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 number and can often be technically challenging. We have utilised a regional hip register (the Trent Regional Arthroplasty Study) to analyse the epidemiology of revision hip arthroplasties in a single UK health region. The study shows that of the large number (1265) of procedures performed over a 7-year period (1991-1997), the majority were performed by general orthopaedic surgeons, with 91 different surgeons performing the operation and only two surgeons performing more than 20 procedures per year. Of more than 100 prosthetic combinations used for the procedure, the Charnley prosthesis was the most common (38.3% of acetabular revisions and 37.5% of femoral revisions). The same component was also the most commonly explanted (43%). There was an even geographical spread across the region with revision hip arthroplasty 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 general orthopaedic surgeons.