S. Affatato, Dorina Brando, D. Tigani
Journal name not available for this finding
Abstract: The number of patients who undergo total joint arthroplasty, and consequently revision, has been increasing in recent years. The increase is due to an ageing population, with whom arthritic diseases are more associated, and also because this surgery can offer a better quality of life for young people. In order to achieve the best outcome from the substitution of a joint with a prosthesis it is important for the surgeon to make a correct diagnosis, and so choose the most suitable prosthesis, time and type of surgery for the patient. Wear and infections are the primary causes of failure in implants. Their presence can be monitored by means of radiography and microbiological analyses, but there are now other and more specific techniques that guarantee greater accuracy. Several types of hip and knee prostheses are commercially available, differing from each other in design, materials, bone setting mechanism and degree of invasiveness. Choosing the correct option increases implant lifetime and stability. The establishment of registries means that prosthetic devices can be monitored and patients traced in case of adverse events. The first regional registry in Italy was activated at the Rizzoli Orthopaedic Institute in 1990. It collects data relating to hip, knee and shoulder prostheses implanted in Emilia Romagna and reports on the clinical condition of patients, surgical procedures and the type and fixation of implants for both primary and revision prostheses. Managing such a registry is costly, but it means that fewer revisions are necessary, resulting in savings overall.