Abstract
Aims: In 1979 a national observation study of total hip arthroplasties was started in Sweden. The Swedish Hip Register describes the epidemiology of primary and revision surgery and identifies risk factors for failure. Every unit reports details concerning implants, surgical and cementing technique and revision procedures online via the Internet home page (www.jru.orthop.gu.se). Methods: Currently the register contains 203 625 primary total hip arthroplasties performed during 1979–2001 and 18 067 revision procedures. Revision is the failure endpoint definition and modified Kaplan-Meier statistics and Poisson models are used for survival analysis. Each hospital receive their results annually providing a system for continuous improvement. Results: The results show that serious complications have declined significantly despite an increasing number of patients at risk. The revision burden for cemented THR (94% of the implants are cemented) is only 7.5%, which is much lower than in other countries. Over the 22 year period revision for aseptic loosening has been reduced to one quarter. Demographics are important since male gender and young age significantly increase the risk for revision. Cementless implants have in general had a worse outcome than expected but improved during the last decade. Conclusion: Problem areas are the young population and revision surgery which must be improved. The revision burden is about two times higher in all other countries. This finding implies that the register is extremely cost-effective and the reduction in direct costs for the health care service in Sweden corresponds to approximately USD 140 millions over the last ten years.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
