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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 7, 864-867.
doi: 10.1302/0301-620X.89B7.18593  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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What impact have NICE guidelines had on the trends of hip arthroplasty since their publication?

THE RESULTS FROM THE TRENT REGIONAL ARTHROPLASTY STUDY BETWEEN 1990 AND 2005

V. I. Roberts, MRCS, Research Fellow1; C. N. Esler, FRCS(Orth), Consultant Orthopaedic Surgeon2; and W. M. Harper, FRCS(Orth), MD, Professor of Orthopaedic Surgery2

1 Trent Arthroplasty Audit Group Clinical Science Building, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK.
2 University of Leicester, University Road, Leicester LE1 7RH, UK.

Correspondence should be sent to Miss V. I. Roberts; e-mail: Vero_roberts1{at}hotmail.com

The National Institute for Clinical Excellence (NICE) published the guidelines on the selection of prostheses for primary hip replacement in 2000. They supported the use of cemented hip prostheses to the exclusion of uncemented and hybrid implants. The information from the Trent (and Wales) Regional Arthroplasty Study has been examined to identify retrospectively the types of hip prostheses used between 1990 and 2005, and to assess the impact that the guidelines have had on orthopaedic practice.

The results show that the publication of the NICE guidelines has had little impact on clinical practice, with the use of uncemented prostheses increasing from 6.7% (137) in 2001 to 19.2% (632) in 2005. The use of hybrid prostheses has more than doubled from 8.8% (181) to 22% (722) of all hips implanted in the same period. The recommendations made by NICE are not being followed, which calls into question their value.




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J Bone Joint Surg Br, July 1, 2007; 89-B(7): 849 - 850.
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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General