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Clinical Outcomes for Joint Replacements Clinical outcome data in short is a set of data that shows the survivorship of a hip or knee replacement both in the short and long term. It is useful for surgeons to examine their own practice but also useful for patients in choosing and gaining confidence in their surgeon. In the UK it is a requirement that all joint replacements are registered on the National Joint Registry. This is an independent government owned national organisation funded by the sale of hip and knee replacement implants. This allows for accurate tracking of the progress of the vast majority of hip and knee replacements providing the patient remains within England, Wales or Northern Ireland. There is now an increasing demand to view this data on an individual surgeon basis. Much of the data presented below is available for comparison with other surgeons on the National Joint Register Surgeon and Hospital Profile website: |
Mr. James Hahnel
MBBS(Ncl) MRCS(Eng&Glas) FRCS(Tr&Orth) Consultations: Bradford Royal Infirmary (NHS) Duckworth Lane Bradford BD9 6RJ Secretary: 01274 383336 Email: Melanie.Wilkinson@bthft.nhs.uk Nuffield Health Hospital Leeds (Private) 2 Leighton Street Leeds LS1 3EB Secretary: 07710505960 Email: kayleigh.duree@nuffieldhealth.com www.nuffieldhealth.com/leeds To book an appointment now into the Leeds Nuffield Clinic, please click the link below: https://www.nuffieldhealth.com/consultants/mr-james-hahnel#book The Yorkshire Clinic (Private) Bradford Road Bingley BD16 1TW Secretary: 01274 550845 Email:Emma.Hastings@ramsayhealth.co.uk www.theyorkshireclinic.co.uk |
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NJR Surgeon and Hospital Profile
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Publically available data for Mr. J Hahnel:
Hip Primary - 1st time total hip replacement
Hip Revision - Surgery performed to replace a pre-existing hip replacement
Knee Primary - 1st time total or uni compartmental knee replacement
Knee Revision - Surgery performed to replace a pre-existing knee replacement
Hip Revision - Surgery performed to replace a pre-existing hip replacement
Knee Primary - 1st time total or uni compartmental knee replacement
Knee Revision - Surgery performed to replace a pre-existing knee replacement
1 Year Practice Profile - Number of joint replacements performed
3 Year Practice Profile - Number of joint replacements performed
Revision rate of primary joint replacements
A revision joint replacement is performed due to the failure of the original primary joint replacement. This can be required due to a number of reasons for example that the implant has simply worn out, the patient has had an injury sustaining a broken bone around the implant, a complication of the original surgery or infection. Revision surgery luckily is not common.
This data is collated and is normally only available for private view by the specific surgeon. Due to the small number of patients requiring revision surgery, if there are small inaccuracies of the data this can lead to a very misleading result.
The data is presented to the surgeons in the form of 'funnel plots'. Essentially the lower the surgeon is (shown as a coloured circle) on the plot, the longer their joint replacement will last with less complications. This charts the specific surgeon in comparison to all other surgeons in the country. As you move along the horizontal axis from left to right, the surgeon has performed more cases and therefore would be expected to have more of their patients requiring revision of their joint replacement.
The higher up the vertical axis represents an increasing number of patients having undergone revision surgery of their primary.The green horizontal line represents the average surgeon. Further above this shows that the surgeon has had a higher than average number of patients needing revision. The red dots indicate surgeons who have an even higher number of revisions making them 'outliers'. Below this green line shows the surgeon has a lower than average number of patients needing revision.
For the very technical patients out there the confidence intervals shown on the graph are 95% and 99.8% meaning that if you are below the blue line you would be in the top 2.5% performing surgeons in the country and if below the red line in the top 0.1% in the country!
Mr. Hahnel's revision rates (PTIR's) as the lead surgeon in the last 10 years performing the procedure for knee and hip replacement are as below.
The official explanation of these funnel plots is as below:
Person time incidence rates for each surgeon are calculated using the following algorithm:
For all primary knee procedures (with an NHS Number) performed by a surgeon
1) sum all elapsed time from the date of primary to either revision date, or patient death date or last date of investigation
2) sum the total number of primaries that have been revised
3) divide the number of patients that have had their primary knee revised by the elapsed time
4) multiply this by 100 to get the surgeons Patient Time Incidence Rate per 100 PatientYears
The Person Time Incidence Rates are plotted on a Funnel Plot.
This data is collated and is normally only available for private view by the specific surgeon. Due to the small number of patients requiring revision surgery, if there are small inaccuracies of the data this can lead to a very misleading result.
The data is presented to the surgeons in the form of 'funnel plots'. Essentially the lower the surgeon is (shown as a coloured circle) on the plot, the longer their joint replacement will last with less complications. This charts the specific surgeon in comparison to all other surgeons in the country. As you move along the horizontal axis from left to right, the surgeon has performed more cases and therefore would be expected to have more of their patients requiring revision of their joint replacement.
The higher up the vertical axis represents an increasing number of patients having undergone revision surgery of their primary.The green horizontal line represents the average surgeon. Further above this shows that the surgeon has had a higher than average number of patients needing revision. The red dots indicate surgeons who have an even higher number of revisions making them 'outliers'. Below this green line shows the surgeon has a lower than average number of patients needing revision.
For the very technical patients out there the confidence intervals shown on the graph are 95% and 99.8% meaning that if you are below the blue line you would be in the top 2.5% performing surgeons in the country and if below the red line in the top 0.1% in the country!
Mr. Hahnel's revision rates (PTIR's) as the lead surgeon in the last 10 years performing the procedure for knee and hip replacement are as below.
The official explanation of these funnel plots is as below:
Person time incidence rates for each surgeon are calculated using the following algorithm:
For all primary knee procedures (with an NHS Number) performed by a surgeon
1) sum all elapsed time from the date of primary to either revision date, or patient death date or last date of investigation
2) sum the total number of primaries that have been revised
3) divide the number of patients that have had their primary knee revised by the elapsed time
4) multiply this by 100 to get the surgeons Patient Time Incidence Rate per 100 PatientYears
The Person Time Incidence Rates are plotted on a Funnel Plot.
Patient Reported Outcome Measures (PROM data)
This is data collected directly from patients and included only if they respond to the surveys. Essentially patients complete surveys preoperatively and 6 months postoperatively relating to their level of disability and function. The NHS provide a guide for patients as to what they mean which can be accessed by clicking on the link below:
NHS guide to PROMs data
I have included some satisfaction results for hip and knee below which compares me to all other joint replacement surgeons in the country. Unlike the revision data funnel plots above,with these you want to be as high as possible on the graph to have satisfied patients. A full copy of the report is provided below
Mr Hahnel's PROMS report 2021 (latest data available as per 13/4/2023)
Total Knee Replacements
Total Hip Replacement
All the content provided is for information only and although of high quality does NOT constitute professional medical advice. Please consult a specialist for advice on your condition.