Projections of total hip replacement in Sweden from 2013 to 2030 (original) (raw)
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Trends in hip replacements between 1999 and 2012 in Sweden
Journal of Orthopaedic Research
National Registers document changes in the circumstance, practice, and outcome of surgery with the passage of time. In the context of total hip replacement (THR), registers can help elucidate the relevant factors that affect the clinical outcome. We evaluated the evolution of factors related to patient, surgical procedure, socio-economy, and various outcome parameters after merging databases of the Swedish Hip Arthroplasty Register, Statistics Sweden and the National Board of Health and Welfare. Data on 193,253 THRs (164,113 patients) operated between 1999 and 2012 were merged. We studied the evolution of surgical volume, patient demographics, socioeconomic factors, surgical factors, length-of-stay, mortality rate, adverse events, re-operation and revision rates, and Patient Reported Outcome Measures (PROMs). Throughout this time period the majority of patients were operated on with a diagnosis of primary osteoarthritis. Comorbidity indices increased each year observed. The share of all-cemented implants has dropped from 92% to 68%. More than 88% of the bearings were metal-on-polyethylene. Length-of-stay decreased by 50%. There was a reduction in 30-and 90-day mortality. Re-operation and revision rates at 2 years are decreasing. The post-operative PROMs improved despite the observation of worse pre-operative pain scores getting over time. The demographics of patients receiving a THR, their comorbidities, and their primary diagnosis are changing. Notwithstanding these changes, outcomes like mortality, re-operations, revisions, and PROMs have improved. The practice of hip arthroplasty has evolved, even in a country such as Sweden that is considered to be conservative with regard taking on new surgical practices.
The Swedish Hip Arthroplasty Register Annual Report 2015
2016
All units, public and private, that carry out hip replacements, are included in the Register. The Swedish Hip Arthroplasty Register, thus, has a 100% degree of coverage for hospitals. Coverage for primary hip replacement on an individual basis (completeness), which has been controlled by linking our data with the National Patient Register, was 98.3% for total hip replacement and 97.5% for hemiarthroplasty in 2015. Details regarding coverage are elaborated in a separate chapter. Patient-reported outcome measures were reported from all Swedish hospitals during 2015. The Register now has a nationwide system to prospectively and longitudinally capture patient-reported outcomes for all patients with total hip replacement. The response Completeness for THRs 2015 Hospital Number 1) SHAR 2) PAR 3) University/Regional hospitals
Objective: To compare the lifetime risk of total hip replacement surgery (THR) for osteoarthritis (OA) between countries, and over time. Methods: Data on primary THR procedures performed for OA in 2003 and 2013 were extracted from national arthroplasty registries in Australia, Denmark, Finland, Norway and Sweden. Life tables and population data were also obtained for each country. Lifetime risk of THR was calculated for 2003 and 2013 using registry, life table and population data. Results: In 2003, lifetime risk of THR ranged from 8.7% (Denmark) to 15.9% (Norway) for females, and from 6.3% (Denmark) to 8.6% (Finland) for males. With the exception of females in Norway (where lifetime risk started and remained high), lifetime risk of THR increased significantly for both sexes in all countries from 2003 to 2013. In 2013, lifetime risk of THR was as high as 1 in 7 women in Norway, and 1 in 10 males in Finland. Females consistently demonstrated the highest lifetime risk of THR at both time points. Notably, lifetime risk for females in Norway was approximately double the risk for males in 2003 (females: 15.9%, 95% confidence interval (CI) 15.6% to 16.1%; males: 6.9%, 95%CI 6.7% to 7.1%) and 2013 (females: 16.0%, 95%CI 15.8% to 16.3%; males: 8.3%, 95%CI 8.1 to 8.5%). Conclusion: Using representative, population-based data, this study found statistically significant increases in the lifetime risk of THR in five countries over a 10-year period, and substantial between-sex differences. These multi-national risk estimates can inform resource planning for OA service delivery.
Modeling the need for hip and knee replacement surgery. Part 1. A two‐stage cross‐cohort approach
Arthritis Care & Research, 2009
ObjectiveTo explore inequalities in the need for hip/knee replacement surgery using a 2‐stage cross‐cohort approach.MethodsIn the first stage, a small‐area population‐based survey, the Somerset and Avon Survey of Health, was used to provide a high‐quality measure of need for hip/knee replacement using the New Zealand (NZ) score. Receiver operating characteristic curve analyses were used to validate a simplified NZ score, excluding information from clinical examination. In the second stage, a nationally representative population‐based survey, the English Longitudinal Study of Ageing, was used to explore inequalities in need for hip/knee replacement using the simplified NZ score. Multilevel Poisson regression modeling was used to estimate rates of need for surgery. Exposures considered were age, sex, social class, ethnicity, obesity, Index of Multiple Deprivation 2004 deprivation quintiles, rurality, and ethnic mix of area.ResultsRates of need for hip/knee replacement increase with ag...
The Swedish Hip Arthroplasty Register Annual Report 2011
2012
International cooperation!) arranged the 1st International Congress for Arthroplasty Registries in Bergen with participants from all over the world. Covarage and completeness of registration All units, public and private, that carry out total hip arthroplasty are included in the Register. All hospitals where hemiarthroplasty is carried out also report to the Register. The Swedish Hip Arthroplasty Register thus has 100% coverage for hospitals. Coverage for primary hip replacement on an individual level (completeness) has also been controlled by co-processing with the National Patient Register at the Swedish National Board of Health and Welfare, and is accounted for in detail in a later chapter. The completeness of individual registrations on a national level was 98% for total hip replacement, and 96% for hemiarthroplasty. Patient-reported outcome measures-PROM Patient-reported outcome measures were reported from all hospitals during 2011. The Registry now has a nationwide system to prospectively and longitudinally capture patient-reported outcomes for all patients operated with total hip replacement. The response frequency for one-year follow-ups is slightly higher than 90%. Reporting Most of the clinics report via the web application. Medical record copies from reoperations are sent during the year with varying delay. Reviews of journal copies and systematic central data collection is a necessity for register analysis regarding reoperations and revisions. Feedback data All publications, annual reports and scientific reports are presented on our website. The Swedish Hip Arthroplasty Register calls, in cooperation with the Swedish Knee Arthroplasty Register all clinics to a yearly user meeting in Arlanda, Stockholm. A number of "site visits" are carried out during the year. Local activity analysis and development The Registry has, throughout the years, worked for feedback and open accounting to stimulate participating units to local activity analyses; and that this should lead to measures for improvement. During the last years we have, in each annual report, chosen to pick out good examples of such efforts. This year we have published a unit's written report of its analytical work. We feel this example may stimulate all other units to similar efforts. The year's production During 2011 the annual production of total hip replacements was unaltered compared with 2010. Approximately 16,000 operations were carried out, which is 170/100,000 inhabitants. Even the production of hemiarthroplasties was unchanged with approximately 4,500 operations performed. The amount of reoperations was 2,200 and 330, respectively. A total of 23,000 interventions were reported to the Swedish Hip Arthroplasty Register in 2011. Thanks to all contributors! The Swedish Hip Arthroplasty Register is based on decentralized data capture, which is why the clinics' contact secretaries' and physician contributions are completely necessary and invaluable to the Registry's function. Many thanks for all contributions during the past year! The Registry would also like to express its thanks for the tremendous support from Western Götaland Region and The Registry Center of Western Götaland Region.
Objective: To compare the lifetime risk of total hip replacement surgery (THR) for osteoarthritis (OA) between countries, and over time. Methods: Data on primary THR procedures performed for OA in 2003 and 2013 were extracted from national arthroplasty registries in Australia, Denmark, Finland, Norway and Sweden. Life tables and population data were also obtained for each country. Lifetime risk of THR was calculated for 2003 and 2013 using registry, life table and population data. Results: In 2003, lifetime risk of THR ranged from 8.7% (Denmark) to 15.9% (Norway) for females, and from 6.3% (Denmark) to 8.6% (Finland) for males. With the exception of females in Norway (where lifetime risk started and remained high), lifetime risk of THR increased significantly for both sexes in all countries from 2003 to 2013. In 2013, lifetime risk of THR was as high as 1 in 7 women in Norway, and 1 in 10 males in Finland. Females consistently demonstrated the highest lifetime risk of THR at both time points. Notably, lifetime risk for females in Norway was approximately double the risk for males in 2003 (females: 15.9%, 95% confidence interval (CI) 15.6% to 16.1%; males: 6.9%, 95%CI 6.7% to 7.1%) and 2013 (females: 16.0%, 95%CI 15.8% to 16.3%; males: 8.3%, 95%CI 8.1 to 8.5%). Conclusion: Using representative, population-based data, this study found statistically significant increases in the lifetime risk of THR in five countries over a 10-year period, and substantial between-sex differences. These multi-national risk estimates can inform resource planning for OA service delivery.
Indications for hip and knee replacement in Sweden
Journal of Evaluation in Clinical Practice, 2011
Objectives The aim of this paper was to compare selected indication parameters for patients scheduled for hip and knee replacement at orthopaedic units in Sweden.
The Swedish Hip Arthroplasty Register Annual Report 2014
2015
Coverage All units, public and private, that carry out total hip replacement are included in the Register. The Swedish Hip Arthroplasty Register thus has a 100% degree of coverage for hospitals. Coverage for primary hip replacement on an individual basis (completeness) has also been controlled by coprocessing with the National Patient Register at the Swedish National Board of Health and Welfare, and is accounted for in detail in a later chapter. The degree of coverage on a national level was in 2014 98.1% for total hip replacement and for hemiarthroplasty 96.8%.
Journal of Clinical Medicine
National projections of future joint replacement use can help us understand the changing burden of severe osteoarthritis. This study aimed to compare actual utilisation rates for primary total hip replacement (THR) and total knee replacement (TKR) to previously forecast estimates for Australia. Data from the Australian Orthopaedic Association National Joint Replacement Registry and Australian Bureau of Statistics were used to calculate ‘actual’ THR and TKR utilisation rates for the years 2014–2019, by sex and age group. ‘Forecast’ utilisation rates for 2014–2019 were derived from an earlier study that modelled two alternate scenarios for THR and TKR in Australia: Scenario 1 assumed a constant rate of surgery; Scenario 2 assumed continued growth in surgery rates. Actual utilisation rates were compared descriptively to forecast rates for females and males (overall and by age group). Rate ratios were calculated to indicate the association between actual and forecast THR and TKR rates, ...