Revision joint replacement surgeries of the hip and knee across geographic region and socioeconomic status in the western region of Victoria: a cross-sectional multilevel analysis of registry data.

Journal Article (Journal Article)

BACKGROUND: Residents of rural and regional areas, compared to those in urban regions, are more likely to experience geographical difficulties in accessing healthcare, particularly specialist services. We investigated associations between region of residence, socioeconomic status (SES) and utilisation of all-cause revision hip replacement or revision knee replacement surgeries. METHODS: Conducted in western Victoria, Australia, as part of the Ageing, Chronic Disease and Injury study, data from the Australian Orthopaedic Association National Joint Replacement Registry (2011-2013) for adults who underwent a revision hip replacement (n = 542; 54% female) or revision knee replacement (n = 353; 54% female) were extracted. We cross-matched residential addresses with 2011 census data from the Australian Bureau of Statistics (ABS), and using an ABS-derived composite index, classified region of residence according to local government areas (LGAs), and area-level SES into quintiles. For analyses, the control population (n = 591,265; 51% female) was ABS-determined and excluded adults already identified as cases. Mixed-effects logistic regression was performed. RESULTS: We observed that 77% of revision hip surgeries and 83% of revision knee surgeries were performed for residents in the three most socially disadvantaged quintiles. In adjusted multilevel models, total variances contributed by the variance in LGAs for revisions of the hip or knee joint were only 1% (SD random effects ±0.01) and 3% (SD ± 0.02), respectively. No differences across SES or sex were observed. CONCLUSIONS: No differences in utilisation were identified between SES groups in the provision of revision surgeries of the hip or knee, independent of small between-LGA differences.

Full Text

Duke Authors

Cited Authors

  • Brennan-Olsen, SL; Vogrin, S; Graves, S; Holloway-Kew, KL; Page, RS; Sajjad, MA; Kotowicz, MA; Livingston, PM; Khasraw, M; Hakkennes, S; Dunning, TL; Brumby, S; Sutherland, AG; Talevski, J; Green, D; Kelly, T-L; Williams, LJ; Pasco, JA

Published Date

  • June 25, 2019

Published In

Volume / Issue

  • 20 / 1

Start / End Page

  • 300 -

PubMed ID

  • 31238918

Pubmed Central ID

  • PMC6591811

Electronic International Standard Serial Number (EISSN)

  • 1471-2474

Digital Object Identifier (DOI)

  • 10.1186/s12891-019-2676-z


  • eng

Conference Location

  • England