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HIPSKNEESANKLESELBOWSSHOULDERSPROMsProstheses used inhip, knee, ankle,elbow and shoulderreplacementprocedures 201614th Annual Report2017National Joint Registryfor England, Wales,Northern Ireland andthe Isle of ManISSN 2054-183X (Online)Surgical data to 31 December 2016
Contents41 Prostheses used in hip procedures 20161.1 Femoral head material and size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.2 Brand sales of conventional total hips and resurfacing prostheses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51.3 Combinations of cups and stems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191.4 Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73742 Prostheses used in knee procedures 20162.1 Prostheses entered into the NJR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 742.2 Usage of fixed versus mobile bearing tibial inserts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 793 Prostheses used in ankle procedures 2016804 Prostheses used in elbow procedures 2016815 Prostheses used in shoulder procedures 2016826 Cement use 2016857 Bone substitute use 201690TablesTable 1 Frequency of material chosen for femoral heads in procedures performed in 2016. . . . . . . . . . . . . . . . . . . . . . . 4Table 2 Frequency of femoral head sizes for procedures performed in 2016. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Table 3 (a) Cemented cup brands for primary hip procedures performed during 2016 . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Table 3 (b) Cemented cup brands for revision hip procedures performed during 2016. . . . . . . . . . . . . . . . . . . . . . . . . . . 7Table 4 (a) Cementless cup brands for primary hip procedures performed during 2016. . . . . . . . . . . . . . . . . . . . . . . . . . 8Table 4 (b) Cementless cup brands for revision hip procedures performed during 2016. . . . . . . . . . . . . . . . . . . . . . . . . 10Table 5 (a) Cemented stem brands for primary hip procedures performed during 2016 . . . . . . . . . . . . . . . . . . . . . . . . . 12Table 5 (b) Cemented stem brands for revision hip procedures performed during 2016. . . . . . . . . . . . . . . . . . . . . . . . . 14Table 6 (a) Cementless stem brands for primary hip procedures performed during 2016 . . . . . . . . . . . . . . . . . . . . . . . . 15Table 6 (b) Cementless stem brands for revision hip procedures performed during 2016. . . . . . . . . . . . . . . . . . . . . . . . 17Table 7 Brands of resurfacing head for primary hip procedures performed during 2016. . . . . . . . . . . . . . . . . . . . . . . . . 18Table 8 (a) Cup-stem brand combinations for primary hip procedures performed during 2016. . . . . . . . . . . . . . . . . . . . 19Table 8 (b) Cup-stem brand combinations for revision hip procedures performed during 2016. . . . . . . . . . . . . . . . . . . . 57Table 9 (a) Brands for total condylar knee primary procedures performed during 2016. . . . . . . . . . . . . . . . . . . . . . . . . . 74Table 9 (b) Brands for total condylar knee revision procedures performed during 2016. . . . . . . . . . . . . . . . . . . . . . . . . 75Table 10 Brands for primary and revision unicondylar knee replacement procedures performed during 2016. . . . . . . . . 77Table 11 Brands for primary and revision patellofemoral joint replacement procedures performed during 2016. . . . . . . . . 78Table 12 Fixed and rotating hinged knee brands for primary and revision knee procedures performed during 2016. . . . . . . . 78Table 13 Tibial insert type for primary and revision knee procedures performed during 2016 . . . . . . . . . . . . . . . . . . . . . 79www.njrcentre.org.uk2
National Joint Registry 14th Annual ReportTable 14 (a) Brands for primary ankle procedures performed in 2016. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Table 14 (b) Brands for revision ankle procedures performed in 2016. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Table 15 Brands for humeral elbow primary and revision procedures performed in 2016. . . . . . . . . . . . . . . . . . . . . . . .Table 16 Brands for radial head elbow primary and revision procedures performed in 2016. . . . . . . . . . . . . . . . . . . . . .Table 17 Brands for primary shoulder resurfacing procedures performed in 2016. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Table 18 (a) Shoulder humeral stem brands for primary shoulder procedures performed in 2016 . . . . . . . . . . . . . . . . . .Table 18 (b) Shoulder humeral stem brands for revision shoulder procedures performed in 2016. . . . . . . . . . . . . . . . . .Table 19 Type of cement used in hip, knee, ankle, elbow and shoulder replacement procedures performed in 2016. . .Table 20 (a) Brands of cement used in hip procedures performed in 2016. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Table 20 (b) Brands of cement used in knee procedures performed in 2016. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Table 20 (c) Brands of cement used in ankle procedures performed in 2016 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Table 20 (d) Brands of cement used in elbow procedures performed in 2016. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Table 20 (e) Brands of cement used in shoulder procedures performed in 2016. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Table 21 (a) Brands of synthetic bone substitute used in hip procedures during 2016 . . . . . . . . . . . . . . . . . . . . . . . . . .Table 21 (b) Brands of synthetic bone substitute used in knee procedures during 2016. . . . . . . . . . . . . . . . . . . . . . . . .Table 21 (c) Brands of synthetic bone substitute used in ankle procedures during 2016. . . . . . . . . . . . . . . . . . . . . . . . .Table 21 (d) Brands of synthetic bone substitute used in elbow procedures during 2016. . . . . . . . . . . . . . . . . . . . . . . .Table 21 (e) Brands of synthetic bone substitute used in shoulder procedures during 2016. . . . . . . . . . . . . . . . . . . . . 09191913
1 Prostheses used in hipprocedures 2016This section reports the numbers of prosthesesimplanted and reported to the NJR between 1 Januaryand 31 December 2016. National Joint Registry 2017The procedure counts in this section of the report mayvary from the procedure counts detailed elsewhere asthis section will only count those procedures wherethe implants have been used. Therefore, if a procedurehas been submitted with missing implant informationthis will cause numbers to differ.1.1 Femoral head material and sizeTable 1 shows the relative use of different modularheads. There has been no change in the ratio of femoralhead composition compared with operations in 2015.Table 1 Frequency of material chosen for femoral heads in procedures performed in 2016.MaterialNumber ofprocedures101,065Number ofmodular femoralheads www.njrcentre.org.uk4Table 2 shows the frequency of the differentfemoral head sizes. The main change comparedwith 2015 is the 2% increase in the use of 32mmheads at the expense of 28mm heads. There hasbeen a 2% decrease in the use of ceramic onceramic articulations compared with 2015 and acorresponding increase in the use of ceramic onpolyethylene.
National Joint Registry 14th Annual ReportTable 2 Frequency of femoral head sizes for procedures performed in 2016.Head size(mm)Ceramic head22.2526Metal head Ceramic headMetal headCeramic headMetal head10,8960%110%410%820 1%28,622 1%57,6592%98,0491,0501%0%0%0%0%0% 1%419 1%285%18%44%3%21%36%27,29528%300%0%0%0%0% 1%19 1%3230%18%5% 1%46%47%43,38044%340%0%0%0%0%0%00%3661%64%7% 1%32%15%24,61425%380%0%2% 1%0%0%4 1%403%0%2% 1% 1% 1%412 1%420%0%7%1%0%0%15 1%44 1%0%17%2%0% 1%62 1%460%0%7%4%0%0%35 1%48 1%0%0%9%0%0%93 1%500%0%5%37%0%0%306 1%520%0%0%19%0%0%155 1%54 0%0%2%23%0%0%190 1% National Joint Registry 2017Number ofproceduresCeramicCeramicMetalMetal Polyethylene Polyethylenewith Percentageacetabulum acetabulum acetabulum acetabulum acetabulum acetabulumcompleteofarticulation articulation articulation articulationarticulation articulation articulation procedures1.2 Brand sales of conventional totalhips and resurfacing prosthesesTables 3 to 8 show the most frequently used brands inEngland, Wales, Northern Ireland and the Isle of Manduring 2016, as assessed by their rate of entry into theNJR database.ManufacturerBrandNumber ofproceduresPercentage29,6398,08827%StrykerExeter Contemporary FlangedDePuyMarathon5,81920%StrykerExeter X3 Rimfit4,93717%StrykerExeter Contemporary Hooded2,0777%Zimmer BiometZCA1,7036%DePuyElite Plus Ogee1,6956% National Joint Registry 2017Table 3 (a) C emented cup brands for primary hip procedures performed during 2016.Continued www.njrcentre.org.uk5
National Joint Registry 2017Table 3 (a) (continued)Number ofprocedures1,015Percentage3%Original ME Muller Low Profile Cup6492%Zimmer BiometExceed ABT Cemented4562%StrykerExeter Duration4021%DePuyCharnley Ogee3851%DePuyElite Plus Cemented Cup322 1%Zimmer BiometStanmore-Arcom Cup216 1%Dedienne SanteADES Cemented211 1%B Braun / AesculapChirulen207 1%SerfNovae Stick187 1%Smith & NephewReflection Cemented178 1%Zimmer BiometDuracel167 1%Mathys Orthopaedics LtdCCB Cup130 1%JRI Orthopaedics LtdAeon Cemented Acetabular Cup127 1%Zimmer BiometAvantage Cemented Cup108 1%OrthimoOptiCup CEP83 1%StrykerTrident Constrained Cup67 1%Zimmer BiometSHP Cup63 1%Zimmer BiometApollo62 1%DePuyCharnley Cemented Cup50 1%DePuyWroblewski Golf Ball40 1%JRI Orthopaedics LtdJRI Cemented Cup39 1%Waldemar LinkInterplanta28 1%Waldemar LinkSnap Fit28 1%Smith & NephewPolarcup Cemented27 1%StrykerRestoration Gap222 1%CorinCenator Cemented Cup15 1%Waldemar LinkLink Flange Cup13 1%Zimmer BiometZimmer Cemented Cup6 1%Implantcast GmbHEcoFit Cemented Cup4 1%CorinCTI Cemented Cup2 1%MicroPort OrthopedicsA Class2 1%Ortho-IDPolarcup Cemented2 1%United Orthopedic CorporationXPE Cup2 1%Zimmer BiometCenterpulse Muller2 1%B Braun / AesculapBBraun Bipolar Cup1 1%DePuySolution Cemented Cup1 1%FinsburyFreeman Cup Finsbury1 1%ManufacturerDePuyBrandCharnley and Elite Plus LPWZimmer Biometwww.njrcentre.org.uk6
National Joint Registry 14th Annual ReportTable 3 (b) Cemented cup brands for revision hip procedures performed during 2016.ManufacturerBrandNumber eter X3 Rimfit22115%SerfNovae Stick19913%StrykerExeter Contemporary Flanged1339%Zimmer BiometAvantage Cemented Cup1067%Dedienne SanteADES Cemented1057%StrykerTrident Constrained Cup1017%DePuyElite Plus Ogee473%Zimmer BiometExceed ABT Cemented463%StrykerExeter Contemporary Hooded433%Smith & NephewPolarcup Cemented272%Zimmer BiometZCA262%DePuyElite Plus Cemented Cup201%StrykerRestoration Gap2191%DePuyCharnley Ogee17 1%DePuyCharnley and Elite Plus LPW14 1%DePuyWroblewski Golf Ball11 1%Zimmer BiometOriginal ME Muller Low Profile Cup9 1%Smith & NephewReflection Cemented8 1%Waldemar LinkSnap Fit7 1%StrykerExeter Duration6 1%Zimmer BiometFreedom6 1%Zimmer BiometStanmore-Arcom Cup6 1%Zimmer BiometDuracel4 1%Implantcast GmbHEcoFit Cemented Cup3 1%Zimmer BiometSHP Cup3 1%B Braun / AesculapChirulen2 1%JRI Orthopaedics LtdJRI Cemented Cup2 1%MaterialiseaMace2 1%JRI Orthopaedics LtdAeon Cemented Acetabular Cup2 1%CorinCenator Cemented Cup1 1%DePuyCharnley Cemented Cup1 1%Zimmer BiometApollo1 1%www.njrcentre.org.uk National Joint Registry 20171,5517
National Joint Registry 2017Table 4 (a) Cementless cup brands for primary hip procedures performed during 2016.Number eDePuyPinnacleStrykerTrident13,44622%Smith & NephewR3 Cementless3,6136%Zimmer BiometTrilogy3,4796%Zimmer BiometExceed ABT3,4195%JRI Orthopaedics LtdFurlong HAC CSF Plus3,0045%CorinTrinity2,8885%Zimmer BiometTrilogy IT2,8275%Zimmer BiometContinuum2,4784%DePuyPinnacle Gription2,4254%StrykerTritanium9412%Zimmer BiometG7 Cementless Acetabular Component535 1%Zimmer BiometAllofit471 1%Zimmer BiometTrabecular Metal Modular Cementless Cup457 1%Medacta UK LtdVersafit CC Trio342 1%MicroPort OrthopedicsProcotyl L317 1%B Braun / AesculapPlasmacup SC310 1%JRI Orthopaedics LtdCSF269 1%Mathys Orthopaedics LtdRM Pressfit vitamys255 1%Symbios SAApril - Ceramic246 1%Smith & NephewEP-Fit Plus233 1%B Braun / AesculapPlasmafit Cementless Cup232 1%StrykerXLFit Acetabular Cup228 1%LimaDelta TT205 1%Dedienne SanteADES147 1%Zimmer BiometMallory-Head Cementless Cup144 1%DePuyDeltaMotion137 1%SerfNovae134 1%Zimmer BiometAvantage Cementless Cup118 1%FH OrthopedicsAtlas IIIp117 1%Mathys Orthopaedics LtdRM Pressfit115 1%StrykerABG II Cementless Cup77 1%Zimmer BiometAllofit IT73 1%29%Zimmer BiometTrabecular Metal Natural Cup67 1%LimaDelta One TT66 1%Mathys Orthopaedics LtdRM Classic59 1%Symbios SAApril - Polyethylene50 1%Zimmer BiometTrabecular Metal Revision Shell41 1%Zimmer BiometCLS Cementless Cup37 1%StrykerRestoration ADM Cup35 1%Continued www.njrcentre.org.uk8
National Joint Registry 14th Annual ReportNumber ofprocedures28Percentage 1%Polarcup Cementless20 1%EvolutisCaptiv DM18 1%Adler OrthoFixa Duplex14 1%Medacta UK LtdMPACT12 1%Mathys Orthopaedics LtdseleXys PC10 1%Smith & NephewReflection Cementless10 1%Zimmer BiometAllofit-S IT10 1%Zimmer BiometMaxera10 1%FH OrthopedicsHipNGo8 1%JRI Orthopaedics LtdUnited OrthopedicCorporationAdler OrthoTribofit7 1%U-Motion II7 1%Fixa Ti-Por4 1%LimaDelta Revision TT3 1%Adler OrthoPolymax1 1%Dedienne SanteseleXys DS Cementless1 1%Medacta UK LtdVersafit DM1 1%StrykerSecure Fit Cementless Cup1 1%Symbios SAHilock1 1%Zimmer BiometBiomex1 1%Zimmer BiometExceed1 1%ManufacturerZimmer BiometBrandRegenerex Ringloc Smith & Nephewwww.njrcentre.org.uk National Joint Registry 2017Table 4 (a) (continued)9
Table 4 (b) Cementless cup brands for revision hip procedures performed during 2016.ManufacturerNumber ular Metal Modular CementlessCupPinnacle GriptionStrykerTritanium50413%Zimmer BiometContinuum41110%StrykerTrident3358%Zimmer BiometTrabecular Metal Revision Shell2787%LimaDelta One TT2356%LimaDelta TT2195%DePuyPinnacle1043%Smith & NephewR3 Cementless812%Zimmer BiometRegenerex Ringloc 792%Zimmer BiometTrilogy622%CorinTrinity551%JRI Orthopaedics LtdFurlong HAC CSF Plus531%Zimmer BiometTrilogy IT471%Zimmer BiometG7 Cementless Acetabular Component33 1%LimaDelta Revision TT31 1%Zimmer BiometExceed ABT30 1%SerfNovae23 1%Mathys Orthopaedics LtdRM Pressfit vitamys18 1%Zimmer BiometAvantage Cementless Cup14 1%StrykerRestoration ADM Cup12 1%Dedienne SanteADES10 1%Zimmer BiometTrabecular Metal Natural Cup7 1%MicroPort OrthopedicsProcotyl L6 1%Dedienne SanteseleXys DS Cementless5 1%Medacta UK LtdVersafit CC Trio5 1%B Braun / AesculapPlasmacup SC3 1%DePuyDeltaMotion3 1%EvolutisCaptiv DM3 1%Mathys Orthopaedics LtdRM Pressfit3 1%Peter Brehm GmbHMRS Titan3 1%Zimmer Biomet National Joint Registry 2017BrandZimmer BiometAllofit3 1%Zimmer BiometMallory-Head Cementless Cup3 1%B Braun / AesculapPlasmafit Cementless Cup2 1%Exactech (UK) LtdAcumatch Cup2 1%Smith & NephewEP-Fit Plus2 1%Adler OrthoFixa Duplex1 1%Continued www.njrcentre.org.uk10
National Joint Registry 14th Annual ReportNumber ofprocedures1Percentage 1%Mutars Cup1 1%CSF1 1%Mathys Orthopaedics LtdRM Classic1 1%Medacta UK LtdMPACT1 1%Smith & NephewPolarcup Cementless1 1%Symbios SAApril - Ceramic1 1%Zimmer BiometAllofit IT1 1%Zimmer BiometRegenerex Revision1 1%Zimmer BiometZimmer Bipolar1 1%ManufacturerFH OrthopedicsBrandAtlas IIIpImplantcast GmbHJRI Orthopaedics Ltdwww.njrcentre.org.uk National Joint Registry 2017Table 4 (b) (continued)11
Table 5 (a) Cemented stem brands for primary hip procedures performed during 2016.ManufacturerBrandNumber of procedures53,724PercentageStrykerExeter V4032,41560%Zimmer BiometDePuyCPT9,14117%C-Stem AMT Cemented Stem4,6049%DePuyC-Stem Cemented Stem1,5823%Corin1,2032%511 1%Smith & NephewTaperfit Cemented StemExeter No.1 125mm stem LineExtensionCPCS478 1%DePuyCharnley Cemented Stem445 1%Zimmer BiometMS-30433 1%Zimmer BiometMuller Straight Stem397 1%Zimmer BiometStanmore Modular Stem337 1%B Braun / AesculapExcia Cemented306 1%Zimmer BiometTaperloc Cemented Stem269 1%DePuyC-Stem AMT Line Extension206 1%DePuyCorail Cemented194 1%Zimmer BiometOlympia178 1%JRI Orthopaedics LtdAeon Cemented Stem140 1%Mathys Orthopaedics Ltd CCA Cemented Stem137 1%OrthimoOptiStem101 1%Waldemar LinkSP II Cemented Stem69 1%MicroPort OrthopedicsProfemur Xm66 1%Zimmer BiometBimetric Cemented (Ti)61 1%Zimmer BiometSirius stem57 1%JRI Orthopaedics LtdFurlong Cemented Stem55 1%Medacta UK LtdXActa45 1%B Braun / AesculapTrilliance42 1%Smith & NephewSpectron42 1%Medacta UK LtdAMIStem-C36 1%StrykerExeter34 1%DePuySummit Cemented Stem29 1%JRI Orthopaedics LtdFurlong Cemented Hemiarthroplasty13 1%StrykerStanmore ImplantsWorldwideZimmer BiometUnited OrthopedicCorporationWaldemar LinkGMRS13 1%METS Cemented12 1%P10 Muller11 1%UCP Stem10 1%SP II Cemented Revision9 1%DePuyCharnley Modular7 1%Zimmer BiometBimetric Cemented (CoCr)7 1% National Joint Registry 2017StrykerContinued www.njrcentre.org.uk12
National Joint Registry 14th Annual ReportManufacturerStrykerBrandRestoration Cemented StemNumber of procedures5Percentage 1%Zimmer BiometImplantcast GmbHSegmental5 1%Mutars4 1%Smith & NephewEchelon Cemented Stem4 1%Symbios SAArcad4 1%Implantcast GmbHEcoFit Cemented Stem2 1%DePuyElite Plus Cemented Stem1 1%OrthodynamicsCannulok Cemented Stem1 1%Smith & NephewSL-Plus Cementless Stem1 1%Zimmer BiometVerSys Cemented Plus Stem1 1%Zimmer BiometVerSys Heritage1 1%www.njrcentre.org.uk National Joint Registry 2017Table 5 (a) (continued)13
Table 5 (b) Cemented stem brands for revision hip procedures performed during 2016.ManufacturerStrykerExeter V40Zimmer BiometCPT441Proceduresusing femoralPercentagebone graft11956%6816%22DePuyC-Stem AMT Cemented Stem1857%0DePuyC-Stem Cemented Stem1827%17DePuyC-Stem AMT Line ExtensionExeter No.1 125mm stem LineExtension612%3562%1522%3Stryker National Joint Registry 2017BrandNumber ofprocedures2,7631,549Stanmore ImplantsWorldwideCorinTaperfit Cemented Stem452%3Zimmer BiometStanmore Modular Stem291%1METS CementedStrykerGMRS25 1%0Smith & NephewCPCS14 1%0StrykerRestoration Cemented Stem14 1%0Zimmer BiometSegmental12 1%0Smith & NephewEchelon Cemented Stem10 1%0B Braun / AesculapExcia Cemented8 1%0DePuyCorail Cemented8 1%0DePuySummit Cemented Stem8 1%1Zimmer BiometTaperloc Cemented Stem8 1%0Waldemar LinkSP II Cemented Revision7 1%0Zimmer BiometMS-307 1%0Implantcast GmbHMutars5 1%0Zimmer BiometSirius stem5 1%0DePuyCharnley Modular4 1%0Zimmer BiometBimetric Cemented (Ti)4 1%0JRI Orthopaedics LtdFurlong Cemented Stem3 1%0Zimmer BiometBimetric Cemented (CoCr)3 1%0DePuyCharnley Cemented Stem2 1%0Smith & NephewSpectron2 1%0StrykerExeter2 1%0Waldemar LinkSP II Cemented Stem2 1%0Zimmer BiometMuller Straight Stem2 1%0Medacta UK LtdXActa1 1%0MicroPort OrthopedicsProfemur Xm1 1%0SerfSagitta Cemented Stem1 1%0JRI Orthopaedics LtdAeon Cemented Stem1 1%0StrykerAccolade Cemented1 1%0Symbios SAArcad1 1%0Zimmer BiometOlympia1 1%0Zimmer BiometP10 Muller1 1%0www.njrcentre.org.uk14
National Joint Registry 14th Annual ReportTable 6 (a) Cementless stem brands for primary hip procedures performed during 2016.BrandDePuyZimmer BiometJRI Orthopaedics LtdZimmer BiometSmith & NephewStrykerZimmer BiometStrykerCorinJRI Orthopaedics LtdSmith & NephewB Braun / AesculapDePuyCorinSmith & NephewSmith & NephewDePuyMicroPort OrthopedicsCorinZimmer BiometZimmer BiometMedacta UK LtdSymbios SADePuyMicroPort OrthopedicsSymbios SAMicroPort OrthopedicsMathys Orthopaedics LtdStrykerLimaMedacta UK LtdImplantcast GmbHJRI Orthopaedics LtdSymbios SAZimmer BiometZimmer BiometDePuyMicroPort OrthopedicsB Braun / AesculapZimmer BiometB Braun / AesculapZimmer BiometCorailTaperloc Cementless StemFurlong HAC StemM/L Taper CementlessPolarstem CementlessAccoladeTaperloc Complete Cementless StemAccolade IIMetafix StemFurlong Evolution CementlessAnthologyExcia CementlessTrilock BPSTriFit TS hip stemSL-Plus Cementless StemSynergy Cementless StemSummit Cementless StemProfemur Modular NeckminiHipCLS Cementless StemBimetric Cementless StemQuadra-HSPS EvolutionS-Rom Cementless StemProfemur L ModularSPS HaProfemur L ClassicTwinsys Cementless StemRestoration Cementless StemMaster SLAMIStem-HEcoFit Cementless StemFurlong HAC Active StemSPS ModularArcos ConeZweymullerCorail Revision StemProfemur TLMetha Monoblock StemAlloclassic Cementless StemBicontact Cementless StemAvenir Muller CementlessNumber of age50%6%5%5%5%4%4%3%2%2%2% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% National Joint Registry 2017ManufacturerContinued www.njrcentre.org.uk15
National Joint Registry 2017Table 6 (a) (continued)ManufacturerZimmer BiometMedacta UK LtdMicroPort OrthopedicsSymbios SADePuyMedacta UK LtdStrykerLimaESKAMicroPort OrthopedicsSmith & NephewLimaStrykerDePuyImplantcast GmbHJRI Orthopaedics LtdSmith & NephewZimmer BiometZimmer BiometPeter Brehm GmbHStanmore ImplantsWorldwideDePuyMathys Orthopaedics LtdOrthodynamicsWaldemar LinkZimmer BiometZimmer BiometZimmer BiometZimmer BiometZimmer BiometLimaMathys Orthopaedics LtdMedacta UK LtdWaldemar LinkWaldemar LinkWaldemar LinkBrandZMR Cementless Proximal StemAMIStem HPProfemur TL ClassicArcad CementlessRECLAIMSMSABG II Monolithic Cementless StemH-Max S Monoblock StemQuadra-HProfemur ZNanosLima Revision StemOmnifit Cementless StemLPSMutars CementlessFurlong HAC Revision StemEchelon Cementless StemM/L Taper Kinectiv CementlessWagner ConePeter Brehm Revision StemNumber of procedures1814141312121210999776666654Percentage 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1%METS Cementless4 1%ReefCBC EvolutionCannulok Cementless StemMP RevisionRevitan Cementless StemFitmore StemTrabecular Cementless StemVersys Cementless StemWagner Revision StemModulusMathys Revision StemQuadra-SCFPMega C stemMP Neck Cementless Stem333332222111111 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1%www.njrcentre.org.uk16
National Joint Registry 14th Annual ReportTable 6 (b) Cementless stem brands for revision hip procedures performed during 2016.BrandStrykerRestoration Cementless StemZimmer BiometArcos Cone423Proceduresusing femoralPercentagebone graft16324%2720%31Zimmer BiometZMR Cementless Proximal uyCorail Revision Stem744%11Zimmer BiometRevitan Cementless Stem693%10Peter Brehm GmbHPeter Brehm Revision Stem663%3Waldemar LinkMP Revision653%8LimaLima Revision Stem502%13DePuyS-Rom Cementless Stem281%1DePuyReef271%1OrthodynamicsCannulok Cementless Stem241%2Smith & NephewEchelon Cementless Stem221%0Zimmer BiometM/L Taper Cementless211%0CorinMetafix Stem20 1%2Zimmer BiometTaperloc Cementless Stem20 1%1Zimmer BiometTaperloc Complete Cementless Stem18 1%0JRI Orthopaedics LtdFurlong HAC Stem16 1%0Smith & NephewAnthology16 1%3Smith & NephewSynergy Cementless Stem15 1%0MicroPort OrthopedicsProfemur Modular Neck13 1%0JRI Orthopaedics LtdFurlong HAC Revision Stem12 1%012 1%0Mathys Orthopaedics Ltd Twinsys Cementless StemSmith & NephewPolarstem Cementless11 1%2StrykerAccolade11 1%0JRI Orthopaedics LtdFurlong Evolution Cementless9 1%1StrykerAccolade II9 1%0JRI Orthopaedics LtdSecurus7 1%2Implantcast GmbHMutars Cementless6 1%0CorinminiHip5 1%1DePuyStanmore ImplantsWorldwideZimmer BiometLPS5 1%0METS Cementless5 1%1Wagner Revision Stem5 1%1Implantcast GmbHEcoFit Cementless Stem3 1%0Zimmer BiometBimetric Cementless Stem3 1%0DePuyTrilock BPS2 1%12 1%0Mathys Orthopaedics Ltd Mathys Revision Stem National Joint Registry 2017ManufacturerNumber ofprocedures2,087494Continued www.njrcentre.org.uk17
Table 6 (b) (continued) National Joint Registry 2017ManufacturerMicroPort OrthopedicsBrandProfemur L ClassicProceduresusing femoralPercentagebone graft 1%0Number ofprocedures2Symbios SASPS Ha2 1%0Zimmer BiometCLS Cementless Stem2 1%0AmplitudeIntegrale1 1%0B Braun / AesculapBicontact Cementless Stem1 1%0B Braun / AesculapExcia Cementless1 1%0B Braun / AesculapPrevision Cementless Revision Stem1 1%1CorinTriFit TS hip stem1 1%1DePuyKar1 1%0DePuySolution Cementless Stem1 1%0ESKAQuadra-H1 1%0LimaH-Max S Monoblock Stem1 1%0Medacta UK LtdAMIStem-H1 1%0Medacta UK LtdQuadra-H1 1%0MicroPort OrthopedicsProfemur L Modular1 1%0MicroPort OrthopedicsProfemur TL1 1%0Smith & NephewMDF Modular1 1%0Smith & NephewRedapt Cementless1 1%0StrykerOmnifit Cementless Stem1 1%0Symbios SASPS Evolution1 1%0Zimmer BiometAvenir Muller Cementless1 1%0Zimmer BiometMallory-Head Cementless Stem1 1%0Zimmer BiometVersys Cementless Stem1 1%0 National Joint Registry 2017Table 7 Brands of resurfacing head for primary hip procedures performed during 2016.ManufacturerBrandNumber of procedures762560PercentageSmith & NephewInternationalOrthopaedics LtdMATOrtho LimitedBHR Resurfacing Head11815%Adept Resurfacing Head588%Implantcast GmbHAccis Resurfacing Head233%MicroPort OrthopedicsConserve3 1%Iconwww.njrcentre.org.uk73%18
National Joint Registry 14th Annual Report1.3 Combinations of cups and stemsTables 8 (a) and 8 (b) detail the combinations ofcup and stem brands used in primary and revisionhip procedures respectively. Table 8 (a) also detailswhich combinations have a different stem and cupmanufacturer – a practice known as ‘mix and match’.For 92,207 hip primary replacement procedures in the2016 data, both the cup and stem brand were knownand a total of 851 different combinations of cup andstem brands were recorded.The most common cup-stem combination for primaryprocedures was the Corail stem combined with thePinnacle cup. Of the 92,207 primary procedures9,127 (10%) used ‘mix and match’ cup-stemcombinations from different suppliers, approximately1% less than in 2015 and 5% less than 2013.Of the 3,425 revision hip procedures where boththe cup and stem were replaced, 493 cup-stemcombinations were used. The most common cupstem combination for revision procedures was theExeter V40 stem combined with the Tritanium cupboth from Stryker.Table 8 (a) Cup-stem brand combinations for primary hip procedures performed during 2016.Cup brandStem dentStrykerExeter V4010,77312%NoStrykerExeter ContemporaryFlangedStrykerExeter V407,6898%NoStrykerExeter X3 RimfitStrykerExeter V404,6895%NoZimmer BiometTrilogyZimmer Biomet CPT2,4553%NoZimmer BiometExceed ABTZimmer BiometTaperloc CementlessStem2,1612%NoStrykerExeter ContemporaryHoodedStrykerExeter V402,0052%NoDePuyPinnacleDePuyC-Stem AMT CementedStem1,9542%NoSmith & NephewR3 CementlessSmith &NephewPolarstem Cementless1,7732%NoFurlong HAC Stem1,7722%NoJRIJRI OrthopaedicsFurlong HAC CSF Plus OrthopaedicsLtdLtdNumber ofprocedures92,207MixandPercentage matchStemmanufacturerZimmer BiometTrilogy ITZimmer Biomet CPT1,7652%NoDePuyPinnacle il1,6932%NoZimmer BiometZCAZimmer Biomet CPT1,6722%No1,6692%No1,4122%NoC-Stem AMT CementedStemDePuyMarathonDePuyZimmer BiometContinuumZimmer Biomet CPT National Joint Registry 2017CupmanufacturerContinued www.njrcentre.org.uk19
National Joint Registry 2017Table 8 (a) (continued)CupmanufacturerStrykerNumber ofprocedures1,358MixandPercentage match1%NoCup brandTridentStemmanufacturerStrykerStem brandAccoladeDePuyMarathonStrykerExeter V401,1081%DePuyMarathonDePuyC-Stem Cemented Stem1,0871%NoDePuyPinnacleStrykerExeter V401,0321%YesCorinTrinityCorinTaperfit Cemented Stem1,0051%NoCorinTrinityCorinMetafix Stem873 1%NoStrykerTridentStrykerAccolade II871 1%NoDePuyElite Plus OgeeStrykerExeter V40842 1%YesZimmer BiometTrilogy ITZimmer Biomet M/L Taper Cementless842 1%NoZimmer BiometExceed ABTZimmer Biomet820 1%NoZimmer BiometContinuumZimmer Biomet M/L Taper Cementless808 1%NoTaperloc CompleteCementless StemYesJRIJRI OrthopaedicsFurlong HAC CSF Plus OrthopaedicsLtdLtdFurlong EvolutionCementless757 1%NoStrykerTritaniumStrykerExeter V40684 1%NoZimmer BiometTrilogyStrykerExeter V40681 1%YesSmith & NephewR3 CementlessSmith &NephewAnthology668 1%NoZimmer BiometG7 CementlessTaperloc CompleteZimmer BiometAcetabular ComponentCementless Stem431 1%NoDePuyCharnley and Elite PlusStrykerLPWExeter V40409 1%YesStrykerExeter DurationStrykerExeter V40401 1%NoSmith & NephewR3 CementlessStrykerExeter V40382 1%Yes363 1%NoDePuyElite Plus OgeeDePuyC-Stem AMT CementedStemCorinTrinityCorinTriFit TS hip stem351 1%NoSmith & NephewR3 CementlessSmith &NephewSynergy Cementless Stem330 1%NoSmith & NephewR3 CementlessSmith &NephewCPCS325 1%NoZimmer BiometTrabecular MetalModular CementlessCupZimmer Biomet CPT287 1%NoContinued www.njrcentre.org.uk20
National Joint Registry 14th Annual ReportTable 8 (a) (continued)StemmanufacturerCup brandExceed ABTZimmer BiometZimmer BiometCementedOriginal ME Muller LowZimmer BiometZimmer BiometProfile CupJRIJRI OrthopaedicsCSFOrthopaedicsLtdLtdStem brandNumber ofproceduresMixandPercentage matchCPT247 1%NoCPT245 1%NoFurlong HAC Stem240 1%No236 1%NoZimmer BiometOriginal ME Muller LowZimmer Biomet Muller Straight StemProfile CupSmith & NephewEP-Fit PlusSmith &NephewSL-Plus Cementless Stem227 1%NoCorinTrinityCorinminiHip219 1%NoMicroPortOrthopedicsProcotyl LMicroPortOrthopedicsProfemur Modular Neck213 1%NoZimmer BiometExceed ABTZimmer Biomet Taperloc Cemented Stem207 1%NoB
Table 9 (b) Brands for total condylar knee revision procedures performed during 2016. . 75 Table 10 Brands for primary and revision unicondylar knee replacement procedures performed during 2016. 77 Table 11 Brands for primary and revision patellofemoral joint replacement procedures performed during 2016 . 78 Table 12 Fixed and rotating hinged knee brands for primary and revision .
