2020 Demographics of Hip Knee and Shoulder Arthroplasty

Australian Orthopaedic
Association National Joint

Replacement Registry
Demographics of Hip, Knee

& Shoulder Arthroplasty
ANNUAL
REPORT
2020
AOANJRR | 2020 ANNUAL REPORT
Contents

INTRODUCTION ....................................................................................................................................................................................... 3
HIP REPLACEMENT .................................................................................................................................................................................. 4
Categories of Hip Replacement ........................................................................................................................................................ 4
Public and Private Sector .................................................................................................................................................................. 5
Incidence of Hip Replacment ........................................................................................................................................................ 13
Primary Partial Hip Replacement ..................................................................................................................................................... 19
Classes of Partial Hip Replacement ........................................................................................................................................... 19
Primary Partial Resurfacing Hip Replacement ........................................................................................................................... 21
Primary Unipolar Monoblock Hip Replacement ........................................................................................................................ 22
Primary Unipolar Modular Hip Replacement ............................................................................................................................. 23
Primary Bipolar Hip Replacement............................................................................................................................................... 24
Primary Total Hip Replacement ....................................................................................................................................................... 25
Classes of Total Hip Replacement .............................................................................................................................................. 25
Primary Total Conventional Hip Replacement .......................................................................................................................... 27
Primary Total Resurfacing Hip Replacement ............................................................................................................................. 28
Primary Thrust Plate Hip Replacement ....................................................................................................................................... 29
All Revision Hip Replacement.......................................................................................................................................................... 30
Classes of Revision Procedures ................................................................................................................................................... 30
KNEE REPLACEMENT ............................................................................................................................................................................. 33
Categories of Knee Replacement.................................................................................................................................................. 33
Public and Private Sector ................................................................................................................................................................ 34
Primary Partial Knee Replacement ................................................................................................................................................ 45
Classes of Partial Knee Replacement ........................................................................................................................................ 45
Primary Partial Resurfacing Knee Replacement ....................................................................................................................... 47
Primary Unispacer Knee Replacement ...................................................................................................................................... 47
Primary Bicompartmental Knee Replacement ......................................................................................................................... 49
Primary Patella/Trochlea Knee Replacement ........................................................................................................................... 50
Primary Unicompartmental Knee Replacement ....................................................................................................................... 51
Primary Total Knee Replacement ................................................................................................................................................... 53
All Revision Knee Replacement ..................................................................................................................................................... 55
Classes of Revision Procedures ................................................................................................................................................... 55
SHOULDER REPLACEMENT .................................................................................................................................................................... 58
Categories of Shoulder Replacement............................................................................................................................................ 58
Primary Partial Shoulder Replacement .......................................................................................................................................... 72
Classes of Partial Shoulder Replacement .................................................................................................................................. 72
Primary Partial Resurfacing Shoulder Replacement ................................................................................................................. 73
Primary Hemi Resurfacing Shoulder Replacement ................................................................................................................... 74
Primary Hemi Stemmed Shoulder Replacement ....................................................................................................................... 75
Primary Hemi Mid Head Shoulder Replacement ...................................................................................................................... 75
Primary Total Shoulder Replacement ............................................................................................................................................. 76
Classes of Total Shoulder Replacement .................................................................................................................................... 76
Primary Total Resurfacing Shoulder Replacement .................................................................................................................... 77
Primary Total stemmed Shoulder Replacement ........................................................................................................................ 78
Primary Total Reverse Shoulder Replacement .......................................................................................................................... 79
Primary Total Mid Head Shoulder Replacement ....................................................................................................................... 80
All Revision Shoulder Replacement ............................................................................................................................................... 82
LIST OF TABLES ...................................................................................................................................................................................... 84
LIST OF FIGURES .................................................................................................................................................................................... 86
Data Period: 1 September 1999 – 31 December 2019 Page | 2

2 ao a. o r g. au D at a Pe r i od 1 S e p t e m b e r 1999 – 31 D e c e mb e r 2 0 1 9
Introduction
Data presented in this report have been All hip, knee and shoulder replacement
submitted to the Registry by both public and procedures recorded by the Registry from the
private hospitals. Currently, this involves 357 commencement date to 31 December 2019
hospitals nationally but varies from time to time have been included in this report.
due to hospital closures, new hospitals or
changes to services within hospitals.
The Registry was implemented in a staged

manner on a state-by-state basis.
Implementation was completed nationally by
mid-2002; therefore 2003 was the first year of
complete national data.
Number of Patients and Procedures Recorded by the Registry

Between 1/9/1999 and 31/12/2019
HIP, KNEE AND SHOULDER REPLACEMENT
1,079,617 Individual Patients

1,603,846 Procedures
266,490 (23.7%) Deaths
35.7% of patients have had more than one procedure
HIP REPLACEMENT KNEE REPLACEMENT SHOULDER REPLACEMENT
538,976 Individual Patients 592,684 Individual Patients 49,011 Individual Patients

694,730 Procedures 849,329 Procedures 59,787 Procedures
168,169 (31.2%) Deaths 110,905 (18.7%) Deaths 7,272 (14.8%) Deaths
24.5% of patients have had more 37.8% of patients have had more 18.1% of patients have had more
than one hip procedure than one knee procedure than one shoulder procedure

D a t a P e r iod 1 Sep temb er 1999 – 31 Decem ber 2019
a o a .o r g.au 3
Hip Replacement
CATEGORIES OF HIP REPLACEMENT
The Registry groups hip replacement into three bipolar. Total hip classes are resurfacing,
broad categories, primary partial, primary total conventional and thrust plate.
and revision hip replacement.
Revision hips are re-operations of previous hip
A primary replacement is the initial replacements where one or more of the
replacement procedure undertaken on a joint prosthetic components are replaced, removed,
and involves replacing either part (partial) or all or another component is added. Revisions
(total) of the articular surface. include re-operations of primary partial, primary
total or previous revision procedures.
Primary partial and primary total hip
replacement are further subcategorised into Hip revisions are subcategorised into three
classes depending on the type of prostheses classes: major total, major partial or minor
used. Partial hip classes are partial resurfacing, revisions. These are defined in the chapter on
unipolar monoblock, unipolar modular and revision outcomes.
HIP REPLACEMENT
Partial Total Revision
Partial Total
Major Total
Resurfacing Conventional
Unipolar
Total Resurfacing Major Partial
Monoblock
Unipolar Modular Thrust Plate Minor
Bipolar

PUBLIC AND PRIVATE SECTOR

More than half of all hip replacement in the public sector by 40.4% compared to a
procedures reported to the Registry are decrease of 14.5% in the private sector.
undertaken in private hospitals (59.9% in 2019).
There were 30,156 private sector hip In 2019, 26,978 private sector primary total hip
replacements reported in 2019, an increase of replacements were reported, an increase of
3.0% compared to 2018. In the public sector, 3.3% compared to 2018. In the public sector,
there were 20,207 hip replacements (Figure there were 13,311 primary total hip
SH1). Since 2003, hip replacement in the private replacements, an increase of 2.3% compared
sector has increased by 100.6% compared to to 2018. Since 2003, primary total hip
74.6% in the public sector. replacement has increased in the private
sector by 124.2% compared to an increase of
Primary partial hip replacement has decreased 101.5% in the public sector.
in the public sector since 2018 (3.4%) and
decreased in the private sector (4.2%). In 2019, There were 2,383 revision hip replacements
there were 5,041 primary partial hip reported in the private sector in 2019, an
replacements reported in the public sector and increase of 2.3% compared to 2018. In the
795 in the private sector. Since 2003, primary public sector, there were 1,855 revision hip
partial hip replacement has increased replacements, a decrease of 2.5% compared
to 2018. Since 2003, revision hip replacement in
the private sector has increased by 15.1%
compared to 35.0% in the public sector.
Figure SH1 Hip Replacement by Hospital Sector
50000
ALL HIP
45000 Private
Public
40000
35000
30000
25000
20000
15000
10000
5000
0
2002 2004 2006 2008 2010 2012 2014 2016 2018 2020

a o a .o r g.au 5
Table SH1 All Hip Replacement by Age and Gender
Gender Number Percent Minimum Maximum Median Mean Std Dev

Male 304113 43.8% 5 107 68 67.6 12.6
Female 390617 56.2% 9 108 73 71.7 12.4
TOTAL 694730 100.0% 5 108 71 69.9 12.6
Table SH2 Number of Hip Replacements by Gender
Female Male TOTAL

Hip Replacement
N % N % N %
Partial Resurfacing 3 20.0 12 80.0 15 0.0
Unipolar Monoblock 21116 72.8 7879 27.2 28995 28.5
Unipolar Modular 32614 70.4 13689 29.6 46303 45.6
Bipolar 18479 70.2 7859 29.8 26338 25.9
All Primary Partial 72212 71.0 29439 29.0 101651 100.0
Total Resurfacing 3611 19.8 14639 80.2 18250 3.5
Total Conventional 274486 55.0 224953 45.0 499439 96.4
Thrust Plate 74 28.7 184 71.3 258 0.0
All Primary Total 278171 53.7 239776 46.3 517947 100.0
Major Total 10333 50.2 10236 49.8 20569 27.4
Major Partial 22515 54.9 18527 45.1 41042 54.6
Minor 7386 54.6 6135 45.4 13521 18.0
All Revisions 40234 53.6 34898 46.4 75132 100.0
ALL Hips 390617 56.2 304113 43.8 694730 100.0

Figure SH2 Percentage of Females by Type of Hip Replacement and Procedure Year
100 Partial
Total Conventional
90 Total Resurfacing
80
70
Percentage Female
60
50
40
30
20
10
0
03
04
05
06
07
08
09
10
11
12
13
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19
20
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20
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20
20
20
20
20
20
20
20
20
20
20
Procedure Year
Figure SH3 Percentage of Females by Partial Hip Replacement and Procedure Year (Excluding Partial Resurfacing)
100 Unipolar Monoblock

Unipolar Modular
90 Bipolar
80
70
Percentage Female
60
50
40
30
20
10
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
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20
Procedure Year

a o a .o r g.au 7
Figure SH4 Percentage of Females by Total Hip Replacement and Procedure Year (Excluding Thrust Plate)

Total Conventional
90
80
70
Percentage Female
60
50
40
30
20
10
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Procedure Year
Figure SH5 Percentage of Females by Revision Hip Replacement and Procedure Year
100 Major Total

Major Partial
90 Minor
80
70
Percentage Female
60
50
40
30
20
10
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
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18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Procedure Year

Figure SH6 Percentage of Patients Aged <65 Years by Type of Hip Replacement and Procedure Year
100 Partial
Total Conventional
80
70
Percentage <65 Years
60
50
40
30
20
10
0
03
04
05
06
07
08
09
10
11
12
13
14
15
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18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Procedure Year
Figure SH7 Percentage of Patients Aged <65 Years by Partial Hip Replacement and Procedure Year (Excluding Partial
resurfacing)

Unipolar Modular
90 Bipolar
80
70
60
50
40
30
20
10
0
03
04
05
06
07
08
09
10
11
12
13
14
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20
20
20
20
20
20
Procedure Year

a o a .o r g.au 9
Figure SH8 Percentage of Patients Aged <65 Years by Total Hip Replacement and Procedure Year (Excluding Thrust Plate)

Total Conventional
90
80
70
60
50
40
30
20
10
0
03
04
05
06
07
08
09
10
11
12
13
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19
20
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20
20
20
20
20
20
20
20
Procedure Year
Figure SH9 Percentage of Patients Aged <65 Years by Revision Hip Replacement and Procedure Year
100 Major Total

Major Partial
90 Minor
80
70
60
50
40
30
20
10
0
03
04
05
06
07
08
09
10
11
12
13
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19
20
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20
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20
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20
20
20
20
20
20
20
20
20
20
Procedure Year

Figure SH10 Trends in Usage of Hip Replacement by Procedure Year
40000 Partial
Total
Revision
35000
30000
25000
20000
15000
10000
5000
0
03
04
05
06
07
08
09
10
11
12
13
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19
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20
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20
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20
20
20
20
20
20
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20
20
20
Figure SH11 Trends in Usage of Partial Hip Replacement by Procedure Year (Excluding Partial Resurfacing)

Unipolar Modular
4500 Bipolar
4000
3500
3000
2500
2000
1500
1000
500
0
03
04
05
06
07
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10
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20
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20

a o a .o r g.au 11
Figure SH12 Trends in Usage of Total Hip Replacement by Procedure Year (Excluding Thrust Plate)

Total Conventional
35000
30000
25000
20000
15000
10000
5000
0
03
04
05
06
07
08
09
10
11
12
13
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16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Figure SH13 Trends in Usage of Revision Hip Replacement by Procedure Year
5000 Major Total

Major Partial
4500 Minor
4000
3500
3000
2500
2000
1500
1000
500
0
03
04
05
06
07
08
09
10
11
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19
20
20
20
20
20
20
20
20
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20
20
20
20
20
20
20

INCIDENCE OF HIP REPLACMENT

Table SH3 Incidence of Hip Replacement per 100,000 between 2003 to 2019
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Hip Replacement
N N N N N N N N N N N N N N N N N N
Partial Resurfacing . 0.0 0.0 0.0 0.0 0.0 0.0 . . . . 0.0 . . . . . 0.0
Unipolar Monoblock 12.7 13.3 11.6 9.7 9.0 8.6 7.8 7.3 6.7 6.1 5.1 4.6 3.2 2.3 1.6 0.9 0.6 6.2
Unipolar Modular 3.4 4.0 5.8 8.5 10.9 12.2 13.5 13.7 14.9 14.7 14.5 14.9 13.9 14.0 14.1 14.1 12.1 11.9
Bipolar 6.8 7.0 6.5 5.7 4.4 4.0 3.6 3.9 4.2 4.4 4.7 5.9 8.4 8.7 8.8 9.2 10.4 6.4
All Primary Partial 22.9 24.2 23.9 23.9 24.3 24.8 24.9 24.9 25.7 25.1 24.3 25.4 25.5 25.0 24.6 24.2 23.0 24.5
Total Resurfacing 7.8 8.5 9.1 8.6 7.9 6.9 5.6 4.4 2.6 2.0 1.7 1.6 1.5 1.7 1.6 1.5 2.1 4.2
Total Conventional 86.6 91.2 94.1 96.1 98.1 105.5 110.0 115.7 119.5 121.5 127.8 137.4 142.8 149.5 151.8 155.0 156.8 123.0
Thrust Plate 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.0 . . . . . . . 0.0
All Primary Total 94.5 99.8 103.3 104.8 106.2 112.5 115.8 120.1 122.2 123.5 129.6 139.0 144.4 151.2 153.4 156.6 158.9 127.3
All Revisions 17.5 17.5 17.6 17.3 16.9 17.8 17.8 18.6 21.4 20.1 18.4 19.0 18.3 17.6 17.6 16.9 16.7 18.1
ALL HIPS 134.9 141.5 144.8 145.9 147.3 155.2 158.5 163.6 169.3 168.8 172.3 183.4 188.2 193.9 195.6 197.7 198.6 169.9
Figure SH14 Incidence of Hip Replacement per 100,000 between 2003 to 2019
160 All Primary Partial

All Primary Total
All Revisions
140
120
Incidence per 100,000
100
80
60
40
20
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

a o a .o r g.au 13
Table SH4 Incidence of Hip Replacement in Patients Aged <55 Years per 100,000 between 2003 to 2019
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Hip Replacement
Partial Resurfacing . 0.0 0.0 0.0 0.0 0.0 0.0 . . . . 0.0 . . . . . 0.0
Unipolar Monoblock 0.0 0.0 0.0 . 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 . 0.0 0.0
Bipolar 0.3 0.2 0.2 0.1 0.2 0.2 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.1 0.2 0.1 0.1
Thrust Plate 0.1 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 . . . . . . . 0.0
All Revisions 2.2 2.3 2.2 2.3 2.1 2.4 2.3 2.4 3.2 3.0 2.3 2.6 2.3 2.0 2.4 2.0 1.9 2.3
ALL HIPS 21.1 21.4 22.8 23.5 23.2 24.3 25.1 26.1 26.4 26.3 27.0 28.8 29.3 29.4 29.7 29.7 28.9 26.2
Figure SH15 Incidence of Hip Replacement in Patients Aged <55 Years per 100,000 between 2003 to 2019

All Primary Total
All Revisions
25
20
15
10
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

Table SH5 Incidence of Hip Replacement in Patients Aged 55-64 Years per 100,000 between 2003 to 2019
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Hip Replacement
Bipolar 4.9 4.1 3.4 2.4 2.1 2.1 1.8 1.4 1.4 1.9 1.8 1.9 3.0 2.6 3.0 2.3 2.9 2.5
Thrust Plate 0.3 0.5 0.3 0.4 0.4 0.4 0.4 0.2 0.4 0.1 . . . . . . . 0.2
All Revisions 29.3 27.3 26.7 27.5 25.8 28.7 27.9 29.7 37.4 32.6 29.9 29.3 25.9 24.9 25.0 23.6 24.0 27.9
ALL HIPS 252.9 264.9 270.8 261.0 270.3 283.9 295.7 297.8 316.2 301.6 308.7 324.8 333.0 346.3 343.2 343.9 343.2 306.8
Figure SH16 Incidence of Hip Replacement in Patients Aged 55-64 Years per 100,000 between 2003 to 2019

All Primary Total
All Revisions
350
300
250
200
150
100
50
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

a o a .o r g.au 15
Table SH6 Incidence of Hip Replacement in Patients Aged 65-74 Years per 100,000 between 2003 to 2019
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Hip Replacement
Bipolar 19.1 19.4 15.3 10.7 9.3 8.2 7.8 6.0 7.4 6.2 7.1 8.7 13.0 12.2 12.8 13.1 15.3 11.2
Thrust Plate 0.2 0.4 0.5 0.2 0.5 0.5 0.5 0.3 0.4 0.1 . . . . . . . 0.2
All Revisions 79.7 77.8 75.6 74.5 71.3 74.1 67.7 76.6 88.0 79.1 68.8 68.7 68.6 65.6 61.2 60.4 56.3 70.3
ALL HIPS 579.1 592.9 600.2 597.0 587.0 622.9 613.8 638.3 647.8 640.7 649.4 679.9 696.9 708.6 701.5 707.6 708.0 653.5
Figure SH17 Incidence of Hip Replacement in Patients Aged 65-74 Years per 100,000 between 2003 to 2019

All Primary Total
All Revisions
600
500
400
300
200
100
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

Table SH7 Incidence of Hip Replacement in Patients Aged ≥75 Years per 100,000 between 2003 to 2019
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Hip Replacement
Unipolar
194.7 199.3 171.4 143.4 132.2 125.9 116.9 109.1 97.2 89.3 75.0 66.1 45.2 33.0 22.3 12.5 6.9 89.6
Monoblock
Bipolar 80.4 83.5 80.3 74.4 55.2 49.4 45.7 51.4 54.0 56.5 60.7 76.0 106.0 109.6 109.1 112.4 123.5 80.1
Total Resurfacing 1.3 0.8 0.5 0.2 0.5 0.5 0.2 0.2 0.1 . 0.1 0.2 . 0.1 0.3 0.1 0.3 0.3
All Revisions 124.1 126.3 129.4 119.4 120.2 122.9 130.2 126.5 128.0 126.1 121.9 125.1 121.5 116.1 114.5 108.8 108.5 121.2
ALL HIPS 901.5 945.5 937.1 948.1 951.7 988.5 1007.8 1018.7 1025.6 1024.6 1021.5 1073.8 1074.9 1088.1 1095.6 1084.2 1071.8 1021.8
Figure SH18 Incidence of Hip Replacement in Patients Aged ≥75 Years per 100,000 between 2003 to 2019

All Primary Total
All Revisions
600
500
400
300
200
100
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

a o a .o r g.au 17
Figure SH19 Trends in Usage of Hip Replacement by State/Territory and Year
Table SH8 Time between Procedures for Bilateral Primary Hip Replacement
Same Day 1 day - 3 months 3 – 6 months ≥6 months TOTAL

Bilateral Procedures
N Row% Col% N Row% Col% N Row% Col% N Row% Col% N Row% Col%
Both Partial 39 0.9 0.8 626 14.3 10.9 428 9.8 4.3 3292 75.1 4.0 4385 100.0 4.3
Both Total 4955 5.2 99.1 5043 5.3 87.9 9379 9.8 94.7 76355 79.8 93.3 95732 100.0 93.4
Total/Partial 4 0.2 0.1 67 2.8 1.2 102 4.3 1.0 2191 92.7 2.7 2364 100.0 2.3
TOTAL 4998 4.9 100.0 5736 5.6 100.0 9909 9.7 100.0 81838 79.9 100.0 102481 100.0 100.0
Table SH9 Number of Hip Procedures by Patient
Not Revised 1 Revision 2 Revisions 3 or more Revisions TOTAL

Hip Procedures
N Row% N Row% N Row% N Row% N Row%
Unknown Primary/Primaries . . 16513 75.5 3833 17.5 1513 6.9 21859 100.0
Single Primary Procedure 390335 94.1 19413 4.7 3429 0.8 1459 0.4 414636 100.0
2 Primary Procedures 92636 90.4 7160 7.0 1830 1.8 855 0.8 102481 100.0
TOTAL 482971 89.6 43086 8.0 9092 1.7 3827 0.7 538976 100.0

PRIMARY PARTIAL HIP REPLACEMENT

CLASSES OF PARTIAL HIP REPLACEMENT
The Registry identifies four classes of primary Unipolar modular involves the use of a femoral
partial hip replacement. These are defined by stem and exchangeable large head prosthesis
the type of prostheses used. that replaces the natural femoral head.
Bipolar involves the use of a femoral stem and
Partial resurfacing involves the use of one or standard head prosthesis that articulates with a
more button prosthesis to replace part of the non-fixed component that replaces the natural
natural articulating surface on one or both sides femoral head.
of the hip joint.
Unipolar monoblock involves the use of a
femoral stem with a fixed large head that
replaces the natural femoral head.
Table SHP1 Primary Partial Hip Replacement by Age and Gender

Female 72212 71.0% 9 108 84 83.1 8.5
Male 29439 29.0% 5 107 83 81.6 9.6
TOTAL 101651 100.0% 5 108 84 82.7 8.9
Figure SHP1 Primary Partial Hip Replacement by Age and Table SHP2 Primary Partial Hip Replacement by Primary
Gender Diagnosis
Primary Diagnosis Number Percent

30
Fractured Neck Of Femur 96901 95.3
25 Osteoarthritis 2701 2.7
Tumour 1118 1.1
20
Failed Internal Fixation 575 0.6
Osteonecrosis 215 0.2
Percent
15
Rheumatoid Arthritis 55 0.1

10 Developmental Dysplasia 47 0.0
Osteochondritis Dissecans 1 0.0
5
Other 38 0.0
0 TOTAL 101651 100.0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female

a o a .o r g.au 19
Figure SHP2 Trends in Usage of Primary Partial Hip Replacement by State/Territory and Year

PRIMARY PARTIAL RESURFACING HIP REPLACEMENT

Table SHP3 Primary Partial Resurfacing Hip Replacement by Age and Gender

Female 3 20.0% 17 53 23 31.0 19.3
Male 12 80.0% 18 39 27 26.6 6.6
TOTAL 15 100.0% 17 53 25 27.5 9.5
Figure SHP3 Primary Partial Resurfacing Hip Replacement Table SHP4 Primary Partial Resurfacing Hip Replacement
by Age and Gender by Primary Diagnosis

40
Osteoarthritis 5 33.3
35
30 Osteochondritis Dissecans 1 6.7

25 Other 2 13.3
TOTAL 15 100.0
Percent
20
15
10
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female

a o a .o r g.au 21
PRIMARY UNIPOLAR MONOBLOCK HIP REPLACEMENT
Table SHP5 Primary Unipolar Monoblock Hip Replacement by Age and Gender

Female 21116 72.8% 16 108 86 85.0 7.2
Male 7879 27.2% 32 107 84 83.4 7.8
TOTAL 28995 100.0% 16 108 85 84.5 7.4
Figure SHP4 Primary Unipolar Monoblock Hip Table SHP6 Primary Unipolar Monoblock Hip Replacement
Replacement by Age and Gender by Primary Diagnosis
30
25
20 Tumour 64 0.2
Percent
15
5
Other 3 0.0
TOTAL 28995 100.0
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Female Male
Figure SHP5 Trends in Fixation of Primary Unipolar Monoblock Hip Replacement by State/Territory and Year
Note: NT is excluded from this graph due to low procedure numbers

PRIMARY UNIPOLAR MODULAR HIP REPLACEMENT

Table SHP7 Primary Unipolar Modular Hip Replacement by Age and Gender

Female 32614 70.4% 18 108 84 83.0 8.5
Male 13689 29.6% 5 106 83 81.5 9.5
TOTAL 46303 100.0% 5 108 84 82.5 8.8
Figure SHP6 Primary Unipolar Modular Hip Replacement Table SHP8 Primary Unipolar Modular Hip Replacement

30
Tumour 361 0.8
20
Percent
15

Other 18 0.0
5
TOTAL 46303 100.0
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female
Figure SHP7 Trends in Fixation of Primary Unipolar Modular Hip Replacement by State/Territory and Year
Note: There were no unipolar modular hip replacements in 2002 in NT

ACT is excluded from this graph due to low procedure numbers

a o a .o r g.au 23
PRIMARY BIPOLAR HIP REPLACEMENT

Table SHP9 Primary Bipolar Hip Replacement by Age and Gender

Female 18479 70.2% 9 107 83 81.4 9.6
Male 7859 29.8% 16 103 82 80.2 10.7
TOTAL 26338 100.0% 9 107 83 81.0 9.9
Figure SHP8 Primary Bipolar Hip Replacement by Age and Table SHP10 Primary Bipolar Hip Replacement by Primary
Gender Diagnosis

30
Tumour 693 2.6
20
Percent
15

Other 15 0.1
5
TOTAL 26338 100.0
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female
Figure SHP9 Trends in Fixation of Primary Bipolar Hip Replacement by State/Territory and Year

PRIMARY TOTAL HIP REPLACEMENT

CLASSES OF TOTAL HIP REPLACEMENT
The Registry subcategorises primary total hip Total resurfacing includes acetabular
replacement into three classes. These are replacement and the use of a femoral
defined by the type of femoral prosthesis used. prosthesis that replaces the femoral articular
A total hip procedure replaces both the surface without resecting the head.
femoral and acetabular articular surfaces.
Thrust Plate includes acetabular replacement
Total conventional includes acetabular combined with resection of the femoral head
replacement combined with resection of the and replacement with a femoral component
femoral head and replacement with a that has a lateral fixation plate and femoral
stemmed femoral prosthesis and femoral head head prosthesis.
prosthesis.
Table SHT1 Primary Total Hip Replacement by Age and Gender

Female 278171 53.7% 11 101 70 68.7 11.5
Male 239776 46.3% 12 102 66 65.5 11.8
TOTAL 517947 100.0% 11 102 68 67.2 11.8
Figure SHT1 Primary Total Hip Replacement by Age and Table SHT2 Primary Total Hip Replacement by Primary
Gender Diagnosis

30
25 Fractured Neck Of Femur 23545 4.5
20
Developmental Dysplasia 6872 1.3
Percent
15
Tumour 2707 0.5

10 Other Inflammatory Arthritis 2229 0.4
5
Fracture/Dislocation 622 0.1
0 Arthrodesis Takedown 149 0.0
Other 186 0.0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
TOTAL 517947 100.0

Age
Male Female

a o a .o r g.au 25
Figure SHT2 Trends in Usage of Primary Total Hip Replacement by State/Territory and Year

PRIMARY TOTAL CONVENTIONAL HIP REPLACEMENT

Table SHT3 Primary Total Conventional Hip Replacement by Age and Gender

Female 274486 55.0% 11 101 70 68.9 11.4
Male 224953 45.0% 12 102 67 66.3 11.5
TOTAL 499439 100.0% 11 102 69 67.7 11.5
Figure SHT3 Primary Total Conventional Hip Replacement Table SHT4 Primary Total Conventional Hip Replacement

30
25 Fractured Neck Of Femur 23545 4.7
20
Percent
15
Tumour 2705 0.5

5
0 Arthrodesis Takedown 148 0.0
Other 182 0.0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
TOTAL 499439 100.0

Age
Male Female
Figure SHT4 Trends in Fixation of Primary Total Conventional Hip Replacement by State/Territory and Year

a o a .o r g.au 27
PRIMARY TOTAL RESURFACING HIP REPLACEMENT

Table SHT5 Primary Total Resurfacing Hip Replacement by Age and Gender

Female 3611 19.8% 14 81 53 51.6 8.6
Male 14639 80.2% 13 82 54 53.4 9.1
TOTAL 18250 100.0% 13 82 54 53.1 9.0
Figure SHT5 Primary Total Resurfacing Hip Replacement by Table SHT6 Primary Total Resurfacing Hip Replacement by
Age and Gender Primary Diagnosis

30
20
Other Inflammatory Arthritis 70 0.4
Percent
15
10 Tumour 2 0.0
Arthrodesis Takedown 1 0.0
5
Other 4 0.0
0 TOTAL 18250 100.0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female
Figure SHT6 Trends in Fixation of Primary Total Resurfacing Hip Replacement by State/Territory and Year

PRIMARY THRUST PLATE HIP REPLACEMENT

Table SHT7 Primary Thrust Plate Hip Replacement by Age and Gender

Female 74 28.7% 27 71 56 54.5 9.9
Male 184 71.3% 33 75 59 58.5 8.7
TOTAL 258 100.0% 27 75 58 57.3 9.2
Figure SHT7 Primary Thrust Plate Hip Replacement by Age Table SHT8 Primary Thrust Plate Hip Replacement by
and Gender Primary Diagnosis

30
25 Rheumatoid Arthritis 6 2.3
Osteonecrosis 5 1.9
20
Percent
15
TOTAL 258 100.0

10
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Female Male

a o a .o r g.au 29
ALL REVISION HIP REPLACEMENT

CLASSES OF REVISION PROCEDURES
The Registry defines revision of a hip Major partial revision is the insertion, removal
replacement as any re-operation of a previous and/or replacement of one major component.
hip replacement procedure that involves the Major components are prostheses that are fixed
insertion, removal and/or replacement of a to bone. These are the femoral prosthesis and
prosthesis or implant. Revisions are sub the acetabular shell or cup in hip replacement.
-categorised into three classes: major total, Different types of major partial and minor
major partial and minor. revisions are identified based on the specific
prostheses or implants used in the revision.
Major total revision is the insertion, removal
and/or replacement of all major components.
Minor revision is the insertion removal and/or

replacement of any other prostheses or
implant including patellar prostheses in knee
replacement.
Table SHR1 All Revision Hip Replacement by Age and Gender

Male 34888 46.4% 15 102 72 70.1 11.9
Female 40224 53.6% 11 104 73 71.6 12.2
TOTAL 75112 100.0% 11 104 72 70.9 12.1
Figures SHR1 All Revision Hip Replacement by Age and Gender
30
25
20
Percent
15
10
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female

Table SHR2 All Revision Hip Replacement by Reason Table SHR3 All Revision Hip Replacement by
for Revision Type of Revision
Reason for Revision Number Percent Type of Revision Number Percent

Loosening 27166 36.2 Acetabular Component 22619 30.1
Infection 12763 17.0 THR (Femoral/Acetabular) 20569 27.4
Prosthesis Dislocation 10870 14.5 Femoral Component 14208 18.9
Fracture 9033 12.0 Head/Insert 9613 12.8
Lysis 4361 5.8 Cement Spacer 2892 3.9
Metal Related Pathology 2988 4.0 Head Only 1871 2.5
Pain 1467 2.0 Minor Components 937 1.2
Wear Acetabular Insert 1206 1.6 Removal of Prostheses 717 1.0
Implant Breakage Stem 729 1.0 Insert Only 655 0.9
Implant Breakage Acetabular 627 0.8 Bipolar Head and Femoral 523 0.7
Instability 510 0.7 Bipolar Only 194 0.3
Chondrolysis/Acetab. Erosion 491 0.7 Head/Neck/Insert 147 0.2
Malposition 427 0.6 Head/Neck 89 0.1
Leg Length Discrepancy 407 0.5 Reinsertion of Components 56 0.1
Implant Breakage Acetabular Insert 400 0.5 Neck Only 8 0.0
Wear Acetabulum 331 0.4 Saddle 5 0.0
Incorrect Sizing 182 0.2 Cement Only 5 0.0
Osteonecrosis 119 0.2 Thrust Plate 2 0.0
Tumour 117 0.2 Neck/Insert 1 0.0
Implant Breakage Head 110 0.1 Incomplete 1 0.0
Wear Head 84 0.1 TOTAL 75112 100.0
Heterotopic Bone 71 0.1
Progression Of Disease 21 0.0
Synovitis 15 0.0
Other 617 0.8
TOTAL 75112 100.0

a o a .o r g.au 31
Figures SHR2 Trends in All Revision Hip Replacement by State/Territory and Year

Knee Replacement
CATEGORIES OF KNEE REPLACEMENT
The Registry groups knee replacement into These are defined in the supplementary report
three broad categories, primary partial, primary on Partial Knee Arthroplasty. Revision knee
total and revision knee replacement. replacements are re-operations of previous
knee replacements where one or more of the
A primary replacement is the initial prosthetic components are replaced, removed
replacement procedure undertaken on a joint or another component is added. Revisions
and involves replacing either part (partial) or all include re-operations of primary partial, primary
(total) of the articular surface. total or previous revision procedures.
Primary partial knee replacements are sub Knee revisions are subcategorised into three
-categorised into five classes depending on the classes: major total, major partial or minor
type of prostheses used. The classes of primary revisions. These are defined in the chapter on
partial knee are: partial resurfacing, unispacer, revision outcomes.
bicompartmental, patella/trochlea and
unicompartmental.
KNEE REPLACEMENT
Partial Total Revision
Partial Resurfacing Total Major Total
Unispacer Major Partial
Bicompartmental Minor
Total
Patella/Trochlea
Unicompartmental

a o a .o r g.au 33

In 2019, 70.7% of all knee replacement Since 2003, knee replacement has increased by
procedures reported to the Registry were 147.7% in the private sector compared to
undertaken in private hospitals. 103.0% in the public sector.
In the last year, there was an increase in the There were 3,369 primary partial knee
number of knee replacements recorded in the replacements reported for the private sector in
private sector and a decrease in the public 2019, a decrease of 4.6% compared to 2018
sector. The private sector recorded 47,268 and a decrease of 1.2% since 2003. In the
procedures, an increase of 2.9% and the public public sector, there were 647 partial knee
sector recorded 18,759 procedures, a decrease replacements, an increase of 6.6% compared
of 2.6% compared to 2018 (Figure SK1). to 2018 and a decrease of 24.9% since 2003.
Figure SK1 Knee Replacement by Hospital Sector In 2019, 40,234 primary total knee replacements
were reported in the private sector, an increase
of 3.2% compared to 2018. In the public sector
65000
ALL KNEE in 2019, there were 16,470 primary total knee
60000 Private
replacements, a decrease of 3.9% compared
Public
55000
to 2018. Since 2003, primary total knee
50000 replacement has increased by 185.9% in the
45000 private sector compared to 1115.0% in the
40000 public sector.
35000
30000 There were 3,665 private sector revision knee
25000 replacements reported in 2019. This is an
20000 increase of 7.7% compared to 2018. In the
15000
public sector, there were 1,642 revision knee
10000
replacements, an increase of 7.5% compared
to 2018. Since 2003, revision knee replacement
5000
has increased by 129.5% in the private sector
0
2002 2004 2006 2008 2010 2012 2014 2016 2018 2020 compared to 129.0% in the public sector.
Table SK1 All Knee Replacement by Age and Gender

Male 378955 44.6% 8 101 68 67.9 9.3
Female 470374 55.4% 8 103 69 68.5 9.6
TOTAL 849329 100.0% 8 103 69 68.2 9.5
Table SK2 Number of Knee Replacements by Gender
Female Male TOTAL

Knee Replacement
N % N % N %
Unispacer 19 47.5 21 52.5 40 0.1
Patella/Trochlear 3252 76.9 975 23.1 4227 6.5
Unicompartmental 27957 46.3 32430 53.7 60387 92.8
Bicompartmental 100 60.6 65 39.4 165 0.3
Total Knee 403791 56.4 311994 43.6 715785 100.0
Major Total 17032 52.3 15503 47.7 32535 47.5
Major Partial 5819 49.4 5959 50.6 11778 17.2
Minor 12284 50.8 11883 49.2 24167 35.3
All Revision 35135 51.3 33345 48.7 68480 100.0
ALL KNEES 470374 55.4 378955 44.6 849329 100.0

a o a .o r g.au 35
Figure SK2 Percentage of Females by Type of Primary Knee Replacement and Procedure Year
100 Patella/Trochlear
Unicompartmental
90 Total Knee
80
70
Percentage Female
60
50
40
30
20
10
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Procedure Year
Figure SK3 Percentage of Females by Revision Knee Replacement and Procedure Year
100 Major Total

Major Partial
90 Minor
80
70
Percentage Female
60
50
40
30
20
10
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Procedure Year
Figure SK4 Percentage of Patients Aged <65 Years by Type of Primary Knee Replacement and Procedure Year
100 Patella/Trochlear
Unicompartmental
90 Total Knee
80
70
60
50
40
30
20
10
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Procedure Year
Figure SK5 Percentage of Patients Aged <65 Years by Revision Knee Replacement and Procedure Year
100 Major Total

Major Partial
90 Minor
80
70
60
50
40
30
20
10
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Procedure Year

a o a .o r g.au 37
Figure SK6 Trends in Usage of Knee Replacement by Procedure Year
60000 Unicompartmental
Total Knee
55000 Revision
50000
45000
40000
35000
30000
25000
20000
15000
10000
5000
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Figure SK7 Trends in Usage of Revision Knee Replacement by Procedure Year
3000 Major Total

Major Partial
Minor
2500
2000
1500
1000
500
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Table SK3 Incidence of Knee Replacement per 100,000 between 2003 to 2019
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Knee Replacement
Partial Resurfacing . 0.0 0.1 0.2 0.2 0.1 0.1 0.0 0.0 0.0 0.1 0.1 0.0 0.0 0.0 0.0 . 0.1
Unispacer 0.1 0.1 0.0 . . . . . . . . . . . . . . 0.0
Patella/Trochlear 0.8 0.9 0.9 0.9 0.9 1.1 1.1 1.2 1.1 1.0 1.1 1.0 1.0 1.3 1.2 1.3 1.2 1.1
Unicompartmental 20.8 18.7 19.2 17.7 16.8 15.2 14.2 11.9 10.8 9.4 9.2 9.7 10.7 12.6 14.9 15.2 14.7 14.1
Bicompartmental . . . 0.0 0.2 0.2 0.2 0.1 0.0 0.0 . . . . . . . 0.0
Total Knee 110.2 118.4 130.5 133.9 140.7 153.5 158.2 172.1 180.7 186.7 192.4 201.4 213.2 217.1 224.0 224.5 223.6 178.3
All Revisions 11.7 13.4 13.5 13.8 14.4 15.3 15.2 16.9 17.4 17.2 18.0 18.3 18.7 18.9 19.7 19.7 20.9 16.9
ALL KNEES 143.6 151.5 164.2 166.5 173.1 185.5 188.9 202.2 210.1 214.4 220.8 230.5 243.6 249.9 259.8 260.8 260.4 210.4
Figure SK8 Incidence of Knee Replacement per 100,000 between 2003 to 2019

All Primary Total
All Revisions
200
160
120
80
40
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

a o a .o r g.au 39
Table SK4 Incidence of Knee Replacement in Patients Aged <55 Years per 100,000 between 2003 to 2019
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Knee Replacement
Partial Resurfacing . 0.0 0.1 0.2 0.2 0.1 0.1 0.0 0.0 0.0 0.1 0.1 0.0 0.0 0.0 0.0 . 0.1
Unispacer 0.1 0.1 . . . . . . . . . . . . . . . 0.0
Bicompartmental . . . . 0.1 0.0 0.0 0.0 0.0 0.0 . . . . . . . 0.0
Total Knee 10.1 10.5 11.3 11.5 12.9 13.9 14.6 16.3 17.2 17.1 18.4 18.2 19.6 20.4 20.4 19.9 19.3 16.2
All Revisions 1.4 1.8 1.5 1.6 1.7 2.0 1.7 2.1 2.0 1.9 2.0 2.0 2.2 2.1 2.0 2.1 2.1 1.9
ALL KNEES 15.4 16.1 16.9 17.3 18.4 19.5 19.7 21.4 22.1 21.5 23.0 22.8 24.4 25.8 25.8 25.4 24.6 21.4
Figure SK9 Incidence of Knee Replacement in Patients Aged <55 Years per 100,000 between 2003 to 2019

All Primary Total
All Revisions
20
15
10
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Table SK5 Incidence of Knee Replacement in Patients Aged 55-64 Years per 100,000 between 2003 to 2019
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Knee Replacement
Partial Resurfacing . . 0.0 0.2 0.2 0.1 0.2 0.1 0.1 0.1 0.2 0.1 0.0 0.1 . . . 0.1
Unispacer 0.2 0.6 0.0 . . . . . . . . . . . . . . 0.0
Bicompartmental . . . . 0.5 0.8 0.6 0.5 0.2 0.1 . . . . . . . 0.1
Total Knee 242.6 260.1 287.5 300.7 320.5 370.5 383.7 421.8 449.5 449.1 466.2 479.4 512.0 518.8 523.3 523.0 509.5 423.2
All Revisions 22.5 28.4 26.6 29.7 31.1 33.3 34.3 38.5 38.6 39.0 38.6 39.8 42.1 38.0 40.6 38.7 40.2 35.9
ALL KNEES 333.5 351.6 377.5 388.4 407.3 455.0 467.5 502.0 524.6 520.0 535.4 551.0 589.6 597.7 607.8 608.1 591.9 504.6
Figure SK10 Incidence of Knee Replacement in Patients Aged 55-64 Years per 100,000 between 2003 to 2019

All Primary Total
All Revisions
500
400
300
200
100
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

a o a .o r g.au 41
Table SK6 Incidence of Knee Replacement in Patients Aged 65-74 Years per 100,000 between 2003 to 2019
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Knee Replacement
Partial Resurfacing . . . 0.4 0.3 0.3 0.1 . . 0.1 0.3 0.1 0.1 . . . . 0.1
Unispacer . 0.2 . . . . . . . . . . . . . . . 0.0
Bicompartmental . . . 0.2 0.6 0.7 0.6 0.2 0.1 . . . . . . . . 0.1
Total Knee 616.5 659.8 705.5 726.2 750.5 810.5 835.3 886.4 910.0 944.9 944.7 994.5 1024.0 1030.8 1065.4 1052.6 1039.2 907.2
All Revisions 56.3 65.8 67.2 66.3 66.4 70.8 73.4 80.5 82.4 80.7 85.4 86.3 83.8 84.6 88.4 89.9 91.6 79.4
ALL KNEES 776.9 811.7 863.1 876.8 894.6 950.5 974.5 1022.6 1039.8 1067.3 1070.3 1122.5 1154.8 1171.7 1220.8 1207.3 1194.0 1049.4
Figure SK11 Incidence of Knee Replacement in Patients Aged 65-74 Years per 100,000 between 2003 to 2019

All Primary Total
All Revisions
1000
800
600
400
200
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Table SK7 Incidence of Knee Replacement in Patients Aged ≥75 Years per 100,000 between 2003 to 2019
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Knee Replacement
Partial Resurfacing . . . . 0.1 0.1 . . . 0.1 0.4 . 0.1 . . . . 0.0
Unispacer . 0.1 . . . . . . . . . . . . . . . 0.0
Bicompartmental . . . 0.1 0.7 1.1 0.4 0.3 . . . . . . . . . 0.1
Total Knee 604.3 635.2 702.5 688.3 698.4 721.0 715.5 754.7 759.3 774.6 781.6 799.3 828.0 817.3 833.8 825.9 824.7 758.3
All Revisions 76.4 75.2 79.9 77.8 80.9 81.9 77.4 80.0 84.7 79.3 83.3 81.1 79.2 87.0 87.4 85.0 94.1 82.2
ALL KNEES 758.1 782.7 849.4 823.3 837.8 856.6 837.0 869.8 876.3 882.0 893.0 907.5 936.3 935.1 961.5 954.8 961.8 884.5
Figure SK12 Incidence of Knee Replacement in Patients Aged ≥75 Years per 100,000 between 2003 to 2019

All Primary Total
900 All Revisions
800
700
600
500
400
300
200
100
0
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

a o a .o r g.au 43
Figure SK13 Trends in Usage of Knee Replacement by State/Territory and Year
Table SK8 Time between Procedures for Bilateral Primary Knee Replacement
Same Day 1 day - 3 months 3 - 6 months ≥6 months TOTAL

Both Partial 4375 39.1 10.3 622 5.6 9.1 835 7.5 5.6 5368 47.9 4.0 11200 100.0 5.6
Both Total 37704 21.2 88.7 6130 3.4 89.7 13828 7.8 93.0 120395 67.6 89.5 178057 100.0 89.6
Total/Partial 424 4.5 1.0 83 0.9 1.2 202 2.1 1.4 8817 92.6 6.6 9526 100.0 4.8
TOTAL 42503 21.4 100.0 6835 3.4 100.0 14865 7.5 100.0 134580 67.7 100.0 198783 100.0 100.0
Table SK9 Number of Knee Procedures by Patient

Knee Procedures
TOTAL 542624 91.6 37779 6.4 8642 1.5 3639 0.6 592684 100.0
PRIMARY PARTIAL KNEE REPLACEMENT

CLASSES OF PARTIAL KNEE REPLACEMENT
The Registry subcategorises partial knee prosthesis, as well as the medial tibial articular
replacement into five classes. These are surface with a unicompartmental tibial
defined by the type of prostheses used. prosthesis. It may also include the use of a
patella prosthesis.
Partial resurfacing involves the use of one or Patella/trochlea involves the use of a trochlea
more button prosthesis to replace part of the prosthesis to replace the femoral trochlea
natural articulating surface on one or more articular surface and on most occasions a
sides of the joint in one or more articular patella prosthesis.
compartments of the knee. Unicompartmental procedure involves the
Unispacer involves the use of a medial or lateral replacement of the femoral and tibial articular
femorotibial compartment articular spacer. surface of either the medial or lateral
Bicompartmental involves the replacement of femorotibial compartment using
the medial femoral and trochlea articular unicompartmental femoral and tibial
surface of the knee with a single femoral prostheses.
Table SKP1 Primary Partial Knee Replacement by Age and Gender

Female 31448 48.3% 13 98 64 64.1 10.6
Male 33616 51.7% 17 98 65 65.5 9.8
TOTAL 65064 100.0% 13 98 65 64.8 10.2
Figure SKP1 Primary Partial Knee Replacement by Age Table SKP2 Primary Partial Knee Replacement by Primary
and Gender Diagnosis

30
25
Percent
15
10 Fracture 5 0.0
Tumour 1 0.0
5
Chondrocalcinosis 1 0.0
Other 16 0.0
0
TOTAL 65064 100.0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female

a o a .o r g.au 45
Figure SKP2 Trends in Usage of Primary Partial Knee Replacement by State/Territory and Year
PRIMARY PARTIAL RESURFACING KNEE REPLACEMENT

Table SKP3 Primary Partial Resurfacing Knee Replacement by Age and Gender

Female 120 49.0% 30 88 51 51.3 11.7
Male 125 51.0% 17 85 49 48.9 14.4
TOTAL 245 100.0% 17 88 50 50.1 13.2
Figure SKP3 Primary Partial Resurfacing Knee Table SKP4 Primary Partial Resurfacing Knee
Replacement by Age and Gender Replacement by Primary Diagnosis

35
30
25 Osteochondritis Dissecans 7 2.9

20
Chondrocalcinosis 1 0.4
Percent
15 Other 4 1.6
10
TOTAL 245 100.0
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female
PRIMARY UNISPACER KNEE REPLACEMENT
Table SKP5 Primary Unispacer Knee Replacement by Age and Gender

Female 19 47.5% 40 69 56 54.1 8.4
Male 21 52.5% 41 75 55 55.2 9.2
TOTAL 40 100.0% 40 75 55 54.7 8.7
Figure SKP4 Primary Unispacer Knee Replacement by Table SKP6 Primary Unispacer Knee Replacement by
Age and Gender Primary Diagnosis

35
30
TOTAL 40 100.0
25
20
Percent
15
10
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female

a o a .o r g.au 47
PRIMARY BICOMPARTMENTAL KNEE REPLACEMENT
Table SKP7 Primary Bicompartmental Knee Replacement by Age and Gender

Female 100 60.6% 46 84 61 63.8 10.6
Male 65 39.4% 45 86 62 65.1 9.9
TOTAL 165 100.0% 45 86 62 64.3 10.3
Figure SKP5 Primary Bicompartmental Knee Replacement Table SKP8 Primary Bicompartmental Knee Replacement

30
25 Osteonecrosis 3 1.8
20
TOTAL 165 100.0
Percent
15
10
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female

a o a .o r g.au 49
PRIMARY PATELLA/TROCHLEA KNEE REPLACEMENT
Table SKP9 Primary Patella/Trochlea Knee Replacement by Age and Gender

Female 3252 76.9% 22 95 57 57.9 11.8
Male 975 23.1% 24 95 60 60.9 13.0
TOTAL 4227 100.0% 22 95 58 58.6 12.2
Figure SKP6 Primary Patella/Trochlea Knee Replacement Table SKP10 Primary Patella/Trochlea Knee Replacement

25
20
15
Fracture 2 0.0
Osteonecrosis 2 0.0
Percent
10 Other 11 0.3
TOTAL 4227 100.0
5
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female
PRIMARY UNICOMPARTMENTAL KNEE REPLACEMENT
Table SKP11 Primary Unicompartmental Knee Replacement by Age and Gender

Female 27957 46.3% 13 98 65 64.9 10.2
Male 32430 53.7% 24 98 66 65.8 9.6
TOTAL 60387 100.0% 13 98 65 65.3 9.9
Figure SKP7 Primary Unicompartmental Knee Table SKP12 Primary Unicompartmental Knee

25

20
15
Percent

10
Fracture 3 0.0
Tumour 1 0.0
5
Other 1 0.0
TOTAL 60387 100.0
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Female Male
Figure SKP8 Trends in Fixation of Primary Unicompartmental Knee Replacement by State/Territory and Year

a o a .o r g.au 51
PRIMARY TOTAL KNEE REPLACEMENT

The Registry defines a total knee replacement
as a replacement of the entire femorotibial
articulation using a single femoral and a single
tibial prosthesis. This may or may not be
combined with a patella replacement.
Table SKT1 Primary Total Knee Replacement by Age and Gender

Female 403791 56.4% 8 103 69 68.8 9.4
Male 311994 43.6% 8 101 68 68.1 9.1
TOTAL 715785 100.0% 8 103 69 68.5 9.3
Figure SKT1 Primary Total Knee Replacement by Age and Table SKT2 Primary Total Knee Replacement by Primary
Gender Diagnosis

30
20
Tumour 863 0.1
Percent
15
Fracture 546 0.1
10 Chondrocalcinosis 18 0.0
Other 206 0.0
5
0
TOTAL 715785 100.0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female

a o a .o r g.au 53
Figure SKT2 Trends in Fixation of Primary Total Knee Replacement by State/Territory and Year
ALL REVISION KNEE REPLACEMENT

CLASSES OF REVISION PROCEDURES
The Registry defines revision of a joint Major components are prostheses that are fixed
replacement as any re-operation of a previous to bone. These are the femoral and tibial
joint replacement procedure that involves the prostheses in either partial or total knee
insertion, removal and/or replacement of a replacement. Although a patella prosthesis is
prosthesis or implant. Revisions are sub- fixed to bone it is not considered a major
categorised into three classes: major total, component.
major partial and minor.
Different types of major partial and minor
Major total revision is the insertion, removal revisions are identified based on the specific
and/or replacement of all major components. prostheses or implants used in the revision.
Major partial revision is the insertion, removal
and/or replacement of one major component.
Minor revision is the insertion removal and/or
replacement of any other prostheses or implant
including patellar prostheses in knee
replacement.
Table SKR1 All Revision Knee Replacement by Age and Gender

Male 33345 48.7% 13 98 69 68.8 10.2
Female 35135 51.3% 10 99 70 69.1 10.5
TOTAL 68480 100.0% 10 99 70 68.9 10.4

a o a .o r g.au 55
Table SKR2 Reason for Revision of All Knee Replacement Table SKR3 Type of Revision of All Knee Replacement
Reason for Revision Number Percent Type of Revision Number Percent

Loosening 20437 29.8 TKR (Tibial/Femoral) 32535 47.5
Infection 16499 24.1 Insert Only 11045 16.1
Pain 4297 6.3 Patella Only 7220 10.5
Progression Of Disease 4289 6.3 Insert/Patella 4913 7.2
Instability 3734 5.5 Tibial Component 4292 6.3
Patellofemoral Pain 3432 5.0 Cement Spacer 3684 5.4
Wear Tibial Insert 2366 3.5 Femoral Component 2751 4.0
Lysis 2212 3.2 Uni Insert Only 628 0.9
Patella Erosion 1919 2.8 Removal of Prostheses 374 0.5
Fracture 1690 2.5 Minor Components 303 0.4
Arthrofibrosis 1362 2.0 Uni Tibial Component 270 0.4
Malalignment 1015 1.5 UKR (Uni Tibial/Uni Femoral) 188 0.3
Metal Related Pathology 588 0.9 Uni Femoral Component 106 0.2
Implant Breakage Tibial Insert 543 0.8 Patella/Trochlear Resurfacing 87 0.1
Bearing Dislocation 531 0.8 Cement Only 38 0.1
Wear Tibial 487 0.7 Reinsertion of Components 26 0.0
Incorrect Sizing 450 0.7 Removal of Patella 8 0.0
Implant Breakage Tibial 412 0.6 Partial Resurfacing 7 0.0
Implant Breakage Patella 397 0.6 Unispacer 4 0.0
Patella Maltracking 325 0.5 Uni Insert/Patella 1 0.0
Wear Patella 238 0.3 TOTAL 68480 100.0
Prosthesis Dislocation 229 0.3
Implant Breakage Femoral 201 0.3
Synovitis 163 0.2
Tumour 55 0.1
Wear Femoral 19 0.0
Patella Dislocation 4 0.0
Incorrect Side 3 0.0
Post Operative Haematoma 1 0.0
Other 432 0.6
TOTAL 68480 100.0
Figure SKR1 Trends in Usage of All Revision Knee Replacement by State/Territory and Year

a o a .o r g.au 57
Shoulder Replacement
CATEGORIES OF SHOULDER REPLACEMENT
The Registry groups shoulder replacement into Total shoulder classes include total resurfacing,
three broad categories: primary partial, total mid head, total stemmed and total
primary total and revision shoulder reverse shoulder replacement. Definitions for
replacement. each of these are detailed in the subsequent
sections.
A primary replacement is the initial joint
replacement procedure and involves Revision procedures are re-operations of
replacing either part (partial) or all (total) of previous shoulder replacements where one or
the articular surface. more of the prosthetic components are
replaced, removed, or another component is
Primary partial and primary total shoulder
added. Revision procedures include re-
replacements are further subcategorised into
operation of primary partial, primary total, or
classes depending on the type of prosthesis
previous revision procedures.
used. Partial shoulder classes include partial
resurfacing, hemi resurfacing, hemi mid head Shoulder revision procedures are sub-
and hemi stemmed replacement. categorised into three classes: minor, major
partial and major total.
SHOULDER REPLACEMENT
Total
Partial Revision
Partial Total Major

Resurfacing Resurfacing Total
Hemi Total Major

Resurfacing Mid Head Partial
Total
Hemi
Stemmed Minor
Mid Head
Total
Hemi
Reverse
Stemmed

In 2019, 70.9% of all shoulder replacement Since 2008, shoulder replacement has
procedures reported to the Registry were increased by 201.2% in the private sector
undertaken in private hospitals. compared to 156.3% in the public sector.
In the last year, there was an increase in the There were 172 primary partial shoulder
number of shoulder replacements recorded in replacements reported for the private sector in
both the private and public sectors. The private 2019, a decrease of 0.6% compared to 2018
sector recorded 5,353 procedures, an increase and a decrease of 60.6% since 2008. In the
of 4.8% and the public sector recorded 2,202 public sector, there were 90 partial shoulder
procedures, an increase of 5.1% compared to replacements, a decrease of 17.4% compared
2018 (Figure SS1). to 2018 and a decrease of 78.7% since 2008.
In 2019, 4,739 primary total shoulder

Figure SS1 Shoulder Replacement by Hospital Sector replacements were reported in the private
sector, an increase of 5.6% compared to 2018.
10000
ALL SHOULDER In the public sector in 2019, there were 1,910
Private
Public
primary total shoulder replacements, an
increase of 5.9% compared to 2018. Since 2008,
primary total shoulder replacement has
increased by 309.2% in the private sector
compared to 430.6% in the public sector.
5000
There were 442 private sector revision shoulder
replacements reported in 2019. This is a
decrease of 0.9% compared to 2018. In the
public sector, there were 202 revision shoulder
replacements, a decrease of 9.8% reported in
2018. Since 2008, revision shoulder replacement
0 has increased by 142.9% in the private sector
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 compared to 162.3% in the public sector.

a o a .o r g.au 59
Table SS1 All Shoulder Replacement by Age and Gender

Male 23390 39.1% 14 96 70 68.9 10.3
Female 36397 60.9% 13 102 74 73.0 9.1
TOTAL 59787 100.0% 13 102 72 71.4 9.8
Table SS2 Number of Shoulder Replacements by Gender
Female Male TOTAL

Shoulder Replacement N % N % N %
Hemi Resurfacing 698 41.7 977 58.3 1675 23.7
Hemi Stemmed 3641 71.0 1488 29.0 5129 72.6
Hemi Mid Head 28 41.8 39 58.2 67 0.9
Total Resurfacing 94 40.2 140 59.8 234 0.5
Total Stemmed 8189 57.5 6042 42.5 14231 30.3
Total Reverse 19389 63.9 10941 36.1 30330 64.6
Total Mid Head 1143 53.8 981 46.2 2124 4.5
Major Total 1217 58.3 869 41.7 2086 35.9
Major Partial 1308 53.3 1148 46.7 2456 42.3
Minor 646 51.1 618 48.9 1264 21.8
All Revision 3171 54.6 2635 45.4 5806 100.0
ALL SHOULDERS 36397 60.9 23390 39.1 59787 100.0
Figure SS2 Percentage of Females by Type of Partial Shoulder Replacement and Procedure Year
100 Partial Resurfacing
Hemi Resurfacing
90 Hemi Stemmed
Hemi Mid Head
80
70
Percentage Female
60
50
40
30
20
10
0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
Procedure Year
Figure SS3 Percentage of Females by Type of Total Shoulder Replacement and Procedure Year
Total Stemmed
90 Total Reverse
Total Mid Head
80
70
Percentage Female
60
50
40
30
20
10
0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
Procedure Year

a o a .o r g.au 61
Figure SS4 Percentage of Females by Revision Shoulder Replacement and Procedure Year
100 Major Total
Major Partial
90 Minor
80
70
Percentage Female
60
50
40
30
20
10
0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
Procedure Year
Figure SS5 Percentage of Patients Aged <65 Years by Type of Partial Shoulder Replacement and Procedure Year

Hemi Resurfacing
90 Hemi Stemmed
Hemi Mid Head
80
70
60
50
40
30
20
10
0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
Procedure Year
Figure SS6 Percentage of Patients Aged <65 Years by Type of Total Shoulder Replacement and Procedure Year

Total Stemmed
90 Total Reverse
Total Mid Head
80
70
60
50
40
30
20
10
0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
Procedure Year
Figure SS7 Percentage of Patients Aged <65 Years by Revision Shoulder Replacement and Procedure Year
100 Major Total

Major Partial
90 Minor
80
70
60
50
40
30
20
10
0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
Procedure Year

a o a .o r g.au 63
Figure SS8 Trends in Usage of Partial Shoulder Replacement by Procedure Year

Hemi Resurfacing
Hemi Stemmed
Hemi Mid Head
700
600
500
400
300
200
100
0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
Figure SS9 Trends in Usage of Total Shoulder Replacement by Procedure Year

Total Stemmed
Total Reverse
4500 Total Mid Head
4000
3500
3000
2500
2000
1500
1000
500
0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
Figure SS10 Trends in Usage of Revision Shoulder Replacement by Procedure Year
500 Major Total

Major Partial
Minor
400
300
200
100
0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20

a o a .o r g.au 65
Table SS3 Incidence of Shoulder Replacement per 100,000 between 2008 to 2019
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
N N N N N N N N N N N N N
Partial Resurfacing 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.0 0.1 0.0 0.0 0.0
Hemi Resurfacing 1.0 0.9 0.7 0.7 0.8 0.5 0.3 0.3 0.5 0.4 0.3 0.3 0.4
Hemi Stemmed 2.9 2.8 2.7 2.5 2.3 1.9 1.6 1.2 1.0 0.7 0.7 0.6 1.3
Hemi Mid Head 0.0 0.0 0.0 0.0 . 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0
All Primary Partial 4.0 3.8 3.5 3.4 3.2 2.5 1.9 1.6 1.5 1.2 1.1 1.0 1.7
Total Resurfacing 0.1 0.1 0.1 0.2 0.2 0.2 0.1 0.1 0.0 0.0 0.0 0.0 0.1
Total Conventional 4.0 5.2 5.6 5.8 5.6 5.5 5.7 5.6 5.0 4.3 3.6 3.0 3.6
Total Reverse 3.1 3.9 4.4 5.7 6.7 8.1 9.7 11.3 14.2 16.9 19.7 21.1 7.9
Total Mid Head . 0.0 . 0.0 0.3 0.4 0.5 0.7 1.1 1.6 1.9 2.1 0.6
All Primary Total 7.1 9.2 10.1 11.7 12.9 14.1 16.0 17.7 20.3 22.9 25.2 26.2 12.1
All Revisions 1.2 1.4 1.5 1.6 2.0 1.9 2.0 2.4 2.2 2.5 2.5 2.5 1.5
ALL SHOULDERS 12.4 14.4 15.1 16.7 18.0 18.6 20.0 21.6 24.1 26.6 28.8 29.8 15.3
Figure SS11 Incidence of Shoulder Replacement per 100,000 between 2008 to 2019

All Primary Total
All Revisions
20
15
10
0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
Table SS4 Incidence of Shoulder Replacement in Patients Aged <55 Years per 100,000 between 2008 to 2019
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Partial Resurfacing 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.0 0.1 0.0 0.0 0.0
Hemi Stemmed 0.2 0.3 0.3 0.3 0.3 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.2
Hemi Mid Head 0.0 . . . . 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Total Resurfacing 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 . 0.0 . 0.0
Total Reverse 0.1 0.1 0.1 0.1 0.2 0.2 0.1 0.3 0.2 0.4 0.4 0.5 0.2
Total Mid Head . 0.0 . . 0.0 0.0 0.0 0.1 0.1 0.2 0.2 0.2 0.1
All Revisions 0.1 0.1 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.3 0.2 0.3 0.1
ALL SHOULDERS 1.0 1.2 1.2 1.4 1.4 1.1 1.1 1.4 1.5 1.7 1.8 1.9 1.0
Figure SS12 Incidence of Shoulder Replacement in Patients Aged <55 Years per 100,000 between 2008 to 2019
1.2 All Primary Partial

All Primary Total
All Revisions
1.0
0.8
0.6
0.4
0.2
0.0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20

a o a .o r g.au 67
Table SS5 Incidence of Shoulder Replacement in Patients Aged 55-64 Years per 100,000 between 2008 to 2019
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Partial Resurfacing 0.1 0.0 0.1 0.1 0.1 0.0 0.1 0.0 . . . . 0.0
Hemi Stemmed 5.2 4.4 5.0 4.0 3.7 3.2 2.8 2.5 2.0 1.3 1.8 1.9 2.3
Hemi Mid Head . 0.1 . 0.0 . . 0.0 0.0 0.1 0.1 0.1 0.1 0.0
Total Resurfacing 0.2 . 0.2 0.5 0.7 0.4 0.3 0.3 0.1 0.1 0.0 0.0 0.2
Total Reverse 2.3 2.5 3.0 3.6 4.9 5.6 6.1 8.5 12.3 16.2 19.7 20.3 6.8
Total Mid Head . . . 0.2 0.7 0.6 1.3 1.5 2.8 3.7 4.7 4.9 1.3
All Revisions 2.3 2.9 2.8 2.9 3.4 3.4 3.3 3.5 3.6 4.1 4.5 4.0 2.6
ALL SHOULDERS 19.7 22.9 23.9 23.9 25.9 24.6 25.7 29.0 32.5 35.8 39.4 39.2 21.6
Figure SS13 Incidence of Shoulder Replacement in Patients Aged 55-64 Years per 100,000 between 2008 to 2019

All Primary Total
All Revisions
30
25
20
15
10
0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
Table SS6 Incidence of Shoulder Replacement in Patients Aged 65-74 Years per 100,000 between 2008 to 2019
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Partial Resurfacing 0.3 . 0.2 0.2 0.1 0.2 0.2 0.0 . 0.1 . . 0.1
Hemi Stemmed 11.6 11.3 9.8 10.5 9.5 8.1 6.2 4.6 3.0 2.2 1.7 0.8 4.7
Hemi Mid Head . 0.1 0.1 . . 0.2 0.1 . 0.1 0.1 0.0 0.0 0.1
Total Resurfacing 0.4 0.4 0.3 0.6 0.7 1.0 0.6 0.5 0.4 0.3 0.2 0.1 0.3
Total Reverse 13.7 17.3 18.0 25.4 30.7 34.9 43.4 50.8 68.6 78.4 87.0 93.5 38.7
Total Mid Head . . . 0.1 2.0 2.4 2.8 4.0 5.5 8.0 9.2 10.4 3.2
All Revisions 6.1 6.3 7.0 8.4 9.4 8.7 9.4 10.9 11.4 11.3 11.8 11.5 7.4
ALL SHOULDERS 60.1 69.3 69.2 80.4 86.6 91.0 96.1 101.5 117.2 125.7 129.6 133.0 76.6
Figure SS14 Incidence of Shoulder Replacement in Patients Aged 65-74 Years per 100,000 between 2008 to 2019

All Primary Total
All Revisions
100
80
60
40
20
0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20

a o a .o r g.au 69
Table SS7 Incidence of Shoulder Replacement in Patients Aged ≥75 Years per 100,000 between 2008 to 2019
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL
Partial Resurfacing 0.4 0.1 0.1 0.3 0.1 0.1 . . . . . . 0.1
Hemi Stemmed 21.2 20.2 18.6 17.5 15.0 11.8 8.4 5.6 4.3 3.2 2.8 2.0 7.7
Hemi Mid Head . 0.1 0.1 . . 0.1 . 0.1 . . . . 0.0
Total Resurfacing 0.1 0.1 . 0.2 0.1 0.3 0.1 . . . 0.1 0.1 0.1
Total Reverse 29.5 37.3 43.4 53.1 58.0 70.7 82.7 90.9 101.5 118.9 137.9 144.0 62.6
Total Mid Head . . . . 0.8 2.2 2.2 1.9 3.4 4.7 5.2 5.7 1.8
All Revisions 7.7 8.1 9.0 8.0 10.4 11.2 11.7 13.6 11.4 12.5 11.7 12.1 8.0
ALL SHOULDERS 84.9 96.0 101.8 109.4 114.0 120.0 130.0 134.9 138.8 154.4 169.2 172.3 96.5
Figure SS15 Incidence of Shoulder Replacement in Patients Aged ≥75 Years per 100,000 between 2008 to 2019

All Primary Total
All Revisions
150
125
100
75
50
25
0
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
Figure SS16 Trends in Usage of Shoulder Replacement by State/Territory and Year
Note: There were no shoulder replacements undertaken in 2005 in NSW
Table SS8 Time between Procedures for Bilateral Primary Shoulder Replacement
Same Day 1 day - 3 months 3 - 6 months ≥6 months TOTAL

Both Partial 14 5.3 63.6 19 7.2 14.0 35 13.3 6.4 195 74.1 3.6 263 100.0 4.3
Both Total 8 0.1 36.4 112 2.1 82.4 494 9.1 90.6 4790 88.6 89.5 5404 100.0 89.2
Total/Partial . . . 5 1.3 3.7 16 4.1 2.9 367 94.6 6.9 388 100.0 6.4
TOTAL 22 0.4 100.0 136 2.2 100.0 545 9.0 100.0 5352 88.4 100.0 6055 100.0 100.0
Table SS9 Number of Shoulder Procedures by Patient

Shoulder Procedures
TOTAL 44631 91.0 3416 7.0 703 1.4 277 0.6 49027 100.0

a o a .o r g.au 71
PRIMARY PARTIAL SHOULDER REPLACEMENT

CLASSES OF PARTIAL SHOULDER REPLACEMENT
The Registry subcategorises primary partial Hemi stemmed involves the resection of the
shoulder replacement into four main classes. humeral head and replacement with a
These are defined as: humeral head and a humeral stem prosthesis.
A humeral stem prosthesis may have
Partial resurfacing involves the use of one or metaphyseal or diaphyseal fixation.
more button prostheses to replace part of the
natural articulating surface, on one or both
sides of the shoulder joint.
Hemi resurfacing involves the use of a humeral
prosthesis that replaces the humeral articular
surface only, without resecting the head.
Hemi mid head involves resection of part of
the humeral head and replacement with a
humeral head and an epiphyseal fixation
prosthesis.
Table SSP1 Primary Partial Shoulder Replacement by Age and Gender

Female 4411 62.5% 13 101 72 71.2 11.7
Male 2651 37.5% 14 94 62 61.1 14.5
TOTAL 7062 100.0% 13 101 69 67.4 13.7
Figure SSP1 Primary Partial Shoulder Replacement by Age Table SSP2 Primary Partial Shoulder Replacement by
25 Primary Diagnosis Number Percent
Fracture 3023 42.8
Rotator Cuff Arthropathy 324 4.6
Percent
Instability 185 2.6

10
Tumour 158 2.2
5
Other 1 0.0
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
TOTAL 7062 100.0

-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female
Figure SSP2 Trends in Usage of Partial Shoulder Replacement by State/Territory and Year
PRIMARY PARTIAL RESURFACING SHOULDER REPLACEMENT

Table SSP3 Primary Partial Resurfacing Shoulder Replacement by Age and Gender
Female 44 23.0% 16 88 56 55.6 19.9
Male 147 77.0% 14 87 35 38.7 17.6
TOTAL 191 100.0% 14 88 40 42.6 19.4
Figure SSP3 Primary Partial Resurfacing Shoulder Table SSP4 Primary Partial Resurfacing Shoulder
Instability 99 51.8
20
Fracture 12 6.3
15
Osteonecrosis 5 2.6
Percent

10
5
TOTAL 191 100.0
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female

a o a .o r g.au 73
PRIMARY HEMI RESURFACING SHOULDER REPLACEMENT
Table SSP5 Primary Hemi Resurfacing Shoulder Replacement by Age and Gender
Female 698 41.7% 27 100 69 68.0 11.4
Male 977 58.3% 19 90 61 60.3 12.1
TOTAL 1675 100.0% 19 100 64 63.5 12.4
Figure SSP4 Primary Hemi Resurfacing Shoulder Table SSP6 Primary Hemi Resurfacing Shoulder
25
20
15
Instability 21 1.3
Percent
Fracture 14 0.8
10
5
TOTAL 1675 100.0
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female
PRIMARY HEMI STEMMED SHOULDER REPLACEMENT
Table SSP7 Primary Hemi Stemmed Shoulder Replacement by Age and Gender
Female 3641 71.0% 13 101 73 72.1 11.3
Male 1488 29.0% 14 94 65 64.0 13.5
TOTAL 5129 100.0% 13 101 71 69.7 12.5
Figure SSP5 Primary Hemi Stemmed Shoulder Table SSP8 Primary Hemi Stemmed Shoulder Replacement
Replacement by Age and Gender by Primary Diagnosis
25
Fracture 2993 58.4
20
15
Tumour 158 3.1
Percent

Instability 64 1.2
10

5
Other 1 0.0
TOTAL 5129 100.0
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female
PRIMARY HEMI MID HEAD SHOULDER REPLACEMENT

Table SSP9 Primary Hemi Mid Head Shoulder Replacement by Age and Gender
Female 28 41.8% 30 85 66 64.6 10.8
Male 39 58.2% 24 83 50 51.3 12.2
TOTAL 67 100.0% 24 85 56 56.9 13.3
Figure SSP6 Primary Hemi Mid Head Shoulder Table SSP10 Primary Hemi Mid Head Shoulder
30
25
Fracture 4 6.0
20 Rotator Cuff Arthropathy 2 3.0
Percent

15
Instability 1 1.5
10
TOTAL 67 100.0
5
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female

a o a .o r g.au 75
PRIMARY TOTAL SHOULDER REPLACEMENT

CLASSES OF TOTAL SHOULDER REPLACEMENT
The Registry subcategorises primary total Total stemmed involves glenoid replacement
shoulder replacement into four classes. These combined with resection of the humeral head
are defined by the type of prostheses used. and replacement with humeral head and
humeral stem prostheses. A humeral stem
Total resurfacing involves glenoid replacement prosthesis may have metaphyseal or
and the use of a humeral prosthesis that diaphyseal fixation.
replaces the humeral articular surface without Total reverse involves glenoid replacement
resecting the head. with a glenosphere prosthesis combined with
resection of the humeral head and
Total mid head involves glenoid replacement replacement with humeral cup and humeral
combined with resection of part of the stem prostheses. A humeral stem prosthesis
humeral head and replacement with a may have metaphyseal or diaphyseal fixation.
humeral head and an epiphyseal fixation
prosthesis.
Table SST1 Primary Total Shoulder Replacement by Age and Gender

Female 28815 61.4% 13 102 74 73.5 8.4
Male 18104 38.6% 17 96 71 70.2 9.0
TOTAL 46919 100.0% 13 102 73 72.2 8.8
Figure SST1 Primary Total Shoulder Replacement by Age Table SST2 Primary Total Shoulder Replacement by
20
Fracture 4734 10.1
15
Percent

10
Instability 371 0.8
Tumour 184 0.4
5
Other 12 0.0
0
TOTAL 46919 100.0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female
Figure SST2 Trends in Fixation of Primary Total Shoulder Replacement by State/Territory and Year
Note: There were no primary total shoulder replacements undertaken in 2006 in TAS
NT is excluded from this graph due to low procedure numbers
PRIMARY TOTAL RESURFACING SHOULDER REPLACEMENT
Table SST3 Primary Total Resurfacing Shoulder Replacement by Age and Gender
Female 94 40.2% 46 86 67 67.0 6.8
Male 140 59.8% 35 83 63 62.2 9.8
TOTAL 234 100.0% 35 86 65 64.1 9.0
Figure SST3 Primary Total Resurfacing Shoulder 30

Replacement by Age and Gender
25
20
Percent
15
10
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female

a o a .o r g.au 77
Table SST4 Primary Total Resurfacing Shoulder Primary Diagnosis Number Percent
Replacement by Primary Diagnosis
Instability 1 0.4
Osteoarthritis 225 96.2 Osteonecrosis 1 0.4
TOTAL 234 100.0
Fracture 2 0.9
PRIMARY TOTAL STEMMED SHOULDER REPLACEMENT
Table SST5 Primary Total Stemmed Shoulder Replacement by Age and Gender
Female 8189 57.5% 21 96 71 70.4 8.5
Male 6042 42.5% 21 93 67 67.0 9.0
TOTAL 14231 100.0% 21 96 69 69.0 8.8
Figure SST4 Primary Total Stemmed Shoulder

Replacement by Age and Gender Table SST6 Primary Total Stemmed Shoulder Replacement
25 by Primary Diagnosis
Percent
Fracture 126 0.9

5
Instability 42 0.3
Tumour 10 0.1
0
Other 6 0.0
TOTAL 14231 100.0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female
Figure SST5 Trends in Fixation of Primary Total Stemmed Shoulder Replacement by State/Territory and Year
Note: There were no primary total stemmed shoulder replacements undertaken in 2006 in TAS
NT is excluded from this graph due to low procedure numbers
PRIMARY TOTAL REVERSE SHOULDER REPLACEMENT
Table SST7 Primary Total Reverse Shoulder Replacement by Age and Gender
Female 19389 63.9% 13 102 76 75.1 8.0
Male 10941 36.1% 17 96 73 72.6 8.2
TOTAL 30330 100.0% 13 102 75 74.2 8.1
Figure SST6 Primary Total Reverse Shoulder Replacement Table SST8 Primary Total Reverse Shoulder Replacement
30
25
Fracture 4601 15.2
Percent
15
Instability 316 1.0
10
Tumour 174 0.6
5 Other 6 0.0
TOTAL 30330 100.0
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female
Figure SST7 Trends in Fixation of Primary Total Reverse Shoulder Replacement by State/Territory and Year

a o a .o r g.au 79

PRIMARY TOTAL MID HEAD SHOULDER REPLACEMENT
Table SST9 Primary Total Mid Head Shoulder Replacement by Age and Gender
Female 1143 53.8% 37 94 70 69.2 8.2
Male 981 46.2% 34 95 66 65.0 9.1
TOTAL 2124 100.0% 34 95 68 67.2 8.8
Figure SST8 Primary Total Mid Head Shoulder Replacement Table SST10 Primary Total Mid Head Shoulder
by Age and Gender Replacement by Primary Diagnosis
30
20
Instability 12 0.6
Percent
15
10 Fracture 5 0.2
TOTAL 2124 100.0
5
0
<2
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
10
-2
-2
-3
-3
-4
-4
-5
-5
-6
-6
-7
-7
-8
-8
-9
-9
0+
0
Age
Male Female

a o a .o r g.au 81
ALL REVISION SHOULDER REPLACEMENT

Table SSR1 Age and Gender of All Revision Shoulder Replacement
Male 2615 45.3% 19 96 69 68.3 10.3
Female 3153 54.7% 15 95 72 71.3 10.1
TOTAL 5768 100.0% 15 96 71 69.9 10.3
Table SSR2 Reason for Revision of All Shoulder Table SSR3 Type of Revision of All Shoulder Replacement
Replacement
Type of Revision Number Percent
Reason for Revision Number Percent
Humeral/Glenoid 2086 36.2
Instability/Dislocation 1336 23.2
Humeral Component 1523 26.4
Loosening 1090 18.9
Head Only 477 8.3
Infection 1023 17.7
Glenoid Component 438 7.6
Rotator Cuff Insufficiency 659 11.4
Cup/Head 343 5.9
Fracture 394 6.8
Cement Spacer 333 5.8
Pain 269 4.7
Cup Only 321 5.6
Glenoid Erosion 217 3.8
Removal of Prostheses 112 1.9
Implant Breakage Glenoid
108 1.9 Head/Insert 61 1.1
Insert
Minor Components 34 0.6
Lysis 100 1.7
Cement Only 21 0.4
Dissociation 57 1.0
Reinsertion of Components 12 0.2
Implant Breakage Glenoid 54 0.9
Insert Only 4 0.1
Arthrofibrosis 48 0.8
Partial Resurfacing 3 0.1
Incorrect Sizing 45 0.8
TOTAL 5768 100.0
Metal Related Pathology 42 0.7
Malposition 41 0.7
Wear Glenoid Insert 36 0.6
Wear Glenoid 24 0.4
Implant Breakage Head 18 0.3
Progression Of Disease 17 0.3
Wear Humeral Cup 13 0.2
Implant Breakage Humeral 13 0.2
Tumour 8 0.1
Synovitis 2 0.0
Other 140 2.4
TOTAL 5768 100.0
Figure SSR1 Trends in Usage of All Revision Shoulder Replacement by State/Territory and Year

a o a .o r g.au 83
List of Tables
HIP REPLACEMENT .................................................................................................................................................................................. 4
Table SH1 All Hip Replacement by Age and Gender ............................................................................................................ 6
Table SH2 Number of Hip Replacements by Gender ............................................................................................................. 6
Table SH3 Incidence of Hip Replacement per 100,000 between 2003 to 2019 ................................................................. 13
Table SH4 Incidence of Hip Replacement in Patients Aged <55 Years per 100,000 between 2003 to 2019.................... 14
Table SH5 Incidence of Hip Replacement in Patients Aged 55-64 Years per 100,000 between 2003 to 2019 ................. 15
Table SH6 Incidence of Hip Replacement in Patients Aged 65-74 Years per 100,000 between 2003 to 2019 ................. 16
Table SH7 Incidence of Hip Replacement in Patients Aged ≥75 Years per 100,000 between 2003 to 2019 .................... 17
Table SH8 Time between Procedures for Bilateral Primary Hip Replacement .................................................................... 18
Table SH9 Number of Hip Procedures by Patient .................................................................................................................. 18
Table SHP1 Primary Partial Hip Replacement by Age and Gender ...................................................................................... 19
Table SHP2 Primary Partial Hip Replacement by Primary Diagnosis ...................................................................................... 19
Table SHP3 Primary Partial Resurfacing Hip Replacement by Age and Gender ................................................................. 21
Table SHP4 Primary Partial Resurfacing Hip Replacement by Primary Diagnosis ................................................................. 21
Table SHP5 Primary Unipolar Monoblock Hip Replacement by Age and Gender .............................................................. 22
Table SHP6 Primary Unipolar Monoblock Hip Replacement by Primary Diagnosis .............................................................. 22
Table SHP7 Primary Unipolar Modular Hip Replacement by Age and Gender.................................................................... 23
Table SHP8 Primary Unipolar Modular Hip Replacement by Primary Diagnosis .................................................................... 23
Table SHP9 Primary Bipolar Hip Replacement by Age and Gender ..................................................................................... 24
Table SHP10 Primary Bipolar Hip Replacement by Primary Diagnosis ..................................................................................... 24
Table SHT1 Primary Total Hip Replacement by Age and Gender ......................................................................................... 25
Table SHT2 Primary Total Hip Replacement by Primary Diagnosis ......................................................................................... 25
Table SHT3 Primary Total Conventional Hip Replacement by Age and Gender ................................................................. 27
Table SHT4 Primary Total Conventional Hip Replacement by Primary Diagnosis ................................................................. 27
Table SHT5 Primary Total Resurfacing Hip Replacement by Age and Gender .................................................................... 28
Table SHT6 Primary Total Resurfacing Hip Replacement by Primary Diagnosis .................................................................... 28
Table SHT7 Primary Thrust Plate Hip Replacement by Age and Gender .............................................................................. 29
Table SHT8 Primary Thrust Plate Hip Replacement by Primary Diagnosis .............................................................................. 29
All Revision Hip Replacement .......................................................................................................................................................... 30
Table SHR1 All Revision Hip Replacement by Age and Gender ............................................................................................. 30
Table SHR2 All Revision Hip Replacement by Reason for Revision ......................................................................................... 31
Table SHR3 All Revision Hip Replacement by Type of Revision ............................................................................................... 31
Table SK1 All Knee Replacement by Age and Gender ........................................................................................................ 35
Table SK2 Number of Knee Replacements by Gender......................................................................................................... 35
Table SK3 Incidence of Knee Replacement per 100,000 between 2003 to 2019 ............................................................... 39
Table SK4 Incidence of Knee Replacement in Patients Aged <55 Years per 100,000 between 2003 to 2019 ................. 40
Table SK5 Incidence of Knee Replacement in Patients Aged 55-64 Years per 100,000 between 2003 to 2019 .............. 41
Table SK6 Incidence of Knee Replacement in Patients Aged 65-74 Years per 100,000 between 2003 to 2019 .............. 42
Table SK7 Incidence of Knee Replacement in Patients Aged ≥75 Years per 100,000 between 2003 to 2019 ................. 43
Table SK8 Time between Procedures for Bilateral Primary Knee Replacement .................................................................. 44
Table SK9 Number of Knee Procedures by Patient .............................................................................................................. 44
Table SKP1 Primary Partial Knee Replacement by Age and Gender .................................................................................... 45
Table SKP2 Primary Partial Knee Replacement by Primary Diagnosis .................................................................................... 45
Table SKP3 Primary Partial Resurfacing Knee Replacement by Age and Gender ............................................................... 47
Table SKP4 Primary Partial Resurfacing Knee Replacement by Primary Diagnosis ............................................................... 47
Table SKP5 Primary Unispacer Knee Replacement by Age and Gender .............................................................................. 47
Table SKP6 Primary Unispacer Knee Replacement by Primary Diagnosis.............................................................................. 47
Table SKP7 Primary Bicompartmental Knee Replacement by Age and Gender ................................................................. 48
Table SKP8 Primary Bicompartmental Knee Replacement by Primary Diagnosis ................................................................. 48
Table SKP9 Primary Patella/Trochlea Knee Replacement by Age and Gender ................................................................... 49
Table SKP10 Primary Patella/Trochlea Knee Replacement by Primary Diagnosis ................................................................. 49
Table SKP11 Primary Unicompartmental Knee Replacement by Age and Gender .............................................................. 50
Table SKP12 Primary Unicompartmental Knee Replacement by Primary Diagnosis .............................................................. 50

Table SKT1 Primary Total Knee Replacement by Age and Gender ...................................................................................... 51
Table SKT2 Primary Total Knee Replacement by Primary Diagnosis ...................................................................................... 51
Table SKR1 All Revision Knee Replacement by Age and Gender ......................................................................................... 53
Table SKR2 Reason for Revision of All Knee Replacement...................................................................................................... 54
Table SKR3 Type of Revision of All Knee Replacement ........................................................................................................... 54
Table SS1 All Shoulder Replacement by Age and Gender .................................................................................................. 58
Table SS2 Number of Shoulder Replacements by Gender................................................................................................... 58
Table SS3 Incidence of Shoulder Replacement per 100,000 between 2008 to 2019 ......................................................... 64
Table SS4 Incidence of Shoulder Replacement in Patients Aged <55 Years per 100,000 between 2008 to 2019 ........... 65
Table SS5 Incidence of Shoulder Replacement in Patients Aged 55-64 Years per 100,000 between 2008 to 2019 ........ 66
Table SS6 Incidence of Shoulder Replacement in Patients Aged 65-74 Years per 100,000 between 2008 to 2019 ........ 67
Table SS7 Incidence of Shoulder Replacement in Patients Aged ≥75 Years per 100,000 between 2008 to 2019 ........... 68
Table SS8 Time between Procedures for Bilateral Primary Shoulder Replacement ............................................................ 69
Table SS9 Number of Shoulder Procedures by Patient ......................................................................................................... 69
Table SSP1 Primary Partial Shoulder Replacement by Age and Gender .............................................................................. 70
Table SSP2 Primary Partial Shoulder Replacement by Primary Diagnosis .............................................................................. 70
Table SSP3 Primary Partial Resurfacing Shoulder Replacement by Age and Gender ......................................................... 71
Table SSP4 Primary Partial Resurfacing Shoulder Replacement by Primary Diagnosis ......................................................... 71
Table SSP5 Primary Hemi Resurfacing Shoulder Replacement by Age and Gender ........................................................... 72
Table SSP6 Primary Hemi Resurfacing Shoulder Replacement by Primary Diagnosis ........................................................... 72
Table SSP7 Primary Hemi Stemmed Shoulder Replacement by Age and Gender .............................................................. 73
Table SSP8 Primary Hemi Stemmed Shoulder Replacement by Primary Diagnosis .............................................................. 73
Table SSP9 Primary Hemi Mid Head Shoulder Replacement by Age and Gender .............................................................. 73
Table SSP10 Primary Hemi Mid Head Shoulder Replacement by Primary Diagnosis ............................................................ 73
Table SST1 Primary Total Shoulder Replacement by Age and Gender ................................................................................ 74
Table SST2 Primary Total Shoulder Replacement by Primary Diagnosis ................................................................................ 74
Table SST3 Primary Total Resurfacing Shoulder Replacement by Age and Gender............................................................ 75
Table SST4 Primary Total Resurfacing Shoulder Replacement by Primary Diagnosis ........................................................... 75
Table SST5 Primary Total Stemmed Shoulder Replacement by Age and Gender ............................................................... 76
Table SST6 Primary Total Stemmed Shoulder Replacement by Primary Diagnosis ............................................................... 76
Table SST7 Primary Total Reverse Shoulder Replacement by Age and Gender .................................................................. 77
Table SST8 Primary Total Reverse Shoulder Replacement by Primary Diagnosis .................................................................. 77
Table SST9 Primary Total Mid Head Shoulder Replacement by Age and Gender ............................................................... 78
Table SST10 Primary Total Mid Head Shoulder Replacement by Primary Diagnosis ............................................................... 78
Table SSR1 Age and Gender of All Revision Shoulder Replacement .................................................................................... 79
Table SSR2 Reason for Revision of All Shoulder Replacement ................................................................................................ 79
Table SSR3 Type of Revision of All Shoulder Replacement ..................................................................................................... 79

a o a .o r g.au 85
List of Figures
HIP REPLACEMENT .................................................................................................................................................................................. 4
Figure SH1 Hip Replacement by Hospital Sector ...................................................................................................................... 5
Figure SH2 Percentage of Females by Type of Hip Replacement and Procedure Year ....................................................... 7
Figure SH3 Percentage of Females by Partial Hip Replacement and Procedure Year (Excluding Partial Resurfacing) ..... 7
Figure SH4 Percentage of Females by Total Hip Replacement and Procedure Year (Excluding Thrust Plate).................... 8
Figure SH5 Percentage of Females by Revision Hip Replacement and Procedure Year ...................................................... 8
Figure SH6 Percentage of Patients Aged <65 Years by Type of Hip Replacement and Procedure Year ............................ 9
Figure SH7 Percentage of Patients Aged <65 Years by Partial HR and Procedure Year (Excluding Partial Resurfacing) .. 9
Figure SH8 Percentage of Patients Aged <65 Years by THR and Procedure Year (Excluding Thrust Plate) ....................... 10
Figure SH9 Percentage of Patients Aged <65 Years by Revision Hip Replacement and Procedure Year ......................... 10
Figure SH10 Trends in Usage of Hip Replacement by Procedure Year ................................................................................... 11
Figure SH11 Trends in Usage of Partial Hip Replacement by Procedure Year (Excluding Partial Resurfacing) .................... 11
Figure SH12 Trends in Usage of Total Hip Replacement by Procedure Year (Excluding Thrust Plate) .................................. 12
Figure SH13 Trends in Usage of Revision Hip Replacement by Procedure Year ..................................................................... 12
Figure SH14 Incidence of Hip Replacement per 100,000 between 2003 to 2019 .................................................................. 13
Figure SH15 Incidence of Hip Replacement in Patients Aged <55 Years per 100,000 between 2003 to 2019..................... 14
Figure SH16 Incidence of Hip Replacement in Patients Aged 55-64 Years per 100,000 between 2003 to 2019.................. 15
Figure SH17 Incidence of Hip Replacement in Patients Aged 65-74 Years per 100,000 between 2003 to 2019.................. 16
Figure SH18 Incidence of Hip Replacement in Patients Aged ≥75 Years per 100,000 between 2003 to 2019 ..................... 17
Figure SH19 Trends in Usage of Hip Replacement by State/Territory and Year ...................................................................... 18
Figure SHP1 Primary Partial Hip Replacement by Age and Gender ....................................................................................... 19
Figure SHP2 Trends in Usage of Primary Partial Hip Replacement by State/Territory and Year ............................................. 20
Figure SHP3 Primary Partial Resurfacing Hip Replacement by Age and Gender .................................................................. 21
Figure SHP4 Primary Unipolar Monoblock Hip Replacement by Age and Gender ............................................................... 22
Figure SHP5 Trends in Fixation of Primary Unipolar Monoblock Hip Replacement by State/Territory and Year ................... 22
Figure SHP6 Primary Unipolar Modular Hip Replacement by Age and Gender ..................................................................... 23
Figure SHP7 Trends in Fixation of Primary Unipolar Modular Hip Replacement by State/Territory and Year ........................ 23
Figure SHP8 Primary Bipolar Hip Replacement by Age and Gender ...................................................................................... 24
Figure SHP9 Trends in Fixation of Primary Bipolar Hip Replacement by State/Territory and Year .......................................... 24
Figure SHT1 Primary Total Hip Replacement by Age and Gender .......................................................................................... 25
Figure SHT2 Trends in Usage of Primary Total Hip Replacement by State/Territory and Year ............................................... 26
Figure SHT3 Primary Total Conventional Hip Replacement by Age and Gender .................................................................. 27
Figure SHT4 Trends in Fixation of Primary Total Conventional Hip Replacement by State/Territory and Year ..................... 27
Figure SHT5 Primary Total Resurfacing Hip Replacement by Age and Gender ..................................................................... 28
Figure SHT6 Trends in Fixation of Primary Total Resurfacing Hip Replacement by State/Territory and Year ........................ 28
Figure SHT7 Primary Thrust Plate Hip Replacement by Age and Gender ............................................................................... 29
Revision Hip Replacement ............................................................................................................................................................... 30
Figures SHR1 All Revision Hip Replacement by Age and Gender ............................................................................................ 30
Figures SHR2 Trends in All Revision Hip Replacement by State/Territory and Year ................................................................. 32
Figure SK1 Knee Replacement by Hospital Sector ................................................................................................................. 34
Figure SK2 Percentage of Females by Type of Primary Knee Replacement and Procedure Year .................................... 36
Figure SK3 Percentage of Females by Revision Knee Replacement and Procedure Year................................................. 36
Figure SK4 Percentage of Patients Aged <65 Years by Type of Primary Knee Replacement and Procedure Year ......... 37
Figure SK5 Percentage of Patients Aged <65 Years by Revision Knee Replacement and Procedure Year ..................... 37
Figure SK6 Trends in Usage of Knee Replacement by Procedure Year ................................................................................ 38
Figure SK7 Trends in Usage of Revision Knee Replacement by Procedure Year.................................................................. 38
Figure SK8 Incidence of Knee Replacement per 100,000 between 2003 to 2019 ............................................................... 39
Figure SK9 Incidence of Knee Replacement in Patients Aged <55 Years per 100,000 between 2003 to 2019 ................. 40
Figure SK10 Incidence of Knee Replacement in Patients Aged 55-64 Years per 100,000 between 2003 to 2019 .............. 41
Figure SK11 Incidence of Knee Replacement in Patients Aged 65-74 Years per 100,000 between 2003 to 2019 .............. 42
Figure SK12 Incidence of Knee Replacement in Patients Aged ≥75 Years per 100,000 between 2003 to 2019 ................. 43
Figure SK13 Trends in Usage of Knee Replacement by State/Territory and Year ................................................................... 44
Figure SKP1 Primary Partial Knee Replacement by Age and Gender .................................................................................. 45
Figure SKP2 Trends in Usage of Primary Partial Knee Replacement by State/Territory and Year .......................................... 46
Figure SKP3 Primary Partial Resurfacing Knee Replacement by Age and Gender ............................................................... 47
Figure SKP4 Primary Unispacer Knee Replacement by Age and Gender .............................................................................. 47
Figure SKP5 Primary Bicompartmental Knee Replacement by Age and Gender ................................................................. 48
Figure SKP6 Primary Patella/Trochlea Knee Replacement by Age and Gender ................................................................... 49
Figure SKP7 Primary Unicompartmental Knee Replacement by Age and Gender .............................................................. 50
Figure SKP8 Trends in Fixation of Primary Unicompartmental Knee Replacement by State/Territory and Year .................. 50
Figure SKT1 Primary Total Knee Replacement by Age and Gender ...................................................................................... 51
Figure SKT2 Trends in Fixation of Primary Total Knee Replacement by State/Territory and Year .......................................... 52
Figure SKR1 Trends in Usage of All Revision Knee Replacement by State/Territory and Year .............................................. 55
Figure SS1 Shoulder Replacement by Hospital Sector ........................................................................................................... 57
Figure SS2 Percentage of Females by Type of Partial Shoulder Replacement and Procedure Year ................................ 59
Figure SS3 Percentage of Females by Type of Total Shoulder Replacement and Procedure Year................................... 59
Figure SS4 Percentage of Females by Revision Shoulder Replacement and Procedure Year........................................... 60
Figure SS5 Percentage of Patients Aged <65 Years by Type of Partial Shoulder Replacement and Procedure Year ..... 60
Figure SS6 Percentage of Patients Aged <65 Years by Type of Total Shoulder Replacement and Procedure Year........ 61
Figure SS7 Percentage of Patients Aged <65 Years by Revision Shoulder Replacement and Procedure Year ............... 61
Figure SS8 Trends in Usage of Partial Shoulder Replacement by Procedure Year ............................................................... 62
Figure SS9 Trends in Usage of Total Shoulder Replacement by Procedure Year ................................................................. 62
Figure SS10 Trends in Usage of Revision Shoulder Replacement by Procedure Year............................................................ 63
Figure SS11 Incidence of Shoulder Replacement per 100,000 between 2008 to 2019 ......................................................... 64
Figure SS12 Incidence of Shoulder Replacement in Patients Aged <55 Years per 100,000 between 2008 to 2019 ........... 65
Figure SS13 Incidence of Shoulder Replacement in Patients Aged 55-64 Years per 100,000 between 2008 to 2019 ........ 66
Figure SS14 Incidence of Shoulder Replacement in Patients Aged 65-74 Years per 100,000 between 2008 to 2019 ........ 67
Figure SS15 Incidence of Shoulder Replacement in Patients Aged ≥75 Years per 100,000 between 2008 to 2019 ........... 68
Figure SS16 Trends in Usage of Shoulder Replacement by State/Territory and Year ............................................................. 69
Figure SSP1 Primary Partial Shoulder Replacement by Age and Gender .............................................................................. 70
Figure SSP2 Trends in Usage of Partial Shoulder Replacement by State/Territory and Year ................................................. 71
Figure SSP3 Primary Partial Resurfacing Shoulder Replacement by Age and Gender ......................................................... 71
Figure SSP4 Primary Hemi Resurfacing Shoulder Replacement by Age and Gender ........................................................... 72
Figure SSP5 Primary Hemi Stemmed Shoulder Replacement by Age and Gender .............................................................. 73
Figure SSP6 Primary Hemi Mid Head Shoulder Replacement by Age and Gender .............................................................. 73
Figure SST1 Primary Total Shoulder Replacement by Age and Gender ................................................................................ 74
Figure SST2 Trends in Fixation of Primary Total Shoulder Replacement by State/Territory and Year .................................... 75
Figure SST3 Primary Total Resurfacing Shoulder Replacement by Age and Gender............................................................ 75
Figure SST4 Primary Total Stemmed Shoulder Replacement by Age and Gender ............................................................... 76
Figure SST5 Trends in Fixation of Primary Total Stemmed Shoulder Replacement by State/Territory and Year ................... 76
Figure SST6 Primary Total Reverse Shoulder Replacement by Age and Gender .................................................................. 77
Figure SST7 Trends in Fixation of Primary Total Reverse Shoulder Replacement by State/Territory and Year ...................... 77
Figure SST8 Primary Total Mid Head Shoulder Replacement by Age and Gender ............................................................... 78
Figure SSR1 Trends in Usage of All Revision Shoulder Replacement by State/Territory and Year ......................................... 80

a o a .o r g.au 87

2020 Demographics of Hip Knee and Shoulder Arthroplasty

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2020 Demographics of Hip Knee and Shoulder Arthroplasty

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Australian Orthopaedic

Association National Joint

Demographics of Hip, Knee

Data Period: 1 September 1999 – 31 December 2019 Page | 2

The Registry was implemented in a staged

Number of Patients and Procedures Recorded by the Registry

HIP, KNEE AND SHOULDER REPLACEMENT

1,079,617 Individual Patients

35.7% of patients have had more than one procedure

HIP REPLACEMENT KNEE REPLACEMENT SHOULDER REPLACEMENT

538,976 Individual Patients 592,684 Individual Patients 49,011 Individual Patients

Data Period: 1 September 1999 – 31 December 2019 Page | 3

Partial Total Revision

Unipolar Modular Thrust Plate Minor

Data Period: 1 September 1999 – 31 December 2019 Page | 4

PUBLIC AND PRIVATE SECTOR

Figure SH1 Hip Replacement by Hospital Sector

Data Period: 1 September 1999 – 31 December 2019 Page | 5

Table SH1 All Hip Replacement by Age and Gender

Gender Number Percent Minimum Maximum Median Mean Std Dev

Table SH2 Number of Hip Replacements by Gender

Female Male TOTAL

Data Period: 1 September 1999 – 31 December 2019 Page | 6

100 Unipolar Monoblock

Data Period: 1 September 1999 – 31 December 2019 Page | 7

100 Total Resurfacing

100 Major Total

Data Period: 1 September 1999 – 31 December 2019 Page | 8

100 Unipolar Monoblock

Data Period: 1 September 1999 – 31 December 2019 Page | 9

100 Total Resurfacing

100 Major Total

Data Period: 1 September 1999 – 31 December 2019 Page | 10

Figure SH10 Trends in Usage of Hip Replacement by Procedure Year

5000 Unipolar Monoblock

Data Period: 1 September 1999 – 31 December 2019 Page | 11

40000 Total Resurfacing

5000 Major Total

Data Period: 1 September 1999 – 31 December 2019 Page | 12

INCIDENCE OF HIP REPLACMENT

160 All Primary Partial

Data Period: 1 September 1999 – 31 December 2019 Page | 13

30 All Primary Partial

Data Period: 1 September 1999 – 31 December 2019 Page | 14

400 All Primary Partial

Data Period: 1 September 1999 – 31 December 2019 Page | 15

700 All Primary Partial

Data Period: 1 September 1999 – 31 December 2019 Page | 16

700 All Primary Partial

Data Period: 1 September 1999 – 31 December 2019 Page | 17

Figure SH19 Trends in Usage of Hip Replacement by State/Territory and Year

Same Day 1 day - 3 months 3 – 6 months ≥6 months TOTAL

Table SH9 Number of Hip Procedures by Patient

Not Revised 1 Revision 2 Revisions 3 or more Revisions TOTAL

Data Period: 1 September 1999 – 31 December 2019 Page | 18

PRIMARY PARTIAL HIP REPLACEMENT

Table SHP1 Primary Partial Hip Replacement by Age and Gender

Gender Number Percent Minimum Maximum Median Mean Std Dev

Primary Diagnosis Number Percent

Rheumatoid Arthritis 55 0.1

Data Period: 1 September 1999 – 31 December 2019 Page | 19

Data Period: 1 September 1999 – 31 December 2019 Page | 20

PRIMARY PARTIAL RESURFACING HIP REPLACEMENT

Gender Number Percent Minimum Maximum Median Mean Std Dev