Similar incidence and implant survival of multiply revised knee arthroplasties in Norway and Denmark: a register study of the Danish and Norwegian Knee Arthroplasty registries from 1998–2021

Authors

  • Julius Tetens Hald Department of Orthopaedic Surgery, Rigshospitalet, Copenhagen University, Denmark https://orcid.org/0000-0001-7724-2946
  • Anne Marie Fenstad The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway https://orcid.org/0000-0002-6429-0153
  • Anders El-Galaly Department of Orthopaedic Surgery, Rigshospitalet, Copenhagen University, Denmark
  • Anders Odgaard Department of Orthopaedic Surgery, Rigshospitalet, Copenhagen University; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark https://orcid.org/0000-0002-4841-518X
  • Ove Nord Furnes The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway https://orcid.org/0000-0001-8223-2515

DOI:

https://doi.org/10.2340/17453674.2026.45411

Keywords:

Arthroplasty, Implants, Knee

Abstract

Background and purpose: The aim of our study was to identify the absolute incidence and implant survival probability of multiply revised knee arthroplasties in Norway and Denmark from 1998 to 2021.
Methods: This was an observational study of primary and revision knee arthroplasties reported prospectively in Norway and Denmark. The nationwide registers in Norway and Denmark were utilized. After identification of all primary procedures reported from 1998 to 2021, revision procedures were identified. Probabilities of implant survival were calculated using Kaplan–Meier methods. A multiply revised knee arthroplasty was defined as at least 3 revisions of a primary knee arthroplasty.
Results: The proportion of third revisions was 0.4% in both Denmark (621/159,343) and Norway (404/105,192). The 16-year implant survival of third revisions was 57% (CI 52–62) in Denmark and 54% (CI 48–61) in Norway. No difference in the risk of revision between countries was found for the third revision (HR 1.1, CI 0.7–1.8).
Conclusion: The incidence of multiply revised knee arthroplasties was not significantly different between Norway and Denmark. The risk and implant survival probability of multiply revised knee arthroplasties was similar in the 2 countries. The results can be used as a benchmark for incidence and prevalence calculations in other countries.

Downloads

Download data is not yet available.

References

Deere K, Whitehouse M R, Kunutsor S K, Sayers A, Price A J, Mason J, et al. How long do revised and multiply revised knee replacements last? An analysis of the National Joint Registry. Lancet Rheumatol 2021; 3: e438-e446. doi: 10.1016/s2665-9913(21)00079-5. DOI: https://doi.org/10.1016/S2665-9913(21)00079-5

Hald J T, El-Galaly A B, Petersen M M, Lindberg-Larsen M, Christensen R, Odgaard A. Incidence and survival of multiply revised knee arthroplasties in Denmark 1998–2021: a nationwide register-based study. Acta Orthop 2024; 95: 454-9. doi: 10.2340/17453674.2024.41257. DOI: https://doi.org/10.2340/17453674.2024.41257

Yapp L Z, Clement N D, Moran M, Clarke J V, Simpson A, Scott C E H. The estimated lifetime risk of revision after primary knee arthroplasty is influenced by age, sex, and indication. Bone Joint J 2022; 104-b: 1313-22. doi: 10.1302/0301-620x.104b12.Bjj-2021-1631.R3. DOI: https://doi.org/10.1302/0301-620X.104B12.BJJ-2021-1631.R3

Vandenbroucke J P, von Elm E, Altman D G, Gøtzsche P C, Mulrow C D, Pocock S J, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Ann Intern Med 2007; 147: W163-94. doi: 10.7326/0003-4819-147-8-200710160-00010-w1. DOI: https://doi.org/10.7326/0003-4819-147-8-200710160-00010-w1

Schmidt M, Schmidt S A, Sandegaard J L, Ehrenstein V, Pedersen L, Sørensen H T. The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol 2015; 7: 449-90. doi: 10.2147/clep.S91125. DOI: https://doi.org/10.2147/CLEP.S91125

Pedersen A B, Mehnert F, Odgaard A, Schrøder H M. Existing data sources for clinical epidemiology: the Danish Knee Arthroplasty Register. Clin Epidemiol 2012; 4: 125-35. doi: 10.2147/clep.S30050. DOI: https://doi.org/10.2147/CLEP.S30050

Unit TNNA. Annual Report of the Norwegian Knee Arthroplasty Register. Available from: https://www.helse-bergen.no/nasjonalt-kvalitets-og-kom-petansenettverk-for-leddproteser-og-hoftebrudd/arsrapporter/#annual-reports.

Furnes O, Espehaug B, Lie S A, Vollset S E, Engesaeter L B, Havelin L I. Early failures among 7,174 primary total knee replacements: a follow-up study from the Norwegian Arthroplasty Register 1994–2000. Acta Orthop Scand 2002; 73: 117-29. doi: 10.1080/000164702753671678. DOI: https://doi.org/10.1080/000164702753671678

Espehaug B, Furnes O, Havelin L I, Engesæter L B, Vollset S E, Kindseth O. Registration completeness in the Norwegian Arthroplasty Register. Acta Orthopaedica 2006; 77: 49-56. doi: 10.1080/17453670610045696. DOI: https://doi.org/10.1080/17453670610045696

Schmidt M, Pedersen L, Sørensen H T. The Danish Civil Registration System as a tool in epidemiology. Eur J Epidemiol 2014; 29: 541-9. doi: 10.1007/s10654-014-9930-3. DOI: https://doi.org/10.1007/s10654-014-9930-3

Klasan A, Magill P, Frampton C, Zhu M, Young S W. Factors predicting repeat revision and outcome after aseptic revision total knee arthroplasty: results from the New Zealand Joint Registry. Knee Surg Sports Traumatol Arthrosc 2021; 29: 579-85. doi: 10.1007/s00167-020-05985-8. DOI: https://doi.org/10.1007/s00167-020-05985-8

Lygre S H, Espehaug B, Havelin L I, Vollset S E, Furnes O. Failure of total knee arthroplasty with or without patella resurfacing. Acta Orthop 2011; 82: 282-92. doi: 10.3109/17453674.2011.570672. DOI: https://doi.org/10.3109/17453674.2011.570672

Lygre S H, Espehaug B, Havelin L I, Vollset S E, Furnes O. Does patella resurfacing really matter? Pain and function in 972 patients after primary total knee arthroplasty. Acta Orthop 2010; 81: 99-107. doi: 10.3109/17453671003587069. DOI: https://doi.org/10.3109/17453671003587069

Grassi A, Compagnoni R, Ferrua P, Zaffagnini S, Berruto M, Samuelsson K, et al. Patellar resurfacing versus patellar retention in primary total knee arthroplasty: a systematic review of overlapping meta-analyses. Knee Surg Sports Traumatol Arthrosc 2018; 26: 3206-18. doi: 10.1007/s00167-018-4831-8. DOI: https://doi.org/10.1007/s00167-018-4831-8

Tay M L, Young S W, Frampton C M, Hooper G J. The lifetime revision risk of unicompartmental knee arthroplasty. Bone Joint J 2022; 104-b: 672-9. doi: 10.1302/0301-620x.104b6.Bjj-2021-1744.R1. DOI: https://doi.org/10.1302/0301-620X.104B6.BJJ-2021-1744.R1

Johnson W B Jr, Engh C A Jr, Parks N L, Hamilton W G, Ho P H, Fricka K B. A lower threshold for revision of aseptic unicompartmental vs total knee arthroplasty. Bone Joint J 2020; 102-b: 91-5. doi: 10.1302/0301-620x.102b6.Bjj-2019-1538.R1. DOI: https://doi.org/10.1302/0301-620X.102B6.BJJ-2019-1538.R1

Klasan A, Parker D A, Lewis P L, Young S W. Low percentage of surgeons meet the minimum recommended unicompartmental knee arthroplasty usage thresholds: analysis of 3037 surgeons from three national joint registries. Knee Surg Sports Traumatol Arthrosc 2022; 30: 958-64. doi: 10.1007/s00167-021-06437-7. DOI: https://doi.org/10.1007/s00167-021-06437-7

NiemeläInen M J, MäKelä K T, Robertsson O, A WD, Furnes O, Fenstad A M, et al. Different incidences of knee arthroplasty in the Nordic countries. Acta Orthop 2017; 88: 173-8. doi: 10.1080/17453674.2016.1275200. DOI: https://doi.org/10.1080/17453674.2016.1275200

Anneberg M, Kristiansen E B, Troelsen A, Gundtoft P, Sørensen H T, Pedersen A B. Enhancing the data capture of periprosthetic joint infections in the Danish Knee Arthroplasty Registry: validity assessment and incidence estimation. Acta Orthop 2024; 95: 166-73. doi: 10.2340/17453674.2024.40358. DOI: https://doi.org/10.2340/17453674.2024.40358

Published

2026-02-20

How to Cite

Hald, J. T., Fenstad, A. M., El-Galaly, A., Odgaard, A., & Furnes, O. N. (2026). Similar incidence and implant survival of multiply revised knee arthroplasties in Norway and Denmark: a register study of the Danish and Norwegian Knee Arthroplasty registries from 1998–2021. Acta Orthopaedica, 97, 110–116. https://doi.org/10.2340/17453674.2026.45411

Issue

Section

Publications

Categories