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Changes in implant choice and surgical technique for hemiarthroplasty: 21,346 procedures from the Swedish Hip Arthroplasty Register 2005-2009

Leonardsson, Olof LU ; Garellick, Göran; Kärrholm, Johan; Åkesson, Kristina LU and Rogmark, Cecilia LU (2012) In Acta Orthopaedica 83(1). p.7-13
Abstract
Background and purpose Treatment of displaced femoral neck fractures in Sweden has shifted towards more arthroplasties, especially hemiarthroplasties. We describe the hemiarthroplasty population in Sweden 2005 through 2009. Methods Since 2005, the Swedish Hip Arthroplasty Register has registered hemiarthroplasties on a national basis. We assessed hemiarthroplasty procedures in the Register 2005-2009 regarding patient details, implants, and surgical techniques. Completeness of recordings was calculated compared to the Swedish National Patient Register. Results Completeness increased from 89% to 96% during the study period. 21,346 hemiarthroplasty procedures were assessed. The relative number of patients with femoral neck fracture as... (More)
Background and purpose Treatment of displaced femoral neck fractures in Sweden has shifted towards more arthroplasties, especially hemiarthroplasties. We describe the hemiarthroplasty population in Sweden 2005 through 2009. Methods Since 2005, the Swedish Hip Arthroplasty Register has registered hemiarthroplasties on a national basis. We assessed hemiarthroplasty procedures in the Register 2005-2009 regarding patient details, implants, and surgical techniques. Completeness of recordings was calculated compared to the Swedish National Patient Register. Results Completeness increased from 89% to 96% during the study period. 21,346 hemiarthroplasty procedures were assessed. The relative number of patients with femoral neck fracture as diagnosis increased from 91% to 94%; the proportion of men increased from 27% to 30%. The median age increased from 83 to 84 years in men and from 84 to 85 years in women. Patients classified as having evident cognitive impairment increased from 19% to 22%. More men than women were ASA 4. The proportion of monoblock-type implants (Austin-Moore and Thompson) decreased from 18% to 0.9%. Modular implants increased generally, but in 2009 bipolar implants decreased in favor of unipolar implants. Lubinus and Exeter stems, and Mega Caput and Vario Cup implant heads were most common. The use of uncemented implants decreased from 10% to 3%. Use of the anterolateral approach increased from 47% to 56%. Interpretation Important changes in surgical technique and implant choice occurred during the observation period. We interpret these changes as being reflections of the continuing effort by Swedish orthopedic surgeons to improve the quality of treatment, because the changes are consistent with recent findings in the Swedish Hip Arthroplasty Register and in other scientific studies. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
83
issue
1
pages
7 - 13
publisher
Taylor & Francis
external identifiers
  • wos:000300022600002
  • pmid:22112151
  • scopus:84856829146
ISSN
1745-3682
DOI
10.3109/17453674.2011.641104
language
English
LU publication?
yes
id
a0051bf8-950a-4901-974c-20c638df6e08 (old id 2220423)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22112151?dopt=Abstract
date added to LUP
2011-12-03 09:48:25
date last changed
2017-09-17 06:29:21
@article{a0051bf8-950a-4901-974c-20c638df6e08,
  abstract     = {Background and purpose Treatment of displaced femoral neck fractures in Sweden has shifted towards more arthroplasties, especially hemiarthroplasties. We describe the hemiarthroplasty population in Sweden 2005 through 2009. Methods Since 2005, the Swedish Hip Arthroplasty Register has registered hemiarthroplasties on a national basis. We assessed hemiarthroplasty procedures in the Register 2005-2009 regarding patient details, implants, and surgical techniques. Completeness of recordings was calculated compared to the Swedish National Patient Register. Results Completeness increased from 89% to 96% during the study period. 21,346 hemiarthroplasty procedures were assessed. The relative number of patients with femoral neck fracture as diagnosis increased from 91% to 94%; the proportion of men increased from 27% to 30%. The median age increased from 83 to 84 years in men and from 84 to 85 years in women. Patients classified as having evident cognitive impairment increased from 19% to 22%. More men than women were ASA 4. The proportion of monoblock-type implants (Austin-Moore and Thompson) decreased from 18% to 0.9%. Modular implants increased generally, but in 2009 bipolar implants decreased in favor of unipolar implants. Lubinus and Exeter stems, and Mega Caput and Vario Cup implant heads were most common. The use of uncemented implants decreased from 10% to 3%. Use of the anterolateral approach increased from 47% to 56%. Interpretation Important changes in surgical technique and implant choice occurred during the observation period. We interpret these changes as being reflections of the continuing effort by Swedish orthopedic surgeons to improve the quality of treatment, because the changes are consistent with recent findings in the Swedish Hip Arthroplasty Register and in other scientific studies.},
  author       = {Leonardsson, Olof and Garellick, Göran and Kärrholm, Johan and Åkesson, Kristina and Rogmark, Cecilia},
  issn         = {1745-3682},
  language     = {eng},
  number       = {1},
  pages        = {7--13},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Changes in implant choice and surgical technique for hemiarthroplasty: 21,346 procedures from the Swedish Hip Arthroplasty Register 2005-2009},
  url          = {http://dx.doi.org/10.3109/17453674.2011.641104},
  volume       = {83},
  year         = {2012},
}