Dataset Information

Countrywise results of total hip replacement. An analysis of 438,733 hips based on the Nordic Arthroplasty Register Association database.

ABSTRACT:

Background and purpose

An earlier Nordic Arthroplasty Register Association (NARA) report on 280,201 total hip replacements (THRs) based on data from 1995-2006, from Sweden, Norway, and Denmark, was published in 2009. The present study assessed THR survival according to country, based on the NARA database with the Finnish data included.

Material and methods

438,733 THRs performed during the period 1995-2011 in Sweden, Denmark, Norway, and Finland were included. Kaplan-Meier survival analysis was used to calculate survival probabilities with 95% confidence interval (CI). Cox multiple regression, with adjustment for age, sex, and diagnosis, was used to analyze implant survival with revision for any reason as endpoint.

Results

The 15-year survival, with any revision as an endpoint, for all THRs was 86% (CI: 85.7-86.9) in Denmark, 88% (CI: 87.6-88.3) in Sweden, 87% (CI: 86.4-87.4) in Norway, and 84% (CI: 82.9-84.1) in Finland. Revision risk for all THRs was less in Sweden than in the 3 other countries during the first 5 years. However, revision risk for uncemented THR was less in Denmark than in Sweden during the sixth (HR = 0.53, CI: 0.34-0.82), seventh (HR = 0.60, CI: 0.37-0.97), and ninth (HR = 0.59, CI: 0.36-0.98) year of follow-up.

Interpretation

The differences in THR survival rates were considerable, with inferior results in Finland. Brand-level comparison of THRs in Nordic countries will be required.

SUBMITTER: Makela KT

PROVIDER: S-EPMC3967250 | biostudies-literature | 2014 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Countrywise results of total hip replacement. An analysis of 438,733 hips based on the Nordic Arthroplasty Register Association database.

Mäkelä Keijo T KT Matilainen Markus M Pulkkinen Pekka P Fenstad Anne M AM Havelin Leif I LI Engesaeter Lars L Furnes Ove O Overgaard Søren S Pedersen Alma B AB Kärrholm Johan J Malchau Henrik H Garellick Göran G Ranstam Jonas J Eskelinen Antti A

Acta orthopaedica 20140401 2

<h4>Background and purpose</h4>An earlier Nordic Arthroplasty Register Association (NARA) report on 280,201 total hip replacements (THRs) based on data from 1995-2006, from Sweden, Norway, and Denmark, was published in 2009. The present study assessed THR survival according to country, based on the NARA database with the Finnish data included.<h4>Material and methods</h4>438,733 THRs performed during the period 1995-2011 in Sweden, Denmark, Norway, and Finland were included. Kaplan-Meier surviva ...[more]

PMID: 24650019

Similar Datasets

Project description:Background and purpose - The recommended optimal duration of the thromboprophylaxis treatment in total hip arthroplasty (THA) patients has been a matter of debate for years. We examined the association between short (1-5 days), standard (6-14 days), and extended (≥ 15 days) duration of thromboprophylaxis, with regards to the risk of venous thromboembolism (VTE), major bleeding, and death in unselected THA patients. Patients and methods - We performed a cohort study using prospectively collected data from the population-based hip arthroplasty registries, prescription databases, and patient administrative registries in Denmark and Norway. We included 55,540 primary THA patients with osteoarthritis Results - The 90-day cumulative incidence of VTE was 1.0% for patients with standard treatment (reference), 1.1% for those with short-term treatment (adjusted hazard ratio [aHR] of 1.1, 95% confidence interval (CI) 0.8-1.5) and 1.0% for those with extended treatment (aHR of 0.9, CI 0.8-1.2). The aHRs for major bleeding were 1.1 (CI 0.8-1.6) for short and 0.8 (CI 0.6-1.1) for extended vs. standard treatment. In addition, patients with short and extended treatment had aHRs for death of 1.2 (CI 0.8-1.8) and 0.8 (CI 0.5-1.1) vs. standard treatment, respectively. Patients who started short treatment postoperatively had an aHR for death of 1.8 (CI 1.1-3.1) and absolute risk difference of 0.2%, whereas patients who started short treatment preoperatively had an aHR for death of 0.5 (CI 0.2-1.2) and absolute risk difference of 0.3% compared with patients who had standard treatment with post- and preoperative start, respectively. Interpretation - In routine clinical practice, we observed no overall clinically relevant difference in the risks of VTE and major bleeding within 90 days of THA with respect to thromboprophylaxis duration. However, our data indicate that short-term thromboprophylaxis started postoperatively is associated with increased 90-day mortality. The significance of these data should be explored further.

Project description:BackgroundSupercapsular Percutaneously Assisted total hip arthroplasty (SuperPATH approach) is a relatively new minimal invasive approach which has been associated with encouraging postoperative outcomes. The aim of this study is to compare the minimal invasive (MIS) SuperPATHapproach with the standard modified Hardinge approach at the base of muscle damage due to serum markers, functional results and other perioperative and postoperative data.Material and methodsForty eight (48) consecutive patients undergone primary total hip arthroplasty (THA) by the same surgeon (GD), were enrolled in our study. From this study population, the modified Hardinge approach was performed in 23 patients and the SuperPATH approach was performed in 25 patients. Soft tissue impairment was studied based on three representative markers, C-reactive-protein (CRP) and two enzymes, creatine kinase (CK) and lactate dehydrogenase (LDH). We measured these markers 10 min after surgery, on 1st and 2nd postoperative day. The levels of the perceived pain were evaluated according to the Visual Analog Scale/Numerical Rating Scale (VAS/NRS) score which was registered 6 h, 12 h, 1 day and 2 days postoperatively. The functional and clinical evaluation of the patients was achieved with Harris Hip Score (HHS), Charnley's Hip score, EuroQol (EQ-5D)-(EQ-100), Patient Health Questionnaire (PHQ-9) and neuropathic pain questionnaire (DN-4) 6 months and 1 year postoperatively. The rest of the collected data included patient's age, gender, body mass index (BMI), other comorbitities, the American Society of Anesthiologists score (ASA), Charlson Index score, the pre-operative diagnosis, implant positioning through radiographic evaluation, the type of anesthesia, the days of hospitalization, the operating time, incision length, blood loss and blood transfusion requirements and complication rates.ResultsSuperPATH approach was related with statistically considerable lower levels of CRP at 10 min (p = 0,001) and at 24 h (p = 0,047) postoperatively, as well as lower LDH levels in all time points postoperatively. It was also associated with shorter incision length (p < 0.001), longer operating time (p < 0.001), higher mean cup inclination p < 0.001, decreased postoperative pain levels the first 6 and 12 h (p < 0.001) and relatively better clinical and functional results 6 months after surgery, but not at 12 months.ConclusionOur study revealed some advantages in favor of the SuperPATH approach comparing with the standard modified Hardinge approach, mainly in terms of less muscle damage and less perceived pain postoperatively. More research is required in order to further elucidate its efficacy.

Project description:Background and purpose - Socioeconomic status is associated with the outcome of major surgery. We investigated the association of socioeconomic status with the risk of early mortality and readmissions after primary total hip arthroplasty (THA). Patients and methods - We obtained information on income, education, immigration, and cohabiting status as well as comorbidities of 166,076 patients who underwent primary THA due to primary osteoarthritis (OA) from the Swedish Hip Arthroplasty Register, the Swedish National Inpatient Register and Statistics Sweden. Multivariable Cox regression models were fitted to estimate the adjusted risk of mortality or readmissions within 90 days after index surgery. Results - Compared with patients on a low income, the adjusted risk of 30-day mortality was considerably lower in patients on a high income (hazard ratio [HR] 0.5, 95% confidence interval [CI] 0.3-0.7) and in those on a medium income (HR 0.7, CI 0.6-0.9). Similar risk reductions were found for the endpoint 90-day mortality. Patients with a high income had a lower adjusted risk of readmission for cardiovascular reasons than those with a low income (HR 0.7, CI 0.6-0.9), as had those with a higher level of education (adjusted HR 0.7, CI 0.6-0.9). Patients with higher socioeconomic status had a lower degree of comorbidities than socioeconomically disadvantaged patients. However, adjusting for socioeconomic confounders in multivariable models only marginally influenced the predictive ability of the models, as expressed by their area under the curve. Interpretation - Income and level of education are strongly associated with early mortality and readmissions after primary THA, and both parameters are closely connected to health status. Since adjustment for socioeconomic confounders only marginally improved the predictive ability of multivariable regression models our findings indicate that comorbidities may under certain circumstances serve as an acceptable proxy measure of socioeconomic background.

Dataset Information

Countrywise results of total hip replacement. An analysis of 438,733 hips based on the Nordic Arthroplasty Register Association database.

Background and purpose

Material and methods

Results

Interpretation

Publications

Countrywise results of total hip replacement. An analysis of 438,733 hips based on the Nordic Arthroplasty Register Association database.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets