Methodology

Definitions and abbreviations
An overview of definitions and abbreviations used in this LROI annual report

Definitions

An overview of definitions used in this LROI annual report

Acetabulum component
The part of a hip prosthesis that is implanted into the acetabulum – the socket part of a ball and socket joint

Allograft
Transplant of bone tissue from a different body

Anchor question
The anchor question (daily functioning) measures change in daily functioning after joint replacement. The anchor question (pain) measures change in pain degree after joint replacement. The score has a range of 1.0 to 7.0, with 1.0 representing very deteriorated and 7.0 representing very improved

Arthrodesis
A procedure in which a natural joint is fused together

Arthrofibrosis
Rigidity of the joint as a consequence of connective tissue adhesion

Arthroscopy
Keyhole surgery to examine and treat joint disorders

Arthrotomy
Opening a joint during surgery

Articulation
The two surfaces that move together (articulate) in a total joint replacement

ASA score
The American Society of Anaesthesiologists (ASA) score is a scoring system for grading the overall physical condition of the patient, as follows: I – fit and healthy; II – mild disease, not incapacitating; III – incapacitating systemic disease; IV – life threatening disease

Autograft
Transplant of bone tissue originating from the patient’s own body

Bilaterality
Replacing the same joint on both sides of the body by means of a prosthesis within a specific period

Body Mass Index
Index for weight compared to body length (kg/m2); ≤18.5: underweight; >18.5-25: normal weight; >25-30: overweight; >30-40: obesity; >40: morbid obesity

Bonegraft
Bone transplant

Bone resorption
Process by which osteoclasts break down bone tissue

Carpal component
Part of a wrist prosthesis that is implanted in the patient’s carpal bones

Case mix
Term used to describe variation in the population, relating to factors such as diagnosis, patient age, gender and health condition

Cement
Material (polymethyl methacrylate) used to fixate joint replacements to bone

Charnley score
Clinical classification system; A: one joint affected; B1: both joints affected; B2: contralateral joint with a prosthesis; C: several joints affected or a chronic disease that affects quality of life

Competing risk survival analyse
Method to calculate survival taking into account various outcomes, in this case revision and death

Completeness
The completeness of the number of registered procedures in the LROI, based on a comparison with the hospital information system of every hospital that performs hip and/or knee arthroplasty in the Netherlands

Cuff arthropathy
Osteoarthritis of the shoulder joint as a consequence of the tendons around the shoulder joint being affected

Cuff rupture
Rupture of a tendon of the muscles that are around the shoulder joint

Cumulative incidence
The added up incidence over a specific period of an event (such as revision of a prosthesis or death of a patient)

Cumulative revision percentage
Added up revision percentage over a specific time period

Difference score
Difference in calculating score between pre-operative and 3, 6 or 12 months postoperative scores

Distal component
Part of a finger prosthesis that replaces the distal phalanx

Distal hemihumeral prosthesis
Elbow prosthesis in which the distal part of the humerus (upper arm bone) is replaced

Dual mobility cup
Acetabular component that consists of a dual cup and, therefore, has two independent articulation points

EQ-5D index score
The EQ-5D index score measures quality of life. The score has a range of -0.329 to 1.0, with 1.0 representing the best possible quality of life.

EQ-5D thermometer score
The EQ-5D thermometer score measures the health situation. The score has a range of 0.0 to 100.0, with 0.0 representing the worst possible health situation and 100.0 the best possible health situation

Femur component
Part of a hip or knee prosthesis that is implanted into the femur (thigh bone)

Femoral head component
Part of a hip prosthesis that is implanted on top of the femoral component of a hip prosthesis and moves inside the acetabular component or the cup of the hip joint

Flail elbow
Situation after removal of an elbow prosthesis in which no joint is present any more between the upper and lower arm

Girdlestone situation
Revision procedure to a hip in which the hip joint or hip prosthesis is removed and no new prosthesis is implanted (often because of a bacterial infection)

Glenoid baseplate
Part of a reversed shoulder prosthesis: a metal plate that is screwed into the glenoid (shoulder cup) of the shoulder blade, on which the glenosphere is fixed

Glenoid component
The part of a shoulder prosthesis that is placed in the glenoid; the cup-shaped notch of the shoulder blade

Glenoid liner
Intermediate component (inside layer) of a total anatomical shoulder prosthesis that will be placed in a glenoid component (most often a metal one)

Glenosphere
The part of a reversed shoulder prosthesis that is placed on the glenoid baseplate which is screwed into the glenoid and is spherical in shape

HOOS-PS score
The HOOS-PS score measures the physical functioning of patients with osteoarthritis to the hip. The score has a range of 0.0 to 100.0, with 0.0 representing no effort and 100.0 the most possible effort

Hybrid fixation
Fixation of a prosthesis in which (most often) one of both parts of a prosthesis is cemented and the other one uncemented

Humerus component
The part of a shoulder or elbow prosthesis that replaces the humerus (upper arm bone). The humeral component of a shoulder prosthesis may consist of two parts: the humeral head and the humeral stem component

Humeral liner
Intermediate component (inner layer) of a reversed shoulder prosthesis that will be placed in a metaphysical component

Inlay
Intermediate component (inner layer), made of polyethylene

Insert
Intermediate component (inner layer), made of polyethylene that is placed in the tibial component of a knee prosthesis

Kaplan Meier survival analysis
Method to calculate survival, in which only one end point is possible, in this case revision

KOOS-PS score
The KOOS-PS score measures the physical functioning of patients with osteoarthritis to the knee. The score has a range of 0.0 to 100.0, with 0.0 representing no effort and 100.0 the most possible effort

Lateral collateral ligament
Lateral (outer) knee ligament or elbow ligament

Lateral resurfacing arthroplasty
Elbow prosthesis in which only the lateral side of the joint is replaced

Major revision
Revision of at least the acetabular or femoral component (hip) or femoral or tibial component (knee)

Malalignment
Strain on a part of the body due to an abnormal position of a joint component with respect to other components

Medial malleolus osteotomy
Surgical approach of the ankle in which the medial malleolus (protruding part of the tibia on the inside of the ankle) is incised and later re-fixed to be able to have better access to the inside of the joint

Meniscectomy
Meniscus removal

Metallosis
Deposition of metal debris in soft tissues of the body

Metaphysis component
The part of a shoulder prosthesis that replaces the metaphysis (upper part) of the humerus (upper arm bone)

Minor revision
Revision of only inlay and/or femoral head component (hip) or only insert and/or patella exchange (knee)

NRS score
Numeric Rating Scale score. The NRS (rest) score measures pain during rest. The NRS (activity) score measures pain during activity. The score has a range of 0.0 to 10.0, with 0.0 representing no pain and 10.0 representing the most possible pain. The NRS (satisfaction) score measures patients’ satisfaction with the outcome of joint replacement. The score has a range of 0.0 to 10.0, with 0.0 representing very unsatisfied and 10.0 representing very satisfied

ODEP rating
Orthopaedic Data Evaluation Panel. ODEP provides ratings for hip femoral stems, hip acetabular cups and total knee replacement implants. An ODEP rating consists of a number and a letter (A or B), and a star (optional). The number represents the number of years for which the product’s performance had been evidenced. The letter represents the strength of evidence presented by the manufacturer (A represents strong evidence and B represents acceptable evidence). A Star (*) represents very strong evidence above A and B. Detailed information can be found at 
www.odep.org.uk

Olecranon
The most proximal part of the ulna

One-stage revision
A single revision procedure to change (insertion, replacement and/or removal) one or more components of the prosthesis (excluding patella addition)

Open Reduction and Internal Fixation surgery
Type of surgery to treat a bone fracture where the broken bone is reduced or put back into place, followed by internal fixation using devices (screws, plates, rods, or pins) to hold the broken bone together

Osteoarthritis
Disorder in which the cartilage of a joint is affected

Osteochondral bone defect
Defect of the joint surface in which both cartilage and underlying bone are affected

Osteonecrosis
Cellular death of bone tissue

Osteosynthesis
Securing broken bone parts together with plates, pins and/or screws

Osteotomy
Incise the bone in order to correct the position, to shorten or lengthen the bone

Oxford Hip score
The Oxford Hip score measures the physical functioning and pain of patients with osteoarthritis to the hip. The score has a range of 0.0 to 48.0, with 0.0 representing no functional ability and 48.0 representing the most functional ability

Oxford Knee score
The Oxford Knee score measures the physical functioning and pain of patients with osteoarthritis to the knee. The score has a range of 0.0 to 48.0, with 0.0 representing no functional ability and 48.0 representing the most functional ability.

Oxford Shoulder score
The Oxford Shoulder score measures the physical functioning and pain of patients with osteoarthritis to the shoulder. The score has a range of 0.0 to 48.0, with 0.0 representing no functional ability and 48.0 representing the most functional ability.

Patella addition
Knee revision procedure in which only a patella component was added to the primary knee prosthesis

Patella component
Part of a knee prosthesis that is implanted on the inner side of the knee cap

Patellofemoral prosthesis
Two-piece knee prosthesis that provides a prosthetic (knee) articulation surface between the patella and trochlea (furrow) of the thigh bone (femur)

Primary prosthesis
The first time (primary) a prosthesis is implanted to replace the original joint

PROMs
Patient Reported Outcome Measures

Proximal component
Part of a finger prosthesis that replaces the proximal phalanx

Radial head component
Part of an elbow prosthesis that replaces the head of the radius (spoke-bone)

Radial head prosthesis
Elbow prosthesis in which only the head of the radius (spoke-bone) is replaced

Radial stem component
Part of an elbow or wrist prosthesis that is implanted in the shaft of the patient’s radius (spoke-bone)

Recommendation score
The recommendation score measures to what extend the patient would recommend joint replacement to a friend or relative. The score has a range of 1.0 to 5.0, with 1.0 representing totally disagree and 5.0 representing totally agree

Resurfacing hip arthroplasty
Hip prosthesis in which the cup (acetabulum) is replaced and a metal cap is implanted on top of the femoral head

Resurfacing shoulder arthroplasty
Shoulder prosthesis in which a metal cap is implanted on top of the humeral head

Reversed hybrid fixation hip prosthesis
Fixation of a hip prosthesis in which the acetabular component is cemented and the femoral component is uncemented

Reversed shoulder prosthesis
Adjusted type of total shoulder arthroplasty in which the parts are implanted in a reversed manner. A sphere (glenosphere) is implanted onto the glenoid and a stem with cup in the shaft of the shoulder head

Revision arthroplasty
Any change (insertion, replacement and/or removal) of one or more components of the prosthesis

Sauvé Kapandji procedure
Arthrodesis of a natural wrist joint and construction of a new wrist joint by splitting the ulna

Shoulder hemiarthroplasty
Shoulder hemiarthroplasty with humeral stem, stemless hemi shoulder prosthesis (without humeral stem) or resurfacing shoulder hemiarthroplasty

Synovectomy
Removal of inflamed mucosa in a joint

Talus component
Part of an ankle prosthesis that is inserted in the talus (ankle bone)

Tibia component
Part of a knee or ankle prosthesis that is inserted in the tibia (shin bone)

Total arthroplasty
Arthroplasty in which the entire joint of a patient is replaced

Ulnar component
Part of an elbow or wrist prosthesis that is inserted in the ulna

Ulnar nerve
One of the three nerves that runs along the elbow. This nerve largely runs along the ulna

Unicondylar knee arthroplasty
Replacement of half the knee (either inner or outer side) by a prosthesis

Validity
Level of accuracy and completeness of registered data

Vektis
Vektis is a care information centre. Vektis collects and analyses data on the costs and quality of health care in the Netherlands. Vektis data mainly originates from reimbursement files of health care insurers. Therefore, Vektis has national data on medication use and use of aiding devices, data on primary health care and data on Diagnosis Treatment Combinations (DBCs/DOT) in hospitals and any other types of insured care in the Netherlands. In addition, Vektis collects demographic data, based on surveys among insurers and results of quality studies. www.vektis.nl

Walch score
Clinical classification system for level and type of wear of a shoulder joint; A1: humeral head centred, minimal erosion of shoulder cup; A2: humeral head centred, substantial erosion of shoulder cup; B1: Posterior subluxation of humeral head, posterior joint cavity narrow, subchondral sclerosis and osteophytes; B2: posterior subluxation of humerus head, retroversion of shoulder cup with posterior erosion; C: retroversion of shoulder cup over 25 degrees, irrespective of erosion

Abbreviations

An overview of abbreviations used in this LROI annual report

ASA       American Society of Anaesthesiologis
AA         Ankle arthroplasty
AO         Antioxidant
BMI       Body Mass Index
BSN      Citizen Service Number
CI          Confidence Interval
CMC     Carpometacarpal [finger joint]
D(IP)     Distal interphalangeal [finger joint]
DRU      Distal Radioulnar [prosthesis]
EA          Elbow arthroplasty
HIS        Hospital Information System
HA         Hip arthroplasty
IQR        Interquartile range
KA         Knee arthroplasty
LROI     Dutch Arthroplasty Register
MCP     Metacarpophalangeal [finger joint]
NOV      Netherlands Orthopaedic Association
NRS      Numeric Rating Scale
ODEP   Orthopaedic Data Evaluation Panel
ORIF     Open Reduction Internal Fixation
PE          Polyethylene
PIP        Proximal interphalangeal [finger joint]
PKA       Patellofemoral Knee Arthroplasty
PROM  Patient Reported Outcome Measure
RA         Revision arthroplasty
RHA      Resurfacing hip arthroplasty
SA         Shoulder arthroplasty
SD         Standard Deviation
TEA       Total Elbow Arthroplasty
THA       Total Hip Arthroplasty
TKA       Total Knee Arthroplasty
TSA       Total Shoulder Arthroplasty
UKA      Unicondylar Knee Arthroplasty
UMC     University Medical Centre
Zo          Oxidized Zirconium



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