year (2012 to 2022) | Categorical: Linked/ Unlinked |
| Grade of primary surgeon | 10 year (2012 to 2022) | Categorical: Consultant/Other |
| Patient characteristics (Age) | 10 year (2012 to 2022) | Age in years |
| Body mass index | 10 year (2012 to 2022) | BMI measured in in kg/m\^2 |
| Hand dominance | 10 year (2012 to 2022) | Dominant non-dominant hand |
| American Society of Anaesthesiologists (ASA) grade | 10 year (2012 to 2022) | Grades 1-5 |
Countries
United Kingdom
Outcome results
None listed