Total hip arthroplasties in the Dutch Arthroplasty Register (LROI) and the Nordic Arthroplasty Register Association (NARA): comparison of patient and procedure characteristics in 475,685 cases

Liza N  van Steenbergen; Keijo T Mäkelä; Johan Kärrholm; Ola Rolfson; Søren Overgaard; Ove Furnes; Alma B Pedersen; Antti Eskelinen; Geir Hallan; Berend W Schreurs; Rob G H H  Nelissen

doi:10.1080/17453674.2020.1843875

Authors

Liza N van Steenbergen Dutch Arthroplasty Register (LROI), ‘s- Hertogenbosch, the Netherlands
Keijo T Mäkelä Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland; The Finnish Arthroplasty Register, Helsinki, Finland
Johan Kärrholm Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Swedish Hip Arthroplasty Register, Gothenburg, Sweden
Ola Rolfson Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Swedish Hip Arthroplasty Register, Gothenburg, Sweden
Søren Overgaard Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; The Danish Hip Arthroplasty Register, Aarhus, Denmark
Ove Furnes The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
Alma B Pedersen The Danish Hip Arthroplasty Register, Aarhus, Denmark; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
Antti Eskelinen The Finnish Arthroplasty Register, Helsinki, Finland; Coxa Hospital for Joint Replacement, and Faculty of Medicine and Health Technologies, University of Tampere, Tampere, Finland
Geir Hallan Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
Berend W Schreurs Dutch Arthroplasty Register (LROI), ‘s- Hertogenbosch, the Netherlands; Department of Orthopaedics, Radboudumc, Nijmegen, the Netherlands
Rob G H H Nelissen Dutch Arthroplasty Register (LROI), ‘s- Hertogenbosch, the Netherlands; Department of Orthopaedics, Leiden University Medical Centre, Leiden, the Netherlands

DOI:

https://doi.org/10.1080/17453674.2020.1843875

Abstract

Background and purpose — Collaborations between arthroplasty registries are important in order to create the possibility of detecting inferior implants early and improve our understanding of differences between nations in terms of indications and outcomes. In this registry study we compared patient and procedure characteristics, and revision rates in the Nordic Arthroplasty Register Association (NARA) database and the Dutch Arthroplasty Register (LROI).

Patients and methods — All total hip arthroplasties (THAs) performed in 2010–2016 were included from the LROI (n = 184,862) and the NARA database (n = 290,823), which contains data from Denmark, Norway, Sweden, and Finland. Descriptive statistics and Kaplan–Meier survival analyses based on all reasons for revision and stratified by fixation were performed and compared between countries.

Results — In the Netherlands, the proportion of patients aged < 55 years (9%) and male patients (34%) was lower than in Nordic countries (< 55 years 11–13%; males 35–43%); the proportion of osteoarthritis (OA) (87%) was higher compared with Sweden (81%), Norway (77%), and Denmark (81%) but comparable to Finland (86%). Uncemented fixation was used in 62% of patients in the Netherlands, in 70% of patients in Denmark and Finland, and in 28% and 19% in Norway and Sweden, respectively. The 5-year revision
rate for THAs for OA was lower in Sweden (2.3%, 95% CI 2.1–2.5) than in the Netherlands (3.0%, CI 2.9–3.1), Norway (3.8%, CI 3.6–4.0), Denmark (4.6%, CI 4.4–4.8), and Finland (4.4%, CI 4.3–4.5). Revision rates in Denmark, Norway, and Finland were higher for all fixation groups.

Interpretation — Patient and THA procedure characteristics as well as revision rates evinced some differences between the Netherlands and the Nordic countries. The Netherlands compared best with Denmark in terms of patient and procedure characteristics, but resembled Sweden more in terms of short-term revision risk. Combining data from registries like LROI and the NARA collaboration is feasible and might possibly enable tracking of potential outlier implants.