Prosthetic joint infection (PJI) is a serious complication following total hip arthroplasty (THA) entailing increased mortality, decreased quality of life, and high healthcare costs. In 2009 a nationwide, multidisciplinary infection control program was launched in Sweden, PRISS, which aimed to reduce the PJI burden by 50%. The primary aim was to investigate whether the PRISS project reduced PJI incidence after primary THA; the secondary aim was to evaluate other possible benefits of PRISS, such as shorter time to diagnosis. We obtained data on patients undergoing primary THA in Sweden (n = 45,723 patients, 49,946 THAs), 2012–2014. Using personal identity numbers, this cohort was matched with the Swedish Prescribed Drug Registry. Medical records of patients with ≥4 weeks antibiotic consumption were reviewed to verify PJI diagnosis (n = 2240, 2569 THAs).Aim
Method
In 1975, Sweden started registering primary knee replacement surgeries based on the personal identity number. Individual-based registrations of primary total hip replacements started in 1992 and for hemiarthroplasties the registration started in 2006. The completeness of these registrations is estimated at 98% during the last 10-year period. The long history and high completeness allow for accurate calculations of population-based prevalence of joint replacement and trends over time. We used all data on primary joint replacements available in the Swedish Arthroplasty Register. The prevalence was calculated using number of alive patients with 1) at least one joint replacement 2) at least one hip replacement 3) at least one knee replacement at the end of each year from 2010 – 2021. Publicly available population numbers were retrieved from Statistics Sweden. We calculated total prevalence and prevalence per age in years. By the end of 2021, 3.2% of the Swedish population had at least one hip or knee replacement. This was an increase from 2.5% in 2010. Among 80-year-old, the prevalence was 17.5% for any joint replacement. For both hip and knee replacement and all ages, the prevalence was higher for women. For knee replacement, the 2021 prevalence peaked at the age of 89 (9,4%) while the prevalence continuously increased with age for hip replacements. A considerable proportion of the Swedish elderly population is living with at least one hip or knee replacement. The prevalence has increased during the last 12-year period for both hips and knees. An increasing prevalence may also affect the incidence of fractures and infections. Knowledge about the prevalence is fundamental for planning future demand for primary and revision hip and knee replacement.
Dislocation after total hip arthroplasty in individuals treated for acute hip fracture is up to 10 times more frequent than in elective patients. Whilst approach plays a role, the effect of head sizes in conventional THA and dual mobility cups (DMC) is less studied in fracture cases. The total dislocation rate at 1-year and 3-year revision rates were recorded in this observational study on 8,031 patients with acute hip fracture, treated with a THA 2005–2014. Swedish Arthroplasty Register data were linked with the National Patient Register. Cox multivariable regression models were fitted to calculate adjusted hazard ratios stratified by approach and head size. The cumulative risk of dislocation during year 1 was 2.7% (95% CI 2.2–3.2) with lateral approach and 8.3% (7.3–9.3) with posterior approach (KM estimates). In the Neither of the implant designs influenced the dislocation risk when When aiming to reduce the
