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Comparative Study
. 2009 Aug;80(4):393-401.
doi: 10.3109/17453670903039544.

The Nordic Arthroplasty Register Association: a unique collaboration between 3 national hip arthroplasty registries with 280,201 THRs

Leif I Havelin  1 , Anne M Fenstad, Roger Salomonsson, Frank Mehnert, Ove Furnes, Søren Overgaard, Alma B Pedersen, Peter Herberts, Johan Kärrholm, Göran Garellick
Affiliations
Comparative Study

The Nordic Arthroplasty Register Association: a unique collaboration between 3 national hip arthroplasty registries with 280,201 THRs

Leif I Havelin et al. Acta Orthop. 2009 Aug.

Abstract

Background and purpose: The possibility of comparing results and of pooling the data has been limited for the Nordic arthroplasty registries, because of different registration systems and questionnaires. We have established a common Nordic database, in order to compare demographics and the results of total hip replacement surgery between countries. In addition, we plan to study results in patient groups in which the numbers are too small to be studied in the individual countries.

Material and methods: Primary total hip replacements (THRs) from 1995-2006 were selected for the study. Denmark, Sweden, and Norway contributed data. A common code set was made and Cox multiple regression, with adjustment for age, sex, and diagnosis was used to calculate prosthesis survival with any revision as endpoint.

Results: 280,201 operations were included (69,242 from Denmark, 140,821 from Sweden, and 70,138 from Norway). Females accounted for 60% of the patients in Denmark and Sweden, and 70% in Norway. Childhood disease was the cause of 3.1%, 1.8%, and 8.7% of the operations in Denmark, Sweden, and Norway, respectively. Resurfacing of hips accounted for 0.5% or less in all countries. The posterior approach was used in 91% of cases in Denmark, 60% in Sweden, and 24% in Norway. Cemented THRs were used in 46% of patients in Denmark, in 89% of patients in Sweden, and in 79% of patients in Norway. Of the 280,201 primary THRs, 9,596 (3.4%) had been revised. 10-year survival was 92% (95% CI: 91.6-92.4) in Denmark, 94% (95% CI: 93.6-94.1) in Sweden, and 93% (95% CI: 92.3-93.0) in Norway. In Denmark, 34% of the revisions were due to dislocation, as compared to 23% in Sweden and Norway. Replacement of only cup or liner constituted 44% of the revisions in Denmark, 29% in Sweden, and 33% in Norway.

Interpretation: This unique common Nordic collaboration has shown differences between the countries concerning demographics, prosthesis fixation, and survival. The large number of patients in this database significantly widens our horizons for future research.

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Figures

Figure 1.
Figure 1.
Kaplan-Meier estimated curves until revision for any cause, for primary total hip replacements (THAs) in Denmark, Sweden, and Norway 1995–2006. Curves are given for all THAs and also for those classified according to fixation technique as cemented, uncemented, and hybrids (uncemented cup/cemented stem).
Figure 2.
Figure 2.
Kaplan-Meier estimated curves until revision for any cause, for primary cemented and uncemented total hip replacements (THRs) in Denmark, Sweden, and Norway 1995–2006, in patients younger than 60 years and in those aged 60 and older.
See this image and copyright information in PMC

References

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