Australia has been leading the world with its National Joint Replacement Registry since 2000, with every joint replacement and its long term outcome being followed.

Key issues identified this year include:

1. The registry is now tracking the outcome of 1.8 million joint replacements.
2. 2021 saw 52,787 hip replacements, 68,466 knee replacements, and 8,733 shoulder replacements.
3. As a result of COVID, some 19,500 people have not had a joint replacement that in normal times should have occurred. This was predominantly in the public sector, with a 14.9% reduction compared with 2019.

Implants that were implanted 10 years ago, still being used, have a 4.4% ten-year failure for hips, and 4.7% for knees.  Young patients under 55 having knee replacement are the biggest risk.

Various designs and surgical approaches have been advocated to improve results. Highly cross-linked polyethylene (XLPE) is a proven winner, but dual mobility, and constrained liners, have not improved outcomes for primary hip replacement.

Anterior surgical approach in the Australian Registry has a lower dislocation rate, but the overall revision rate not changed.  It seems currently any dislocation improvement is offset by an increased risk in fracture & loosening.  

Total hip replacement for fracture (instead of bipolar) has become more common, with a 10-year revision rate of 6.9% vs 5.3% for the bipolars.  That difference is obvious for the older patients over 70, but not very different for the younger ones.

Hip resurfacing in men, with a femoral head size of 50mm or greater still has a place.

Partial knee replacement has diminished to 5.6% of knee replacements, the robotic Restoris (Mako) doesn’t seem better than the ZUK, or Persona.

Some designs have been identified as having a higher-than-expected revision rate, fortunately we have not routinely used these.

Stretches and range-of-motion exercises aim to improve the mobility and flexibility of your joints. To increase your range of motion, move a joint as far as it can go and then try to push a little farther. These exercises can be done any time, even when your joints are painful, as long as you do them gently.

Here are four range-of-motion exercises that you can do at home.

The next time you have a check-up, don’t be surprised if your doctor hands you a prescription to walk. Yes, this simple activity that you’ve been doing since you were about a year old is now being touted as “the closest thing we have to a wonder drug,” in the words of Dr. Thomas Frieden, former director of the USA Centers for Disease Control and Prevention.

Of course, you probably know that any physical activity, including walking, is a boon to your overall health. But walking in particular comes with a host of benefits. Here’s a list of five that may surprise you.

1. It counteracts the effects of weight-promoting genes.Harvard researchers looked at 32 obesity-promoting genes in over 12,000 people to determine how much these genes actually contribute to body weight. They then discovered that, among the study participants who walked briskly for about an hour a day, the effects of those genes were cut in half.
2. It helps tame a sweet tooth.A pair of studies from the University of Exeter found that a 15-minute walk can curb cravings for chocolate and even reduce the amount of chocolate you eat in stressful situations. And the latest research confirms that walking can reduce cravings and intake of a variety of sugary snacks.
3. It reduces the risk of developing breast cancer.Researchers already know that any kind of physical activity blunts the risk of breast cancer. But an American Cancer Society study that zeroed in on walking found that women who walked seven or more hours a week had a 14% lower risk of breast cancer than those who walked three hours or fewer per week. And walking provided this protection even for the women with breast cancer risk factors, such as being overweight or using supplemental hormones.
4. It eases joint pain.Several studies have found that walking reduces arthritis-related pain, and that walking five to six miles a week can even prevent arthritis from forming in the first place. Walking protects the joints — especially the knees and hips, which are most susceptible to osteoarthritis — by lubricating them and strengthening the muscles that support them.
5. It boosts immune function.Walking can help protect you during cold and flu season. A study of over 1,000 men and women found that those who walked at least 20 minutes a day, at least 5 days a week, had 43% fewer sick days than those who exercised once a week or less. And if they did get sick, it was for a shorter duration, and their symptoms were milder.

Our team of Physiotherapists, Sport & Exercise Medicine physicians and Orthopaedic Surgeons will be able to specifically advise you of your capacity and frequency of walking based on your condition.

To learn about additional benefits of walking, check out Walking for Health, a Special Health Report from Harvard Medical School.