The economic impact of failures in total hip replacement surgery:28,997 cases from the Norwegian Arthroplasty Register, 1987-1993

Furnes, A; Sa, Lie; Havelin, Leif Ivar; Engesæter, Lars B.; Se, Vollset

doi:10.3109/17453679608994653

Cited by 53 publications

(24 citation statements)

References 18 publications

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“…Arthroplasty registers were developed in Scandinavia more than 30 years ago [1] and have given impressive proof of their value for quality control and the development of arthroplasty ever since [2][3][4][5][6][7][8][9][10][11]. The last ten years have seen a rapid spread of this concept [12].…”

Section: Introductionmentioning

confidence: 99%

Organisation, data evaluation, interpretation and effect of arthroplasty register data on the outcome in terms of revision rate in total hip arthroplasty

Labek

Janda

Agreiter

et al. 2010

International Orthopaedics (SICOT)

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Originally developed in Scandinavia, national arthroplasty registers have spread worldwide during the last decade. The value of registers for quality improvement in arthroplasty has frequently been documented. However, for the development of a successful register a few key points should be taken into account. Uncontrolled loss of patients from the registry area should be avoided. Registers should form an integral part of a country's medical system. To realise the potential for improvement, it is crucial that physicians deal with the results in detail. Thus it is absolutely essential to involve the specialty societies in the interpretation and dissemination of results. With respect to revision rates, register data are usually more valid than meta-analyses of clinical studies. For every physician the most valuable data are those coming from a register in his own country; the development of national arthroplasty registers should therefore be continued.

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Section: Introductionmentioning

confidence: 99%

Organisation, data evaluation, interpretation and effect of arthroplasty register data on the outcome in terms of revision rate in total hip arthroplasty

Labek

Janda

Agreiter

et al. 2010

International Orthopaedics (SICOT)

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“…[11][12][13] Many implants which were successful in such studies are no longer commercially available, having been modified or replaced by other designs for various reasons. It is necessary therefore to estimate success or failure of a new or modified design as early as possible.…”

Section: Pattern Of Migrationmentioning

confidence: 99%

The prediction of failure of the stem in THR by measurement of early migration using EBRA-FCA

Krismer¹,

Biedermann²,

Stöckl³

et al. 1999

The Journal of Bone and Joint Surgery. British volume

107

127

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We report the ten-year results for three designs of stem in 240 total hip replacements, for which subsidence had been measured on plain radiographs at regular intervals. Accurate migration patterns could be determined by the method of Einzel-BildRoentgen-Analyse-femoral component analysis (EBRA-FCA) for 158 hips (66%).Of these, 108 stems (68%) remained stable throughout, and five (3%) started to migrate after a median of 54 months. Initial migration of at least 1 mm was seen in 45 stems (29%) during the first two years, but these then became stable. We revised 17 stems for aseptic loosening, and 12 for other reasons. Revision for aseptic loosening could be predicted by EBRA-FCA with a sensitivity of 69%, a specificity of 80%, and an accuracy of 79% by the use of a threshold of subsidence of 1.5 mm during the first two years. Similar observations over a five-year period allowed the long-term outcome to be predicted with an accuracy of 91%.We discuss the importance of four different patterns of subsidence and confirm that the early measurement of migration by a reasonably accurate method can help to predict long-term outcome. Such methods should be used to evaluate new and modified designs of prosthesis. J Bone Joint Surg [Br] 1999;81-B:273-80. Received 17 February 1998; Accepted after revision 12 May 1998 The prognostic value of early migration of an acetabular cup has been demonstrated by several authors, with loosening within two years predicted with sensitivities and specificities of over 80%.

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“…However, it is extremely difficult for individuals to keep track of these long periods of time and the multitude of patients and it seems that the problem of implant fractures is often underestimated in subjective awareness [1,2].…”

Section: Discussionmentioning

confidence: 99%

“…Implant fractures after total hip arthroplasty (THA) are relevant complications for patients, physicians, and the public health system leading to high socioeconomic burdens [1]. They are very distressing for the patients and are leading to technically demanding revision operations [2].…”

Section: Introductionmentioning

confidence: 99%

The incidence of implant fractures after total hip arthroplasty

Sadoghi

Pawelka

Liebensteiner

et al. 2013

International Orthopaedics (SICOT)

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Purpose Implant fractures after total hip arthroplasty (THA) are considered as rare in clinical practice. Nevertheless they are relevant complications for patients, physicians, and the public health system leading to high socioeconomic burdens. The aim of this study was to assess the incidence of fractures after THAs in a comparative analysis of clinical studies and worldwide arthroplasty register datasets. Methods We calculated the pooled incidence of revision operations after fractures of THAs in a comparison of clinical studies published in Medline-listed journals and annual reports of worldwide arthroplasty registers in a structured literature analysis based on a standardised methodology. Results Included clinical studies (sample-based datasets) were mono-centre trials comprising a cumulative number of approximately 70,000 primary implantations whereas worldwide national arthroplasty register datasets referred to 733,000 primary implantations, i.e. approximately ten times as many as samplebased datasets. In general, sample-based datasets presented higher revision rates than register datasets with a maximum deviation of a 14.5 ratio for ceramic heads, respectively. The incidence of implant fractures in total hip arthroplasty in pooled worldwide arthroplasty register datasets is 304 fractures per 100,000 implants. In other words, one out of 323 patients has to undergo revision surgery due to an implant fracture after THA in their lifetime. Conclusions Implant fractures in total hip arthroplasty occur in a relevant number of patients. The authors believe that comprehensive arthroplasty register datasets allow more general evaluations and conclusions on that topic in contrast to clinical studies.

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The economic impact of failures in total hip replacement surgery:28,997 cases from the Norwegian Arthroplasty Register, 1987-1993

Cited by 53 publications

References 18 publications

Organisation, data evaluation, interpretation and effect of arthroplasty register data on the outcome in terms of revision rate in total hip arthroplasty

Organisation, data evaluation, interpretation and effect of arthroplasty register data on the outcome in terms of revision rate in total hip arthroplasty

The prediction of failure of the stem in THR by measurement of early migration using EBRA-FCA

The incidence of implant fractures after total hip arthroplasty

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