The Annual Report 2017
Summary of the 2nd THKJR Data Analysis Meeting
Contents
Contents ...... 1 Preface ...... 9 Background of THKJR ...... 10 Role of Steering Committees in THKJR ...... 13 THKJR Regional Coordinators 2016 – 2018 ...... 14 Data Structure and Data Security ...... 15 Annual Report 2017 ...... 16 THKJR’s Next Step ...... 42 APPENDICES ...... 43 THKJR Advisory Board ...... 44 Annual Activity Report 2017 – 2018 ...... 45 THKJR Steering Committees ...... 49
Appreciation
“Efficiency and precision in surgery are
essential factors when considering the effectiveness of a surgery. This program has both.”
The knee and Hip replacement project is a huge success, and it cannot be done without Dr. Viroj Larbpaiboonpong and his colleague’s unparalleled minds and endeavor. It is delightful to see this project forming, as it relates well to the present situation, where collecting data on surgeries is one of our primary concerns. It is clear since the beginning that this will be a groundbreaking discovery into Total joint replacement. Whether it is about the brand of the prosthesis, the result of the surgery or the evaluation, this program will help surgeons across Thailand to have a clear understanding of surgery as well as increasing its efficiency. I truly believe that every surgeon will collaborate and support this project by collecting data; a reliable evaluation of our methods of surgery can be achieved. In addition, this project can also be referred to when doing an academic program, as well as informing future surgeons across Thailand about prosthesis. It is my pleasure to see this project from the beginning to the end, and I am sure that this will be a significant step towards better surgeries in our country soon.
Prof. Thanainit Chotanaphuti, MD Viec President of RCOST President of Thai Hip & Knee Foundation (THKF). Professor Department of Orthopedics, Phramongkutklao College of Medicine, Bangkok, Thailand.
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Appreciation
“I can say that this is our first stable step towards the so called - Thai National Joint Registry”
We foresee that Joint Registry can be used in many aspects, like to benchmark the surgeon who do joint replacement. Benchmark can be compared in many levels, surgeon to surgeons, hospital to regional hospital, hospital to national level, national to international level. Joint Registry can be used to evaluate effectiveness and complications of certain surgical procedure or a specific prosthesis. Besides we can forecast a survival and complications of each prosthesis or procedure using Joint Registry. This give tremendous value for us to plan our direction of joint surgery in the future. When this project is completed, National Health Security Office can utilize our data for a proper budget and plan for Thai people health.
If we talk about history of Joint Registry in Thailand, it is worth to note that initial joint registry was attempted at Lerdsin Hospital by me and Dr. Chavanont Sumanasethakul, using a Delphi database and C+ language program. Years after that the Thai Hip and Knee Society foreseen the advantage of a National Joint Registry and use the web-based program as a media to collect raw data. This project had many obstacles and progressed too slow, until Dr. Viroj Larbpaiboonpong and his colleges take responsibility on the project, make a rapid progress on the project. A new software company, E. S. M. Solution Co. ,Ltd. , writes this Thai Joint Registry software, which can be run on any computer or mobile phone ( Android and iOS) . Our subcommittees for Joint Registry have many meetings to brainstorm an idea how this program shall work, then we get this working software to put in our data.
I can say that this is our first stable step towards the so called “ Thai National Joint Registry” , we cannot call it a National Joint Registry unless all of us show our unity by participation to the National Registry Project. In my mind, this is the second hardest thing to achieve, we know that every surgeon has a lot of work to do every day but our dream will never be success without your cooperation. Let us make it success.
Wallob Samranvedhya, MD Head of Hip and Knee Center, Bangkok Hospital, Bangkok, Thailand
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Appreciation
“I would like to emphasize that this report
will wind up the next movements of the
national joint registry regarding our national joint surgical data”
First of all, I would like to express my sincere appreciation, as well as congratulations on the success of Police Colonel Viroj Larbpaiboonpong, MD, and his THKJR team for having done a great and successful taskforce on the Thai national joint registry project, which I would define that this taskforce is probably the most difficult strategic project among 5 THKS Key Strategic Plans.
Looking backward to the past 10 years, several of THKS key members, who were interested in national joint registry issue, have tried and worked very hard to establish this project, including running several collaborative contacts with government sectors and private sectors, arranging some useful and informative meetings for a better understanding and cordial agreement in this project. However, a lot of obstacles occurred and several difficult confounding factors could not be fixed. Therefore, the mission “Thai national joint registry” has been still on the road.
At the present time, the working group of Dr. Viroj’s, who have been working very hard and very systematic without tired for several months, have ended up with a successful taskforce of the first mile stone of this project. In fact, it becomes the first Annual Report of the Thai National Joint Registry. Although it may be defined as a preliminary national joint report which has been well prepared to be presented in the annual meeting of the THKS in year 2 0 1 8, this report demonstrates that the determination of this working group has already defeated all the difficult parts of this taskforce. I would like to emphasize that this first report will wind up the next movements of the national joint registry regarding our national joint surgical data. Then, the solid progress of this THKS strategic plan will be continued.
Again, I believe that the successful taskforce of this working group has levelled up to higherr standard for social responsibility of the THKS and the Thai Orthopedic Society.
Prof. Aree Tanavalee, MD Past President, The Thai Hip & Knee Society (2012-2014). President Elect, The Royal College of Orthopedic Surgeons of Thailand (2016-2018).
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Appreciation
“ espite many obstacles, the steering D team of THKJR had shown their
determination to develop THKJR system”
First,I would like to congratulate the THKJR working team, which lead by Dr. Viroj Larbpaiboonpong for developing Thai Joint Registry system. Thai Hip and Knee Society wants this system to be successful. The Joint Registry system has many benefits that will help improve hip and knee replacement patient. The system will help surgeon with decision making of the implants, since the system will provide information about quality of joint prosthesis. It will also indicate a trend for most effective treatment.
Cooperation of all Joint surgeons and data input are the most important factors for developing Thai Hip and Knee Joint Registry. For the corporation to happened, it is necessary for all joint surgeons to see the important of this system. Despite many obstacles, the steering team of THKJR had shown their determination to develop THKJR system. Thus, there is a constant increase of hospitals and surgeons enrolling to the system.
Lastly, I would like to encourage THKJR team and Dr. Viroj Larbpaiboonpong to constantly improve and make the system sustainable for long time.
Pol. Maj. Gen. Thana Turajane, MD (Hons.) Vice President of RCOST. President of the Thai Hip & Knee Association (THKA). Past President of the Thai Hip & Knee Society (THKS). Deputy Surgeon General, Police General Hospital Bangkok, Thailand.
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Appreciation
“ opefully, data from this program will H help us to improve quality of teaching surgeons, quality of patient management”
Total joint replacement is an operative procedure which used to treat patient suffered from severe osteoarthritis or other diseases that fail to conservative treatment. Among of this hip and knee joints are the most frequently performed with great success. However, successfulness of operation reports in our country are usually according to individual results. To assess the result of these procedure in a big picture of country is better done through joint register program. To accomplished this, Thai Hip and Knee Foundation has assigned to Dr. Viroj Larbpaiboonpong to develop a project to collect data from surgeons and establish joint register of Thailand.
Thank you to Dr. Viroj Larbpaiboonpong and his great team for their contribution to develop joint register. They worked very hard in the past few years to make it possible. Hopefully, data from this program will help us to improve quality of teaching surgeons, quality of patient management and also maybe develop to National Joint Register in the future.
Surapoj Meknavin, MD President of Thai Hip & Knee Society (THKS)
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Appreciation
“ e will use our own data in the w registration for evaluating and improving our surgical performance in taking care
our patients with the joint replacement in
our institute”
I am delighted and would like to congratulate for successful of the chair and his members of The Joint Registration Steering Committee, who did a tremendous and magnificent Joint Registration report of Thailand. The Joint Registry, as you know, will provide the benefit of providing a major national database, and allow comparative audit of hospitals and prostheses by the users and policy makers in every levels. Moreover, the Registry will also allow monitoring of ‘ old and new’ joint prostheses and identifying patients who require urgent clinical and function evaluations.
For our interests, we will use our own data in the registration for evaluating and improving our surgical performance of taking care our patients with the joint replacement in our institute. Overall, I expect that utilization of the registration data will have the effect of improving clinical standards care in patients with joint replacement in each hospital, each region, and the whole country. Last but not least, I am looking forward to seeing more cooperation and participation of Thai orthopedic surgeons and hospital participating in the data entry for the next year Annual Report with more confidence and enthusiasm.
Prof. Weerachai Kosuwon, MD, BSc, MSc, FIMS Director of Special Orthopedic Skills Training Center, Khon Kaen University. Director of Research Cent for Orthopedic Biomechanics, Khon Kaen University.
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Appreciation
“These information’s are very
important for the patients, doctors and policy makers”
Joint replacement registration in many countries such as Norway Sweden and Australia had demonstrated vast benefits.
It provided important information for example longevity of each type of prosthesis, causes of failure in different time periods. These information’s are very important for the patients, doctors and policy makers. I am very pleased and like to express my gratitude to Dr. Viroj Larbpaiboonpong and all members of the Thai Joint Registration Team for being exerted and engrossed during this three- year period and created the initiation of joint registration in Thailand.
Assoc. Prof. Sattaya Rojanasthien, MD Head of Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Preface
Pol.Col. Viroj Larbpaiboonpong, M.D.
Chairman of THKJR Steering Committee. Chairman of Hip & Knee Section, RCOST.
After I came back from fellow training, I dream to have my personnel patient data record similar to orthopedic surgeon. Without Top- down Orth wave software and look forward to see compulsory policy from Thai authorize government, something close to Australian Joint Registry. To National registry is far away to reach. At least, we achieve dream, it looks like that I have to pay by have our own design of perfect patient data record myself for very high annual fee for Orth wave and and it is completely FREE for all Thai orthopedic then I think about that all other Thai orthopedic members. This SECURE ENCRYPTED database will colleagues have to pay too if they want to do so. allow members benchmark their personnel data with Fifteen years ago, I still very young so mainly all data groups. Entire data is impossible to trace attention on developing best medical practice, back to origin of entry. All reports in annual book are operative skill, however my dream still in my mind for intention to show anonymous label except implant very long time to create proper patient and implant components. All implants are capability be tracked to database system for me and also our Thai orthopedic approving their appropriate design and quality. surgeons. These will be finally give advantages to the best patient outcome. On January 2015 in Thai Hip and Knee Society (THKS) Strategic Planning conference, as next 4-year This annual report displays more progression of elective chairman of THKS, I successfully purpose a our work than data report. We have to learn more pilot project for patient data record software which about format and data pattern to report that should would be free of charge for every Thai orthopedic meet all purposes include all stake holders for surgeon. We start collaboration work between Police example surgeons, hospital administrators, implant Advance Joint Academic Centre ( PAJAC) and companies, patients and governments. Orthopedic Department from Lerdsin Hospital to develop an essential database and entry system. A lot of Lessons learning from developing THKJR Within one year later, first total knee arthroplasty in first year will make our THKJR steering committee recording system include patent follow up functional continue work hard again. The next generation of score was successfully run on my own design secure THKJR which will be MULTIPURPOSE version of THKJR private cloud database server over stack with Ruby that will be gradually construct on successfully first on Rail framework. For economy and scale up ability version platform and expect to have much better system, it looks like cloud database server provide user interface record, better organize entry form, the best solution. In client side, this responsive web better completeness of data recording for second base user interface can operate on any platform year progress report. independently and also on any device. As my dream, all database system is costless for all Thai orthopedic I would like thanks to all advisory board members. committees for excellent consultation, THKJR Steering team for very hard working to make this Primary purpose of Thai Hip and Knee Joint impossible thing start up and unconditional support Registry (THKJR) is a tool for every single Thai from Johnson and Johnson, Thailand.
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Background of THKJR
Since 1979, Sweden started collecting joint replacement surgery data, and able to report the information so that physicians and researchers can refer the information in their studies and researches. It is known worldwide that joint replacement surgery data can show and reflect on the process and the information of the surgery well that physician who work on this field and management in health business can use this information to improve the process of joint replacement treatment; inefficient surgery can be found easily, replaced joint with side effect can be improve, so that the patients would gain more benefits from the result of better treatment based on accurate medical records. Many countries see benefit of the big data to their health business and improvement, such as Australia, which is one of countries that succeed in collecting 100% of the surgery data. Each year, Australia would publish summary report of all surgery to public, the same goes to developed counties in Europe and America, including some countries in Asia, such as Japan, Korea, China, and India, which also prioritize and try to improve the joint replacement surgery data collecting system, so that their people can get the best out of the results.
In Thailand, there was an attempt in collecting joint replacement surgery data since 2005 as well, however, the process lacked continuity and eventually stopped. The Thai Hip and Knee Joint Registry ( THKJR) have meeting resolution to develop joint replacement surgery data collecting system on 22- 23 January 2015. The development would start from Police General Hospital and Lerdsin Hospital. This process would take 1 year to develop so that the data and program that would be used to collect data can be complete, and then the second process, which is ‘ program testing’ , would start in the same hospitals The Thai Hip and Knee Joint Registry have continuous resolution to appoint working committee from core institutes from all over Thailand to continue to process and drive the project from various perspective.
Consensual meeting took place in Nakhon Pathom during 24-25 June 2016 agreed only necessary data would be collected in order to not put more workload to each hospital. There are also others conclusions from the meeting that would lead to success in motivating physicians to collect data. In 2016 -, the appointed working committee had focused on deploying the program and asking more physicians to join and collecting as much joint replacement surgery data as possible with various methods, such as appointing fellow surgeons to collect the data to use as log book when approaching their graduations or asking cooperation from physicians from every institutes to support data collecting for research purpose. The Thai Hip and Knee Joint Registry hold THKJR Session meeting during 11-13 August 2016 at THKS APOKA event, at Shangri-La Hotel, Bangkok, the first 2 days of the event was a workshop for session participants. The workshop would also be hold at the end of the year in Khon Kaen, and again in Chiang Mai at the beginning of the following year.
In the long run, hopefully, the joint replacement surgery data collecting system from THKJR would be acceptable in wilder range and continue to improve and grow into better and stronger system with collaboration from related parties such as Ministry of Public Health, National Health Security Office ( NHSO) , and others health institutes.
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About The THKJR currently collects data on all hip and knee joint replacements across Thailand by volunteer Thai orthopedic surgeons. Since Hip and knee joint replacement have become more common and highly successful procedure that helps patients return to daily life by improving mobility and relief pain, there are more than ten thousand of such procedures perform in Thailand every year. With constant strive to improve patient outcomes; there are many types of implants can be used in joint replacement procedures. This registry helps to monitor the performance of these implants and effectiveness of different technique of surgery, improving clinical standards and surgery outcome, and the orthopedics sector as a whole.
Goal To monitor outcomes achieved by brand of prosthesis, hospital and surgeon, and highlight where these fail below an expected performance in order to allow prompt investigation. Inform patients, clinicians, providers and commissioners of healthcare, regulators and implant suppliers of the outcomes achieved in joint replacement surgery. Evidence variations in outcome achieved across surgical practice in order to inform best practice. Support evidence- based purchasing of joint replacement implants for healthcare providers to support quality and cost effectiveness.
Provide standardize systematic joint procedure and related implant data record for all surgeons without expense and allow benchmarking between those data. Allow better healthcare management and improvement by the way of reliable evidence base information.
Objective When creating this annual report, the working group aimed to clarify the first Thai Hip and Knee registry in order to study on the prevalence of hip and knee surgery. Regarding the decision made by committees, the objective of this registry was to collect important information that can be used to identify the patients and the operations, including national identification number, side of incision, joint and used implants.
Later, the idea has become the agreements between various institutions. This is a retrospective record of the year 2017. The results of this data collection had been exhaustively categorized within the book.
In addition, the committees had agreed to build a large database to cover the actual number of operations over the whole country by connecting to database of from different sources, where the hip and knee information are stored, such as the National Health Security Office (NHSO). Thus, the guidelines for storing important information and standards as a basis for disseminating information to the public had been established.
Mission The purpose of the Thai Hip and Knee Joint Registry is to collect high quality and relevant data about joint replacement surgery in order to provide an early warning of issues relating to patient safety. In a continuous drive to improve the quality of outcomes and ensure the quality and cost effectiveness of joint replacement surgery, the THKJR will monitor and report on outcomes, and support and enable related research. Support surgeon, administrator and implant company for standard information and benchmarking. Improving patient care for the best outcome result and prevent unwanted complication and poor result.
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Organization Chart
Organization
Chart
แ
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Role of Steering Committees in THKJR
Member Administration
Member's qualification verification. Membership report in every meeting. Open for new membership account.
Information Management
Implant profile database. Database in pdf format available for download. Provide data for public, personal and extra data.
Annual Report
Collect and publish annual reports and make download available for public. Compile the membership requirements to report in the annual report.
Ethics
Design guidelines for data collection to be ethical. Design Informed Consent form (PDF file) to be available for download.
Deployment and Training
Education program training. Program user guide manual. Publish and educate about the program.
Research Paper
Consider adding information from those who want to research. Coordinate with those who wish to use program for research purpose.
Data Interpretation and Analysis
Data Interpretation and analysis. Prepare information and analysis data. Presentation of statistics report and make consensus comments.
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THKJR Regional Coordinators 2016 – 2018
Regional Delegates
Upper Northern Upper North Eastern ■ Assoc. Dr. Sattaya Rojanasathien ■ Prof. Weerachai Kosuwon (Chiangmai University) (Khon Kaen University) ■ Dr. Anuwat Pongkunakorn ■ Dr. Rit Apinyankul (Lampang Hospital) (Khon Kaen University) ■ Dr. Warakorn Jingjit (Chiangmai University) Lower North Eastern ■ Dr. Jithayut Sueajui Lower Northern (Maharat Nakhon Ratchasima Hospital) ■ Asst. Prof. Dr. Artit Laoruengthana (Naresuan University) Eastern ■ Dr. Witoon Triamtrakarnpol ■ Dr. Chatchawan Visetsripong (Buddhachinaraj Hospital) (Chaophraya Abhaibhubejhr Hospital)
Bangkok Western ■ Dr. Ukrit Chaweewannakorn ■ Dr. Wasu Techapaitoon (Police General Hospital) (Nakhon Pathom Hospital)
Central Southern ■ Dr. Apisit Patamarat ■ Dr. Theerawit Hongnaparak (Ayutthaya Hospital) (Songklanagarind Hospital)
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Data Structure and Data Security
After the meeting of THKJR subcommittee steering group, the committee decided to use an online electronic platform which have been developed by E.S.M.solution Co., Ltd. Data structure and analysis were clearly designed and constructed based on data integrity, usability, and data security. By using this platform, users such as doctors were able to entry data from everywhere and anytime via standard web browsers. As it based on UI responsiveness, it was easy to use not only in desktop computer but also portable devices. Since the platform was developed on based standard open-source packages such as Ruby HTTPS on Rails, jQuery and MongoDB, It is flexible to use for sustainable development.
Since data security is the important issue for online multi center registry, our solution then decided to use most important technique range from secure socket layout SSL by HTTPS to data field encryption. For example data consolidation, hospitals and doctors identification will be discarded or bind from data records to protect data privacy of users. Furthermore, there is a try to use two level authentication in order to access important data and functions.
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Annual Report 2017
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Demographic Overview
32 Thai Hip & Knee Joint Registry (THKJR) was developed in 2015. Firstly, we had 4 hospitals to start the registry program and used the trial version for registered the data .In the year 2016, THKJR was assigned to be a part of Thai Hip & Knee Arthroplasty consensus .At that time, we 14 recruited more 10 hospitals .In the first 6 months of this year, the participated hospital was increase by 10 and total number of participated hospitals 4 was 32 at the end of June 2017 (Figure 1).
2015 2016 2017
Figure 1 Number of hospitals participated in 2015 - 2017 (N=32)
Surgeon (N=197)
197 173 Number of orthopedic surgeons who participated at the beginning of program was only 16 doctors .In 2016, there were 173 and increased to 197 surgeons by the first half of 2017, there were 197 surgeons participated in the 16 program .(Figure 2).
2015 2016 2017
Surgeon (N=197)
Figure 2 Number of orthopedic surgeons
Hospital (N=30) Surgeon (N=197)
197 Comparing the amount of doctor and 173 hospital enrolled was increase by years but the increasing rate of doctor recruitment was less in 2017 .Because all hospitals that joined the THKJR I 2016 was medical school hospitals that have much doctor than the smaller hospitals that was recruited in 2017 . 30 16 14 4 2015 2016 2017
Figure 3 The numbers of surgeons and hospitals in 2015 - 2017
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1400 THKJR was established in early 2015 by a small group of surgeons and the joint registry website was 1200 programming completely finished in July 2015 .At the 1000 end of 2015, the total numbers of dataentry were 800 43 .In 2016 there were 10 more hospitals participated 600 in the program, the total numbers of data entry were
400 increased up to 254 data .And at the end of July 2017, the total numbers of data entry were surprisingly 200 increased to 1,223. (Figure 4)
0
Jul-17
Jul-15
Jul-16
Jan-17
Jan-16
Mar-17
Sep-15
Mar-16
Sep-16
Nov-15
Nov-16
May-17 May-16
Patient (N=1223)
Figure 4 Number of patient records submitted by months
1600 1492 1400
1200
1000 Primary Knee (N=1492)
800 Primary Hip (N= 415) Revision Knee (N=37) 600 Revision Hip (N=64) 400 415
200 64
0 37 2015 2016 2017
Figure 5 Number of procedure records submitted by years
There were 4 categories of procedure that registered in THKJR including primary knee arthroplasty, primary hip arthroplasty, revision knee arthroplasty and revision hip arthroplasty . The total number of each procedures were shown in Figure 5. The total number at the end of July 2017 of primary knee arthroplasty, primary hip arthroplasty, revision knee arthroplasty, and revision hip arthroplasty were 993, 274, 25 and 68, respectively. The number of primary knee arthroplasty was about 4 times higher than primary hip arthroplasty. The total number of revision knee arthroplasty and revision hip arthroplasty was same number; however, the numbers were too small to be evaluated.
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1200
1000
800
600
400
200
0
Jul-17
Jul-15
Jul-16
Jan-17
Jun-17
Jan-16
Jun-16
Oct-15
Mar-17
Apr-17
Oct-16
Feb-17
Sep-15
Mar-16
Apr-16
Dec-15 Feb-16
Sep-16
Dec-16
Nov-15
Nov-16
May-17
Aug-15
May-16 Aug-16
Primary Knee (N=993) Revision Knee (N=25) Primary Hip (N=274) Revision Hip (N=68)
Figure 6 Number of procedure records submitted by months
Figure 6 shows the cumulative number of each procedures by month. After January 2017, we had THKJR roadshow in Khon Kaen university hospital, we found that the total procedures recorded were steeply increased.
L(N=526) 33.44% K(N=391) 24.86% J(N=197) 12.52% By the end of December 2017, 12 hospitals I(N=149) 9.47% from various areas of Thailand participated in data H(N=103) 6.55% registration. Hospital N submitted 526 records G(N=92) 5.85% (33.44%) and the others 2 hospitals submitted F(N=84) 5.34% around 24.86% and 12.52% respectively. Others E(N=14) 0.89% submitted the data nearly comparable (mostly less than 10%). D(N=14) 0.89% C(N=1) 0.06% B(N=1) 0.06% A(N=1) 0.06%
Figure 7 Number of patients submitted by hospital
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Procedural Data: Hip
Report from Thai joint registry shows that primary hip arthroplasty was 39.52% Female (N=251) female predominate. The number of female patients was 60%. Male (N=164) 60.48%
Figure 8 Primary hip arthroplasty
Female Male
In the primary hip arthroplasty, 19% there was a significant difference between male and female. Two third of 35% 21% the cases in this annual report were 12% 13% female (60%). In the less than 50 years 30% old group, male was more than female; 20% 19% 18% 14% while, in the more than 60 years old group, female was more than male. < 50 50-59 60-69 70-79 80 >
Figure 9 Hip arthroplasty
23% Total hip arthroplasty represents Bipolar approximately 77% of the hip procedures performed in this annual THR 77% report, with bipolar hemiarthroplasty accounting for the bulk of the remainder at about 23%.
Figure 10 Type of operation
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53%
Bipolar hemiarthroplasty remained a commonly performed procedure with 29% an aging. Most of the bipolar hemiarthroplasty cases were more than 16% 60 years old. In the more than 80 years old group represented more than 50% 2% 0% of the total cases.
< 50 50-59 60-69 70-79 80 >
Figure 11 Age distribution for bipolar hemiarthroplasty
Fracture Neck of femur (N=78) 80.41%
Fracture intertrochanteric of femur (N=9) 9.28%
Other (N=7) 7.22% Bipolar hemiarthroplasty for femoral neck fracture remained a Previous hip surgery/non trauma (N=1) 1.03% commonly performed procedure approximately 80% followed by Osteonecrosis (N=1) 1.03% the intertrochanteric fracture of femur (9%). Implant wear (N=1) 1.03%
Figure 12 Diagnosis for bipolar hemiarthroplasty
Fracture intertrochanteric of femur Fracture Neck of femur
55%
42%
28% 21% 18% 18%
9% 4% 4% 0%
< 50 50-59 60-69 70-79 80 >
Figure 13 TOP 2 Diagnosis for bipolar hemiarthroplasty by age
In the more than 80 years old group, the intertrochanteric fracture was the common diagnosis for bipolar hemiarthroplasty; while, in the less than 80 years old group, the fracture neck of femur was the common diagnosis for bipolar hemiarthroplasty.
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33%
28%
24%
11%
4%
< 50 50-59 60-69 70-79 80 >
Figure 14 Age distribution for THR
The majority (57%) of total hip arthroplasties were performed in the less than 60 years old group.
Female Male
46% Osteonecrosis (N=130) 59%
34% Osteoarthritis (N=76) 24%
13% Fracture neck of femur (N=33) 13%
7% Developmental dysplasia of the hip (N=16) 5%
Figure 15 Top 4 Diagnosis for THR by sex
Osteonecrosis was the diagnosis at the time of surgery for approximately 50% of the patients undergoing total hip arthroplasty. Osteoarthritis was the next most common diagnosis, accounting for one in 3 arthroplasties performed followed by the fracture of the femoral neck and developmental dysplasia of the hip. The majority of osteonecrosis group is male; while, the majority of osteoarthritis group is female.
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23.76% Either hemiarthroplasty or total hip arthroplasty, approximately three- Cemented quarters of primary femoral stem were Cementless cementless (76.24%), the rest were 76.24% cemented (23.76%).
Figure 16 Primary stem type
Tri-lock (Cementless) Depuy (N=51) 12.29% Corail (Cementless) Depuy (N=51) 12.29% Accolade II (Cementless) Stryker (N=46) 11.08% Summit (Cementless) Depuy (N=44) 10.60% M-30 (Cemented) Zimmer Biomet (N=38) 9.16% M/L Taper (Cementless) Zimmer Biomet (N=34) 8.19% LCU (Cementless) LINK (N=23) 5.54% Corail (Cemented) Depuy (N=13) 3.13% C stem (Cemented) Depuy (N=11) 2.65% Wagner SL (Cementless) Zimmer Biomet (N=10) 2.41%
Figure 17 Top 10 primary stems
Three most commonly used cementless stem were Tri-lock (12.29%), Corail (12.29%) and Accolade II (11.08%), whereas M-30 (9.16%), cemented Corail (3.13%) and C-stem (2.65%) were three most popularized cemented stem.
4% 1% 3% Depuy (N=177) 6% Zimmer Biomet (N=125)
13% Stryker (N=53) 43% LINK (N=25)
B.Braun (N=15)
30% Smith & Nephew (N=15) Implantcast (N=5)
Figure 18 Primary stems by implant brands
The data from 415 primary hip arthroplasties demonstrated that more than 80% of femoral stem were from Depuy (43%), Zimmer Biomet (30%) and Stryker (13%), while the rest were shared by LINK (6%), Smith & Nephew (4%), B. Braun (3%) and Implant cast (1%).
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Bangkok
3% 1%
5% Depuy 6% Stryker Sub-analysis revealed that 85% of primary 46% Smith & Nephew femoral stem used in Bangkok were from Depuy
B.Braun (49%) and Stryker (36%), while Smith & Nephew, B. Braun, Zimmer Biomet and LINK were used only 6%, Zimmer Biomet 39% 5%, 3% and 1% respectively. LINK
Figure 19 Regional (Bangkok): primary stems by implant brands
Southern
3%
In southern Thailand, only three brands were
Depuy registered. Stem from Depuy (52%) was the most popular followed by Zimmer Biomet (45%) and 45% Zimmer Biomet 52% implant cast (3%). Implantcast
Figure 20 Regional (Southern): primary stems by implant brands
Northern
2% 1%
8%
Zimmer Biomet Nearly two-third of femoral stem used in Depuy northern region were from Zimmer Biomet (64%) 25% Smith & Nephew followed by Depuy (25%) whereas the rest were from Smith & Nephew (8%), Stryker (2%) and LINK 64% Stryker (1%). LINK
Figure 21 Regional (Northern): primary stems by implant brands
24 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
Northeastern
Surprisingly, the reverse ratio with 19% 63% of femoral stem from LINK and 18% LINK from B.Braun B. Braun while 19% from Zimmer Biomet 18% Zimmer Biomet were observed in northeastern region. 63%
Figure 22 Regional (Northeastern): primary stems by implant brands
1.56%
Almost acetabular cup used in Cemented Thailand was cementless cup that used in Cementless 98.44% of patients.
98.44%
Figure 23 Primary acetabular cup types
4% 1% 5% 6% Depuy (N=165)
Zimmer Biomet (N=57)
Stryker (N=49) The market share of acetabular 15% 51% LINK (N=18) component company was Depuy 51%, Zimmer Biomet 18%, Stryker in 15%, LINK in B.Braun (N=15) 6%, B. Braun in 5%, Smith & Nephew in 4 % 18% Smith & Nephew (N=14) and Implantcast in 2%.
Implantcast (N=2)
Figure 24 Acetabular cup brands
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 25
Pinnacle (Cementless) Depuy 50.94%
Trident (Cementless) Stryker 15.31%
G7 (Cementless) Zimmer Biomet 10.94%
Trilogy (Cementless) Zimmer Biomet 5.94%
TOP II (Cementless) LINK 5.31%
PlasmaFit (Cementless) B.Braun 4.69%
Reflection (Cementless) Smith & Nephew 2.19%
R3 Cup (Cementless) Smith & Nephew 1.88%
Burch-Schneider Reinforcement Cage… 0.94%
Reflection Allpoly Cup (Cemented) Smith &… 0.31%
Figure 25 Top 10 Acetabular cup models The most acetabular cup model used was Pinnacle (Depuy) in 50.94%, Trident (Strykey) 15.31%, G7 (Zimmer Biomet) in 10.94%, Trilogy (Zimmer Biomet) in 5.94%, TOP II (LINK) in 5.31%, PlasmaFit (B. Braun) in 4.69%, Reflection (Smith & Nephew) in 2.19%, R3 Cup (Smith & Nephew) in 1.88%, Burch-Schneider Reinforcement Cage (Zimmer Biomet) in 0.94% and Reflection Allpoly Cup (Smith & Nephew) in 0.31%.
26 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
Revision Data: Hip
In revision hip arthroplasty percentage of 40.32% Female (N=37) gender, female: male was about 60:40 percentage Male (N=25) and same with the percentage of primary total hip 59.68% arthroplasty
Figure 26 Genders
33%
26%
21%
15%
5%
<50 50-59 60-69 70-79 80>
Figure 27 Age distribution revision THA Age groups in revision total hip arthroplasty in patients below 50 years old were 15%, 50-59 years old were 26%, 60-69 years old were 33%, 70-79 years old were 21% and age more than 80 years old are 5%.
Aseptic loosening 53.23% Infection 17.74% Periprosthetic fracture 8.06% Other 4.84% Dislocation 4.84% Malalignment 3.23% Osteolysis 1.61% Loosening acetabular component 1.61% Implant wear 1.61% Implant fracture 1.61% Head/Socket (size) mismatch 1.61%
Figure 28 Diagnosis for revision Diagnosis of revision total hip arthroplasty more than 50% was aseptic loosening, infection was the second most common cause of revision THA in 17.74%, followed by periprosthetic fracture in 8.06%.
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 27
35%
30%
25%
20%
15% 30% 30%
10% 21%
5% 12% 6% 0% <50 50-59 60-69 70-79 80>
Figure 29 Aseptic loosening diagnosis vs age There are 3 graphs illustrate age of patients for revision arthroplasty related to aseptic loosening, infection and fracture. The age range between 50-69 years old was highest percentage (60%) of aseptic loosening in revision total hip arthroplasty. The lowest percentage (6%) was in age more than 80 years old.
80% 70% 70%
60%
50%
40%
30% 20% 20% 10% 10% 0% 0% 0% <50 50-59 60-69 70-79 80>
Figure 30 Infection diagnosis vs age Majority of patient age range in infection for revision total hip arthroplasty was between 70-79 years old. A small minority of range is less than 50 years old (10%).
45% 40% 40%
35%
30%
25% 20% 20% 20% 20%
15%
10%
5% 0% 0% <50 50-59 60-69 70-79 80>
Figure 31 Periprosthetic fracture diagnosis vs age Whereas, the incidence of revision arthroplasty for periprosthetic fracture was maximum in 50-59 years old. ( 40%) the rest old was equal (20%) between 60-69, 70-79, >80 years old, and there was not revision arthroplasty in <50 years old for periprosthetic fracture.
28 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
1.61% 1.61% 4.84% The pie chart shows the distribution of Zimmer Biomet (N=30) stem brand by revision total hip arthroplasty in 2017. Top 3 most common stem brand was Depuy (N=19) 12.90% Zimmer, Depuy and Stryker. Almost half of Stryker (N=8) stem was Zimmer Biomet (48.39%), followed 48.39% LINK (N=3) by Depuy 30.65%, a small minority of stem was Stryker (12.90%). The other brands were Smith & Nephew (N=1) 30.65% Link and Smith & Nephew.
Figure 32 Revision stem brands
Wagner SL (Cementless) Zimmer Biomet (N=17) 27.42%
Solution (Cementless) Depuy (N=12) 19.35%
Restoration(Modular) Stryker (N=7) 11.29%
M/L Taper (Cementless) Zimmer Biomet (N=7) 11.29%
LCU (Cementless) LINK (N=3) 4.84%
Reclaim (Cementless) Depuy (N=2) 3.23%
Corail (Cementless) Depuy (N=2) 3.23%
Corail (Cemented) Depuy (N=2) 3.23%
Figure 33 Top 8 revision stem models (N>1) Revision Stem model from data entry, a quarter of revision stem model was Wagner (Zimmer Biomet) which
was 27.42%. Solution (Depuy) was tied on 2nd placed with 19.35%. Restoration (Stryker) and ML taper (Zimmer Biomet)
were equal on 3rd placed with 11.29%, whereas LCU (LINK), Reclaim (Depuy) and Corail (Depuy) were less used.
1.61% 3.23% The chart shows the distribution of cup brands by revision total hip Zimmer Biomet (N=31) 14.52% arthroplasty in 2017. Half of all cup Depuy (N=19) revision was Zimmer Biomet, Exactly
50.00% Stryker (N=9) 30% of revision cup was Depuy, whereas revision for Stryker were just LINK (N=2) 30.65% 14.52%. LINK and Smith & Nephew were Smith & Nephew (N=1) less than 5%
Figure 34 Revision cup brands
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 29
G7 (Cementless) Zimmer Biomet (N=17) 27.42%
Pinnacle (Cementless) Depuy (N=15) 24.19%
Trilogy (Cementless) Zimmer Biomet (N=9) 14.52%
Trident (Cementless) Stryker (N=9) 14.52%
Gription (Cementless) Depuy (N=4) 6.45%
Burch-Schneider Reinforcement Cage Zimmer Biomet (N=3) 4.84%
TOP II (Cementless) LINK (N=2) 3.23%
Figure 35 Top 8 revision stem models (N>1)
Figure shows that Zimmer Biomet and Pinnacle were the most common brand for cup revision about 27.42%
and 24.19%, respectively. Trilogy (Zimmer Biomet) and Trident (Stryker) accounted for 3nd place was 14.52%. A small
minority model Gription (Depuy), Burch-Schneider Reinforcement Cage (Zimmer Biomet) and Top II (LINK) were about
6.45%, 4.84% and 3.23%, respectively.
Figure 35 Revision Cup Model top 7 (N>1)
nd 30 | THKJR The Annual Report 2017 (The 2 THKJR Data Analysis)
Procedural Data: Knee
TKA UKA
30%
57% 4%
39% 41%
9% 0% 12% 2% 6% < 50 50-59 60-69 70-79 80 >
Figure 36 Primary knee surgery by age
In primary knee surgery, this data shows that the total knee arthroplasty were performed mostly in more than 60 years old patients (86%), and the noncompartmental knee arthroplasty were performed 66% in less than 60 years old patients
In primary knee surgery, this report 97% UKA (N=45) shows that 97% of all patients were 3% TKA (N=1447) performed total knee arthroplasty, and only 3% of all patients were performed unicompartmental knee arthroplasty.
Figure 37 Primary TKA/UKA
39% 36%
In primary knee surgery, the data report shows that the operations were performed mostly in patients age more than 12% 60 years (83%). 8% 4%
<50 50-59 60-69 70-79 80>
Figure 38 Age distribution for primary knee arthroplasty
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 31
18.21%
This pie graph shows the significantly Female (N=1190) different between male and female gender. The female gender (81.79%) shows Male (N=265) significantly much more than male gender (18.21%) 81.79%
Figure 39 Primary knee arthroplasty by genders
Left In primary knee arthroplasty, there was Right 48.93% 51.07% no difference between sides of operation.
Figure 40 Primary knee arthroplasty by sides
Primary Osteoarthritis (N=1429) 98.21%
Inflammatory arthritis (N=10) 0.69%
Posttraumatic arthritis (N=7) 0.48%
Unknow (N=4) 0.27%
Trauma (N=1) 0.07%
Previous infection (N=1) 0.07%
Previous High Tibial Osteotomy (N=1) 0.07%
Other (N=1) 0.07%
Infection (N=1) 0.07%
Figure 41 Diagnosis of primary knee arthroplasty
In order to explain about the diagnosis, almost all patients were diagnosed with primary osteoarthritis, and there were small percentage of others diagnosis including inflammatory arthritis, posttraumatic arthritis, infection and previous high tibial osteotomy.
nd 32 | THKJR The Annual Report 2017 (The 2 THKJR Data Analysis)
9.15% This pie graph shows the simultaneous Bilateral (N=122) bilateral total knee arthroplasty were 9.15% Unilateral (N=1211) of all primary knee arthroplasty performed in our contribution hospital. Most of the primary knee arthroplasty was done in stage 90.85% procedures.
Figure 42 Unilateral vs Bilateral
Cemented
In primary knee arthroplasty, the data
report shows all of patients were performed 100.00% in cemented technique for total knee arthroplasty.
Figure 43 Cemented vs Cementless
3.23%
In order to explain about implant design of total knee arthroplasty (Fix and mobile
bearing design), there were significantly
different between fixed and mobile bearing
design. Almost of the patients was
96.77% performed with fixed bearing design in contribution hospitals (96.77%). Fixed Bearing (N=1408)
Mobile Bearing (N=47)
Figure 44 Fixed bearing vs Mobile bearing
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 33
Most of implants used in primary total knee arthroplasty were posterior sacrifice 6.60% PS (N=1359) CR (N=96) (PS) design accounting for 93.4%. Cruciate retaining (CR) design were used only 6.6%. 93.40%
Figure 45 PS vs CR
0.21% 0.27% 2.47%
CoCr (N=1412) Cobalt Chromium (CoCr) was the most
common coating surface of femoral Oxinium (N=36) component used in primary total knee
AS Coating (N=4) arthroplasty, accounting for 97.04%. Oxinium was less used accounting for 2.47%. TiN Coating (N=3) 97.04% Arsenic (AS) and Titanium (TiN) were rarely used.
Figure 46 Coating surface TKR
Nexgen PS (N=306) 27%
PFC Sigma PS (N=164) 15%
Gemini SL PS (N=157) 14%
Legion PS (N=132) 12%
Nexgen High Flex PS… 10%
Attune PS (N=74) 7%
Scorpio NRG PS (N=54) 5%
Genesis II CR (N=50) 4%
Genesis II PS (N=36) 3%
Legion Constrained… 3%
Figure 47 Top 10 Implant models TKR
The variety of implant models were used in primary total knee arthroplasty.
nd 34 | THKJR The Annual Report 2017 (The 2 THKJR Data Analysis)
0.21% 0.07% 4.54% 3.57% Zimmer Biomet (N=590)
Smith & Nephew (N=294)
10.93% Depuy (N=290)
Link (N=159)
40.55% Stryker (N=66) 19.93% B.Braun (N=52)
Implantcast (N=3)
20.21% Corentec (N=1)
Figure 48 Implant brands TKR
Eight implant brands were used for primary total knee arthroplasty from data entry in 2017. 40.55% was Zimmer
Biomet. Smith & Nephew was 20.21% which was very close to 19.93% of Depuy. LINK, Stryker, B Braun, Implant cast and Corentec were 10.93%, 4.54%, 3.57%. 0.21% and 0.07%, respectively.
Bangkok
0%
B.Braun
22% 20% Corentec Variety of implant brands were used in Depuy Bangkok. Smith & Nephew 29%, Depuy 22%, 0%
Implantcast Link 20%, Zimmer Biomet 14%, Stryker 9% 6% LINK and B Braun 6%.
Smith & Nephew 14% 29% Stryker
9% Zimmer Biomet
Figure 49 Regional (Bangkok): primary TKR by implant brands
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 35
Northeastern
In Northeastern, LINK was the most 12% 2% common brand used in primary total knee 2% Corentec arthroplasty accounting for 79%. The second most common was Zimmer Biomet 12%, the Depuy 5% remaining were Implant cast 5%, Depuy 2% Implantcast and Corentec 2% LINK
79% Zimmer Biomet
Figure 50 Regional (Northeastern): primary TKR by implant brands
Southern
9%
In Southern, there were 2 brands from data entry, Zimmer Biomet was used 92%
Depuy and others was Depuy 9%
Zimmer Biomet
91%
Figure 51 Regional (Southern): primary TKR by implant brands
Northern
2%
B.Braun 26% In Northern, nearly half of implant used
Depuy was Zimmer Biomet, accounting for 46%. 46% Depuy was used 26% which close to 23% of Smith & Nephew Smith & Nephew. Stryker was 3% and B Stryker Braun was 2%
Zimmer Biomet 23%
3%
Figure 52 Regional (Northern): primary TKR by implant brands
36 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
Tear/Avulsion patella tendon 3
Fracture femoral shaft 1
Other 1
Figure 53 Complications
From data entry, there were 3 intra-operative complications in 5 cases. 3 cases of tear/avulsion of patella tendon, 1 cases of femoral shaft fracture and 1 case of other complication.
18.92%
Female (N=30) Unicompartmental knee replacements were performed in male patients 4 times Male (N=7) more than in female. 81.08%
Figure 54 UKR by genders
The number of unicompartmental 45.95% Left (N=17) knee replacements were performed in right knees slightly higher than left knees. Right (N=20) 54.05%
Figure 55 Left vs Right
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 37
8%
The majority of unicompartmental knee replacement (92% of cases) were done in patients with primary osteoarthritis knee. 92% The otherwise was Osteonecrosis of the knee.
Osteonecrosis (N=3) Primary Osteoarthritis (N=34)
Figure 56 Diagnosis UKA
16.22%
Unicompartmental knee Depuy (N=6) replacements from Zimmer Biomet were the most frequently used. Zimmer Biomet (N=31)
83.78%
Figure 57 Implant Brand UKA
16%
Mobile bearing unicompartmental knee
replacements (Oxford ) were used more than fixed bearing design. 84%
PFC Sigma HP GCK (Cemented) (N=6) Oxford UKA (Cemented) (N=31)
Figure 58 Implant model in UKA
38 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
Fracture tibial condyle 1
Fracture femoral condyle 1
Figure 59 Intraoperative Complication UKA
There were few intraoperative complications during performing unicompartmental knee replacements. We found one tibial condyle and one femoral condyle fracture. Other intraoperative complications, e.g. Fracture tibia shaft, Fracture patella, vascular injury, nerve injury, and collateral ligament tear, were not found.
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 39
Revision Data: Knee
37.14% Female (N=22) This pie chart reports data of Revision Total Knee Arthroplasty between sex in Thai joint Male (N=13) 62.86% registry. This data report on male was 37.14%, N = 13; female was 62.86%, N = 22.
Figure 60 Female to Male Ratio
This pie chart reports data of revision total 42.86% Left (N=15) knee arthroplasty cases between right side and
Right (N=20) 57.14% left side. The figure of right side was 57.14%, N
= 20; left side was 42.86%, N = 15.
Figure 61 Left vs Right
Aseptic loosening (N=13) 37.14%
Infection (N=8) 22.86%
Other (N=4) 11.43%
Malalignment (N=3) 8.57%
Instability (N=3) 8.57%
Patellofemoral pain (N=2) 5.71%
Stiffness (N=1) 2.86%
Pain (N=1) 2.86%
Figure 62 Diagnosis The first is aseptic loosening was 37.14%, N = 13. The second is infection was 22.86%, N = 8, other course was
11.43%, N=4. Malalignment was 8.57%, N=3. Instability was 8.57%, N=3. Patellofemoral pain was 5.71%, N=2. Stiffness was 2.86%, N=1. Pain was 2.86%, N=1.
40 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
50% 46% 45%
40%
35%
30% 27%
25%
20%
15% 14% 11% 10%
5% 3%
0% < 50 50-59 60-69 70-79 80 >
Figure 63 Age distribution of Revision TKA
This bar chart reports data of age distribution in case of revision total knee arthroplasty. In age group <50 years was 14%; age 50-59 years was 11%; age 60-69 years was
3% 3%
6%
Zimmer Biomet (N=11) 8% 31% Depuy (N=10)
Smith & Nephew (N=7)
Stryker (N=3)
LINK (N=2) 20% B.Braun (N=1) Corentec (N=1)
29%
Figure 64 Implant brand
This pie chart reports implant brands in cases of revision total knee arthroplasty. Two big companies were
Zimmer Biomet and Depuy. Zimmer brand was 31%, N=11. Depuy was 29%, N=10. Smith & Nephew was 20%, N=7.
Stryker was 8%, N=3. LINK was 6%, N=2. B. Braun was 3%, N=1. Corentec was 3%, N=1.
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 41
THKJR’s Next Step
The Next Step of THKJR. From the first preliminary and progression report last year in 2017, THKJR committees have improved learning processes and experiences how to appropriate best format report. Changing from full form data record to minimal mandatory fields make number of data records increase more than four times in this year. So THKJR committees decided unanimously to continue using minimal mandatory field data record for another year in order to enrolling more data entry members. Trend of 2018-2019 year will be: 1. Persist using minimal mandatory data records without any modification; 2. Sustain and provide previous version of full form data record for any members who want to use them for personal statistic and research; 3. Continue regional enrolling program; 4. Support member to join world joint data registry meeting e.g. International Congress of Arthroplasty Registries; 5. Support Thailand Universal Coverage Fund (UCF) technical for future integrate THKJR database with UCF database for example, using 128bit MD5 data encryption with primary key field (Encrypt citizen ID) to prevent tracking back original patient data and match and pair THKJR data record with UCF data; 6. Annual report and conference will be in every year of THKS annual meeting; 7. Support registry data for clinical study, implant monitoring and research; 8. Update and more complete implant profile data; 9. Update and improvement website www.thaijr.com; and 10. Update follow up patient functional score data.
Pol. Col. Viroj Larbpaiboonpong, MD Chairman of THKJR Steering Committee, THKS. Chairman of Hip&Knee Section, RCOST.
42 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
APPENDICES
THKJR Advisory Board
Associate Professor Dr. Chaithavat Ngarmukos Associate Professor Dr. Sattaya Rojanasathien chulalongkorn hospital Chiangmai University
Professor Dr. Sukit Saengnipanthkul Police Major General Dr. Thana Turajane Khon Kaen University Police General Hospital
Professor Dr. Weerachai Kosuwon Dr. Surapoj Meknavin Khon Kaen University Navamindradhiraj University
Dr. Wallob Samranvethya Airvice-marshal Dr. Chumroonkiet Leelasestaporn Bangkok Hospital Bhumibol Hospital
Clin. Professor Dr. Viroj Kawinwonggowit Assistant Professor Dr. Pornpavit Sriphirom Ramathibodi Hospital Rajavitho Hospital
Assistant Professor Dr. Areesak Chotivichit Dr. Komsan Plangsiri Siriraj Hospital Srinakharinwirot University
Professor Maj. Gen. Dr. Thanainit Chotanaphuti Assistant Professor Dr. Polawat Witoolkollachit Phramongkutklao College of Medicine Ministry of Public Health
Professor Dr. Aree Tanavalee Chulalongkorn University
44 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
Annual Activity Report 2017 – 2018
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 45
THKJR Strategic Plan Set for THKS Meeting in Chumphon The Strategic Plan Committee had approved a pilot program for the collection of prosthetic knee surgery data by Pol. Laab Paiboonpong, the Police General Hospital, and Dr. Chawan Sumanatthanakul. Lerdsin Hospital were the coordinators of this project.
Appointment of the Subcommittee on Driven Strategic Planning Conference "Shaping the future: THKS in Action 2015-2016" - After successful completion of the Primary Knee Replacement Surgery Pilot Project, THKJR had been appointed to carry out the following tasks: - The operation of hip replacement surgery - Revision of artificial hip and knee replacement - Create a record of the Implant Profile of all companies - Keep records for knee and hip replacement surgery both in primary and revision - Record results of hip and prosthetic procedures using HOOS and KOOS scores respectively By doing all of the aforementioned tasks above, the whole system can be used on web browsers of devices such as mobile, tablet, notebook or computer.
THKS 2016 International Conference
August 11 – 13, 2016 at the Shangri-La Hotel, Bangkok.
46 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
THKJR Development Board Meeting August 31, 2016 at Police General Hospital 1. Review THKJR division, including the Steering Committee 2. Review the Regional Coordinator 3. Adjust the filling system and registration
Consensus Conference, Nakhon Pathom June 24 - 25, 2016 at Mida Dvaravadee Grand Hotel.
THKJR in Khon Kaen January 11, 2016 at the Department of Orthopedics, Srinakarin Hospital
Long Distance Conference (Inter-regional tele conference) Between regions with board driven THKJR at Police General Hospital
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 47
First Data Review Conference July 13, 2016 at the Intercontinental Hotel, Bangkok.
Preparatory meetings, preliminary reports and advances in surgical information. August 2, 2016 at Police General Hospital
THKJR Regional Roadshow: Hat Yai May 16, 2018 at prince of songkhla university
Statistical processing meeting and report the results of surgery in Thailand in 2018. The 2nd THKJR Data Interpretation & Report on July 12, 2018 at Police General Hospital
48 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
THKJR STEERING COMMITTEES
CHAIRMAN
Dr. Viroj Larbpaiboonpong Police General Hospital
MEMBER ADMINISTRATOR
Dr. Pruk Chaiyakit Vajira Hospital
Dr. Thana Narinsorasak Bhumibol Hospital
Dr. Kreangsak Lekkreusuwan
Phramongkutklao College of Medicine
Dr. Salaktam Tojirakarn Pat Rangsit Hospital
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 49
Dr. Therawut Plepul Pichit Hospital
INFORMATION MANAGEMENT
Dr. Chavanont Sumanasrethakul Lerdsin Hospital
Dr. Chaturong Ponrattanamaneewong Siriraj Hospital
Dr. Siwadol Wongsak
Ramathibodi Hospital
Dr. Natthpong Hongku
Vajira Hospital
50 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
Dr. Anuchit Vejjaijiva
Siriraj Hospital
Dr. Kritkamol Sithitool Bhumibol Hospital
Dr. Rawee Siritammawat
Chularat International Hospital
ANNUAL REPORT
Dr. Pontakorn Panichpol
Bangkok Hospital
Dr. Srihatach Ngarmukos
Chulalongkorn Hospital
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 51
Assistant Professor Dr. Rapeepat Narkbunnam
Siriraj Hospital
Assistant Professor Dr. Piti Rattanaprechavej
Naresuan University
Dr. Kamolsak Sukontaman Khon Kaen University
ETHIC AND INFORMED CONSENT
Dr. Charlee Sumettavanich Lerdsin Hospital
Dr. Saradej Khuangsirikul
Phramongkutklao College of Medicine
52 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
Dr. Theerawit Hongnaparak
Songklanagarind Hospital
DEPLOYMENT AND TRAINING
Dr. Ukrit Chaweewannakorn
Police General Hospital
Dr. Rit Apinyankul
Khon Kaen University
Dr. Warakorn Jingjit
Chiangmai University
Dr. Chatchawan Visetsripong Chaophraya Abhaibhubejhr Hospital
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 53
RESEARCH PAPER
Dr. Satit Thiengwittayapon
Vajira Hospital
Associate Professor Dr. Boonchana Pongcharoen
Thammasat University Hospital
Associate Professor Dr. Aasis Unnanuntana Siriraj Hospital
Dr. Wittawat Boonyanuwat
Srinakharinwirot University
Dr. Lertkong Nitiwarangkul Police General Hospital
54 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
DATA INTERPRETATION AND ANALYSIS
Associate Professor Dr. Piya Pinsornsak Thammasat University Hospital
Associate Professor Dr. Nattapol Tammachote Thammasat University Hospital
Dr. Apisit Patamarat Phra Na Khon Sri Ayutthaya Hospital
Asst Prof. Dr. Artit Laoruengthana Naresuan University
Dr. Siripong Rattanachai
Bumrungrad International Hospital
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 55
Dr. Chavarat Jarungvittayakorn Ramathibodi Hospital
Dr. Paisit voraphani Klang Hospital
Dr. Manoon Sakdinakiattikoon Klang Hospital
Dr. Khanin Iamthanapon
Prince of Songkla University
Dr. Thakrit Chompoosang
Rajavithi Hospital
Dr. Naruepol Reungsilapanant Maharat Nakhon Ratchasima Hospital
56 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
Developer and system analysis
Mr. Supasak Kulawonganunchai E.S.M. Solution Co.,Ltd
Mr. Supasit Kulawonganunchai E.S.M. Solution Co.,Ltd
Mr. Sidthidej Glinplub E.S.M. Solution Co.,Ltd
Mr. kantapong chokboonlom E.S.M. Solution Co.,Ltd
Secretary
Mrs. La-ongtian Sangsuk Police General Hospital
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 57
Collaboration Hospitals Currently there are 32 institutions participating.
1. Police General Hospital 17. Srinakharinwirot University 2. Lerdsin Hospital 18. Bhumibol Adulyadej Hospital 3. Srinagarind Hospital 19. Phra Na Khon Sri Ayutthaya Hospital 4. Phrae Hospital 20. Uttaradit Hospital 5. Phramongkutklao College of Medicine 21. Klang Hospital 6. Maharaj Nakorn Chiang Mai Hospital 22. Sisaket Hospital 7. Thammasat University Hospital 23. Nakhon Pathom Hospital 8. Songklanagarind Hospital 24. Chaophraya Abhaibhubejhr Hospital 9. Vajira Hospital 25. Rajavithi Hospital 10. Naresuan University Hospital 26. Khon Kaen Hospital 11. Ramathibodi Hospital 27. Sappasithiprasong Hospital 12. Bangkok Hospital 28. Hatyai Hospital 13. Chulalongkorn Hospital 29. Taksin Hospital 14. Siriraj Hospital 30. Maharat Nakhon Ratchasima Hospital 15. Buddhachinaraj Hospital 31. Bumrungrad International Hospital 16. Lampang Hospital 32. PatRangsit Hospital
58 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
Patient Enrolled Hospitals Currently, there are 11 participating institutions.
1. Police General Hospital 7. Thammasat University Hospital 2. Phrae Hospital 8. Songklanagarind Hospital 3. Srinagarind Hospital 9. Vajira Hospital 4. Lerdsin Hospital 10. Naresuan University Hospital
5. Phramongkutklao College of Medicine 11. Ramathibodi Hospital 6. Maharaj Nakorn Chiang Mai Hospital
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http versionThai
Documents ://
goo
. gl
/
of form of Consent
t4Wydf Thai hip knee joint registry consent form (Thai version)
60 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
Englishversion of Consent form http
://
goo .
gl Thai hip knee joint registry consent form (English version)
/ S72a83
➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 61
http HOOS versionof Thai
:// goo
HOOS-JR Score (Thai version) .
gl / Prof. Weerachai Kosuwon, MD, BSc, MSc, FIMS afXnxs
62 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
Thaiversion of KOOS http ://
goo KOOS-JR Score (Thai version) .
gl By Assistant Professor Kanda Chaipinyo, PhD /
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➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 63
http Operation PrimaryForm Hip
Intraoperative hip data collecting form (standard form) :// goo
By THKJR Steering Group
.
gl /
c4ajka
64 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
PrimaryKnee Operation Form http
:// Intraoperative knee data collecting form (standard form) goo
By THKJR Steering Group
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gl /
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➢ THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis) | 65
Join Us Now
Join Our Line Group
THKJR User Group
Visit our web site
http://www.thaijr.com
Access the THKJR application http://www.thkjr.info
Contact us [email protected]
66 | THKJR The Annual Report 2017 (The 2nd THKJR Data Analysis)
Thai Hip & Knee Joint Registry Thai Hip & Knee Society (THKS) 492/1 Rama 1 Rd, Pathumwan, Bangkok, Thailand 10330 Tel: 02-207-8532 Email: [email protected] www.thaijr.com