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Patient injuries after total hip arthroplasty for osteoarthritis in Sweden over 10 years : a cohort study based on 1,343 patients

Heijbel, Siri ; Rahmanian, Sabina ; Gustafson, Pelle LU ; Brismar, Harald ; W-Dahl, Annette LU and Hedström, Margareta (2026) In Acta Orthopaedica 97. p.329-335
Abstract

Background and purpose — Injuries after primary total hip arthroplasty (THA) can be compensated through the National Swedish Patient Insurance Company (Löf). This study examined injury incidence, types, consequences, and subgroup differences in compensated claims following primary THA for osteoarthritis (OA) in Sweden over 10 years. Methods — Data from Löf and the Swedish Arthroplasty Register were used for compensated claims following primary THA between 2012 and 2021. Injury incidence and subgroup differences by sex, age, OA diagnosis, and surgical volume were analyzed. Injury types, severity, reoperation rate, and surgical approach were evaluated. Absolute risk differences (ARD) and incidence rate ratios (IRR) were calculated.... (More)

Background and purpose — Injuries after primary total hip arthroplasty (THA) can be compensated through the National Swedish Patient Insurance Company (Löf). This study examined injury incidence, types, consequences, and subgroup differences in compensated claims following primary THA for osteoarthritis (OA) in Sweden over 10 years. Methods — Data from Löf and the Swedish Arthroplasty Register were used for compensated claims following primary THA between 2012 and 2021. Injury incidence and subgroup differences by sex, age, OA diagnosis, and surgical volume were analyzed. Injury types, severity, reoperation rate, and surgical approach were evaluated. Absolute risk differences (ARD) and incidence rate ratios (IRR) were calculated. Results — 1,343 injuries were followed up. The injury incidence was 1.3%. Injury rates were higher in patients < 65 years than ≥ 65 years (ARD 0.2%, 95% confidence interval [CI] 0.1–0.3), in OA due to hip dysplasia compared with primary OA (IRR 1.78, CI 1.31–2.35), and at low-and mediumvolume compared with high-volume hospitals (IRR 1.35, CI 1.11–1.64; IRR 1.27, CI 1.14–1.42). In surgery-related injuries (n = 1,251), infection (38%, CI 35–41) and nerve injury (22%, CI 20–25) were the most common injury types, and direct lateral incisions were more frequent than national reference proportions of all THAs during the study period (ARD 9%, CI 6–12). Permanent disability occurred in 74% (CI 72–77) of the claims, and the 2-year reoperation rate was 51% (CI 48–54) (0.4% of the total population). Conclusion — The injury incidence after primary THA was 1.3% and frequently resulted in permanent disability and reoperation. Infection and nerve injury were the most common injury types. Higher injury rates in younger patients, hip dysplasia, and lower-volume hospitals highlight potential areas for prevention and increased awareness.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
97
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • scopus:105041154350
ISSN
1745-3674
DOI
10.2340/17453674.2026.45971
language
English
LU publication?
yes
id
a950b24d-1968-4d59-8962-3b26bc5a8dca
date added to LUP
2026-09-15 12:18:35
date last changed
2026-09-15 12:19:42
@article{a950b24d-1968-4d59-8962-3b26bc5a8dca,
  abstract     = {{<p>Background and purpose — Injuries after primary total hip arthroplasty (THA) can be compensated through the National Swedish Patient Insurance Company (Löf). This study examined injury incidence, types, consequences, and subgroup differences in compensated claims following primary THA for osteoarthritis (OA) in Sweden over 10 years. Methods — Data from Löf and the Swedish Arthroplasty Register were used for compensated claims following primary THA between 2012 and 2021. Injury incidence and subgroup differences by sex, age, OA diagnosis, and surgical volume were analyzed. Injury types, severity, reoperation rate, and surgical approach were evaluated. Absolute risk differences (ARD) and incidence rate ratios (IRR) were calculated. Results — 1,343 injuries were followed up. The injury incidence was 1.3%. Injury rates were higher in patients &lt; 65 years than ≥ 65 years (ARD 0.2%, 95% confidence interval [CI] 0.1–0.3), in OA due to hip dysplasia compared with primary OA (IRR 1.78, CI 1.31–2.35), and at low-and mediumvolume compared with high-volume hospitals (IRR 1.35, CI 1.11–1.64; IRR 1.27, CI 1.14–1.42). In surgery-related injuries (n = 1,251), infection (38%, CI 35–41) and nerve injury (22%, CI 20–25) were the most common injury types, and direct lateral incisions were more frequent than national reference proportions of all THAs during the study period (ARD 9%, CI 6–12). Permanent disability occurred in 74% (CI 72–77) of the claims, and the 2-year reoperation rate was 51% (CI 48–54) (0.4% of the total population). Conclusion — The injury incidence after primary THA was 1.3% and frequently resulted in permanent disability and reoperation. Infection and nerve injury were the most common injury types. Higher injury rates in younger patients, hip dysplasia, and lower-volume hospitals highlight potential areas for prevention and increased awareness.</p>}},
  author       = {{Heijbel, Siri and Rahmanian, Sabina and Gustafson, Pelle and Brismar, Harald and W-Dahl, Annette and Hedström, Margareta}},
  issn         = {{1745-3674}},
  language     = {{eng}},
  pages        = {{329--335}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Orthopaedica}},
  title        = {{Patient injuries after total hip arthroplasty for osteoarthritis in Sweden over 10 years : a cohort study based on 1,343 patients}},
  url          = {{http://dx.doi.org/10.2340/17453674.2026.45971}},
  doi          = {{10.2340/17453674.2026.45971}},
  volume       = {{97}},
  year         = {{2026}},
}