Indian national joint registry data presented at ISHKS conference held at Pune 2014. The data provides a valuable insight into what is happening in India vis a vis the knee and hip replacement.

1. ISHKS REGISTRY:
ROAD TRAVELLED &
JOURNEY AHEAD
Dr Vaibhav Bagaria
MBBS MS FCPS DIP SICOT
CARE HOSPITAL & ORIGYN CLINIC
NAGPUR, INDIA
www.drbagaria.com
1Monday, 14 April 14

2. The Road Travelled...
2Monday, 14 April 14

3. The Road Travelled...
2Monday, 14 April 14

4. ISHKS REGISTRY
CONCEIVED: 2006
CONTRIBUTORS: 72
TOTAL NO OF TKR: 66352
TOTAL NO OF THR: 5784
REVISION KNEE: 544
REVISION HIP: 584
3Monday, 14 April 14

5. EXPANDING FOOT PRINT
ISHKS%
2006%
4Monday, 14 April 14

6. CONTRIBUTION TREND
0
20
40
60
80
SURGEONS
52
25
72
2006 2012 2013
5Monday, 14 April 14

7. RECORDED CASES
0
17500
35000
52500
70000
HIPS KNEES
2012 2013
66352
5784
51232
4958
6Monday, 14 April 14

8. Year on Year Knees
0
17500
35000
52500
70000
2006 2007 2008 2009 2010 2011 2012 2013
66352
51232
34478
23886
15471
9951
5811
1899
Cases
7Monday, 14 April 14

9. MANUFACTURERS
J&
J
42.20%
Zimmer
34.03%
S
&
N
8.48%
Max
5.40%
Stryker
4.88%
Exatac
1.60%
Biomet
1.05%
B
Braun
0.77%
Indus
0.70%
B
P
0.68%
Wright
Medical
0.06%
Endo
plus
0.05%
Others
0.09%
42.2
34.0
8.5
5.4
4.95.0
J & J ZIMMER S&N MAX STRYKER REST
8Monday, 14 April 14

10. TKR TREND
73.5
26.5
MALES
FEMALES
3.4
2.1
94.5
OA RA OTHERS
9Monday, 14 April 14

11. TKRS
COUNTRY
INDIA SWEDISH AUSTRALIA
PARA
INDIA SWEDISH AUSTRALIA
AGE 64.3
69(D)/70(N)/
71(S)
68.2
BMI 29.15 28.4 29.6
BILATERAL 16.48% 20% 13.3%
10Monday, 14 April 14

12. Bilateral Simultaneous
0
17500
35000
52500
70000
Prior 2011 2012 2013
66532
51232
23886
10291
5219
2147
Bilateral Total No
11Monday, 14 April 14

13. Surgeon Preference
3.7%
21.3%
7.3%
67.7%
PS
CR
All Poly PS
All Poly CR
4.4%
26.1%
69.4%
PS
CR
All Poly PS
J & J Zimmer
12Monday, 14 April 14

14. Patella -J & J
19%
81%
Resurfacing Not Resurfacing
44%
56%
2012 2013
13Monday, 14 April 14

15. Patella -J & J
19%
81%
Resurfacing Not Resurfacing
44%
56%
2012 2013
13Monday, 14 April 14

16. Patella - Zimmer
81%
19%
81%
19%
Resurfacing Not Resurfacing
2012
2013
Aus registry
14Monday, 14 April 14

17. Cement Used
0.4%
3%15%
19%
27%
36%
Palacos Smart Set CMW Simplex antibiotic Others
15Monday, 14 April 14

18. KNEE REVISIONS
0
37.5
75
112.5
150
2006 2007 2008 2009 2010 2011 2012 2013 2014*
11
113109112
98
44
36
20
1
16Monday, 14 April 14

19. Reason for Knee Revision
8%
4%
29%
59%
Aseptic loosening Septic Loosening Fractures Others
17Monday, 14 April 14

20. THR
0
375
750
1125
1500
2006 2007 2008 2009 2010 2011 2012 2013
826
1354
1260
1036
611
175
348
174
No of Cases Total So far: 5784
18Monday, 14 April 14

21. Reason For THR
50.3
7.1
6.9
1.3
3.4
3.5
1.9
6.6
9.9
8.7
AVN ANK SPOND RA FAILED HEMI # DISLOCATION
FAILED #FIX DYSPLASIA # NF PRIMARY OA OTHERS
AVN
50.36%
Ankylosing
spondyliOs
7.11%
RA
6.94%
Failed
Hemi
1.38%
Fracture
dislocaOon
3.43%
Failed
fractures
3.50%
Dysplasia
1.97%
Fresh
fracture
neck
6.60%
Primary
OA
9.98%
Others
8.76%
19Monday, 14 April 14

22. THR DEMOGRAPHICS
Male
61.20%
Female
38.80%
BMI
25.82
38.8%
61.2%
Male Female
20Monday, 14 April 14

23. THR TECHNIQUE
Uncemented
70.35%
Cemeneted
19%
Hybrid
6.79%
Resurfacing
3.66%
(this
year
only
10
has
been
added)
Others
0.18%
18.0
0.13.6
6.7
19.0
70.3
Uncemented Cemented Hybrid Resurfacing Others 2012
21Monday, 14 April 14

24. THR TECHNIQUE
Uncemented
70.35%
Cemeneted
19%
Hybrid
6.79%
Resurfacing
3.66%
(this
year
only
10
has
been
added)
Others
0.18%
18.0
0.13.6
6.7
19.0
70.3
Uncemented Cemented Hybrid Resurfacing Others 2012
21Monday, 14 April 14

25. THR TECHNIQUE
Uncemented
70.35%
Cemeneted
19%
Hybrid
6.79%
Resurfacing
3.66%
(this
year
only
10
has
been
added)
Others
0.18%
18.0
0.13.6
6.7
19.0
70.3
Uncemented Cemented Hybrid Resurfacing Others 2012
Aus registry
21Monday, 14 April 14

26. THR - IMPLANTS
34
28
12
12
4 211
J & J ZIMMER B BRAUN STRYKER S& N BIOMET
EXATAC EVOLOUTIS OTHERS
J
&
J
34.45%
Zimmer
28.05%
B
Braun
12.26%
Stryker
12.16%
Smith
&
Nephew
4.37%
Biomet
3.97%
Exatac
2.48%
Evolutus
1.46%
Others
0.8%
22Monday, 14 April 14

27. THR Revisions
AsepOc
loosening
70.80%
DislocaOon
10.21%
InfecOon
12.89%
Others
6.10%
6%
13%
10%
71%
Aseptic Loosening Dislocation Infection Others
23Monday, 14 April 14

28. The Road Ahead
Realise the potential
Increased Participation.
Detailed Analysis.
Better Use of technology: Mobile, Softwares.
Industry Participation & Legislations
One world One Registry
24Monday, 14 April 14

29. Realise the potential
US reports 620000 knees implanted in 2009
Indian equivalent would be: 4940000 knees /year.
Australian and Swedish registry record less than 100000/
combined hip and knee procedures/yr
Revision pool after 5 years likely to be equiv to primary of some
famous registry.
25Monday, 14 April 14

30. Increased Participation
Pull all stops to increase member participation.
Aggressive marketing
Colour coded forms
Involve Youngsters
Display the coverage data
26Monday, 14 April 14

31. Increased Participation
Pull all stops to increase member participation.
Aggressive marketing
Colour coded forms
Involve Youngsters
Display the coverage data
26Monday, 14 April 14

32. Detailed Analysis
In depth analysis is needed.
Devil lies in details
Different publication levels: Surgeons, Industry, Public, Govt.
Statistical analysis
27Monday, 14 April 14

33. Detailed Analysis
In depth analysis is needed.
Devil lies in details
Different publication levels: Surgeons, Industry, Public, Govt.
Statistical analysis
27Monday, 14 April 14

34. Detailed Analysis
In depth analysis is needed.
Devil lies in details
Different publication levels: Surgeons, Industry, Public, Govt.
Statistical analysis
27Monday, 14 April 14

35. Detailed Analysis
In depth analysis is needed.
Devil lies in details
Different publication levels: Surgeons, Industry, Public, Govt.
Statistical analysis
27Monday, 14 April 14

36. Detailed Analysis
In depth analysis is needed.
Devil lies in details
Different publication levels: Surgeons, Industry, Public, Govt.
Statistical analysis
27Monday, 14 April 14

37. Detailed Analysis
In depth analysis is needed.
Devil lies in details
Different publication levels: Surgeons, Industry, Public, Govt.
Statistical analysis
27Monday, 14 April 14

38. Better Use of technology
Keep It Simple attitude
User friendly.
Accessible
Cost effective
Attitude: We are the “pioneers”
28Monday, 14 April 14

39. Better Use of technology
Keep It Simple attitude
User friendly.
Accessible
Cost effective
Attitude: We are the “pioneers”
28Monday, 14 April 14

40. Industry Participation
Voluntary
? Mandatory
Enlist benefits, come out with white papers.
Close cooperation, Advisory Role.
Financial Support
29Monday, 14 April 14

41. Legislations
Can Adverse event reporting be made compulsory
Can recommendations be made?
India specific comments on prosthesis?
Dealing with Indian Bureaucracy :-(
30Monday, 14 April 14

42. One world One Registry
Taking it too far?
Global registry is the way forward..
Collaboration,innovation and quest for excellence is the way
forward...
31Monday, 14 April 14

43. It started with conviction
The team certainly deserve an Applause !
32Monday, 14 April 14

44. Thank You!
33Monday, 14 April 14