Impact of Nordic Arthroplasty Register Association (NARA) collaboration on demographics, methods and revision rates in knee arthroplasty: a register-based study from NARA 2000–2017
Background and purpose: We have previously observed differences in treatment and outcome of knee arthroplasties in the Nordic countries. To evaluate the impact of Nordic collaboration in the last 15 years we aimed to compare patient demographics, methods, and revision rates in primary knee arthropl...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2022-11-01
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| Series: | Acta Orthopaedica |
| Subjects: | |
| Online Access: | https://actaorthop.org/actao/article/view/5256 |
| _version_ | 1811320975239675904 |
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| author | Tero Irmola Ville Ponkilainen Keijo T Mäkelä Otto Robertsson Annette W-Dahl Ove Furnes Anne M Fenstad Alma B Pedersen Henrik M Schrøder Mika J Niemeläinen Antti Eskelinen |
| author_facet | Tero Irmola Ville Ponkilainen Keijo T Mäkelä Otto Robertsson Annette W-Dahl Ove Furnes Anne M Fenstad Alma B Pedersen Henrik M Schrøder Mika J Niemeläinen Antti Eskelinen |
| author_sort | Tero Irmola |
| collection | DOAJ |
| description |
Background and purpose: We have previously observed differences in treatment and outcome of knee arthroplasties in the Nordic countries. To evaluate the impact of Nordic collaboration in the last 15 years we aimed to compare patient demographics, methods, and revision rates in primary knee arthroplasties among the 4 Nordic countries.
Patients and methods: We included 535,051 primary knee arthroplasties reported 2000–2017 from the Nordic Arthroplasty Register Association (NARA) database. Kaplan–Meier analysis (KM) and restricted mean survival time (RMST) analysis were used to evaluate the cumulative revision rate (CRR) and RMST estimates with 95% confidence intervals (CI) and to compare countries in relation to risk of revision for any reason.
Results: After 2010, the increase in incidence of knee arthroplasty plateaued in Sweden and Denmark but continued to increase in Finland and Norway. In 2017 the incidence was highest in Finland with 226 per 105 person-years, while it was less than 150 per 105 in the 3 other Nordic countries. In total knee arthroplasties performed for osteoarthritis (OA), overall CRR at 15 years for revision due to any reason was higher in Denmark (CRR 9.6%, 95% CI 9.2−10), Norway (CRR 9.1%, CI 8.7−9.5), and Finland (CRR 7.0%, CI 6.8−7.3) compared with Sweden (CRR 6.6%, CI 6.4−6.8). There were differences among the countries in use of implant brand and type, fixation, patellar component, and use of unicompartmental knee arthroplasty.
Interpretation: We evinced a slowing growth of incidence of knee arthroplasties in the Nordic countries after 2010 with Finland having the highest incidence. We also noted substantial differences among the 4 Nordic countries, with Sweden having a lower risk of revision than the other countries. No impact of NARA could be demonstrated and CRR did not improve over time.
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| first_indexed | 2024-04-13T13:10:07Z |
| format | Article |
| id | doaj.art-d7c5941f63614fed9d99210b089a0a6d |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-04-13T13:10:07Z |
| publishDate | 2022-11-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-d7c5941f63614fed9d99210b089a0a6d2022-12-22T02:45:39ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822022-11-019310.2340/17453674.2022.5256Impact of Nordic Arthroplasty Register Association (NARA) collaboration on demographics, methods and revision rates in knee arthroplasty: a register-based study from NARA 2000–2017Tero Irmola0Ville Ponkilainen1Keijo T Mäkelä2Otto Robertsson3Annette W-Dahl4Ove Furnes5Anne M Fenstad6Alma B Pedersen7Henrik M Schrøder8Mika J Niemeläinen9Antti Eskelinen10Coxa Hospital for Joint Replacement, and Faculty of Medicine and Health Technologies, University of Tampere, Tampere, FinlandDepartment of Orthopaedics and Traumatology, Central Finland Hospital Nova, Jyväskylä, FinlandFinnish Arthroplasty Register, National Institute for Health and Welfare, Helsinki, Finland; Department of Orthopaedics and Traumatology, Turku University Hospital, and University of Turku, Turku, FinlandThe Swedish Knee Arthroplasty Register, Department of Orthopedics, Skane University Hospital, Lund, Sweden, and Department of Clinical Sciences, Orthopedics, Lund University, SwedenThe Swedish Knee Arthroplasty Register, Department of Orthopedics, Skane University Hospital, Lund, Sweden, and Department of Clinical Sciences, Orthopedics, Lund University, SwedenThe Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, NorwayThe Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, NorwayDepartment of Clinical Epidemiology, Aarhus University Hospital, Denmark, and the Danish Knee Arthroplasty RegistryDepartment of Orthopaedic Surgery, Naestved Hospital, Denmark, and the Danish Knee Arthroplasty RegisterCoxa Hospital for Joint Replacement, and Faculty of Medicine and Health Technologies, University of Tampere, Tampere, FinlandCoxa Hospital for Joint Replacement, and Faculty of Medicine and Health Technologies, University of Tampere, Tampere, Finland Background and purpose: We have previously observed differences in treatment and outcome of knee arthroplasties in the Nordic countries. To evaluate the impact of Nordic collaboration in the last 15 years we aimed to compare patient demographics, methods, and revision rates in primary knee arthroplasties among the 4 Nordic countries. Patients and methods: We included 535,051 primary knee arthroplasties reported 2000–2017 from the Nordic Arthroplasty Register Association (NARA) database. Kaplan–Meier analysis (KM) and restricted mean survival time (RMST) analysis were used to evaluate the cumulative revision rate (CRR) and RMST estimates with 95% confidence intervals (CI) and to compare countries in relation to risk of revision for any reason. Results: After 2010, the increase in incidence of knee arthroplasty plateaued in Sweden and Denmark but continued to increase in Finland and Norway. In 2017 the incidence was highest in Finland with 226 per 105 person-years, while it was less than 150 per 105 in the 3 other Nordic countries. In total knee arthroplasties performed for osteoarthritis (OA), overall CRR at 15 years for revision due to any reason was higher in Denmark (CRR 9.6%, 95% CI 9.2−10), Norway (CRR 9.1%, CI 8.7−9.5), and Finland (CRR 7.0%, CI 6.8−7.3) compared with Sweden (CRR 6.6%, CI 6.4−6.8). There were differences among the countries in use of implant brand and type, fixation, patellar component, and use of unicompartmental knee arthroplasty. Interpretation: We evinced a slowing growth of incidence of knee arthroplasties in the Nordic countries after 2010 with Finland having the highest incidence. We also noted substantial differences among the 4 Nordic countries, with Sweden having a lower risk of revision than the other countries. No impact of NARA could be demonstrated and CRR did not improve over time. https://actaorthop.org/actao/article/view/5256 Incidence of knee arthroplastyknee implantsKnee osteoarthritisknee replacementprimary arthroplastyregister study |
| spellingShingle | Tero Irmola Ville Ponkilainen Keijo T Mäkelä Otto Robertsson Annette W-Dahl Ove Furnes Anne M Fenstad Alma B Pedersen Henrik M Schrøder Mika J Niemeläinen Antti Eskelinen Impact of Nordic Arthroplasty Register Association (NARA) collaboration on demographics, methods and revision rates in knee arthroplasty: a register-based study from NARA 2000–2017 Acta Orthopaedica Incidence of knee arthroplasty knee implants Knee osteoarthritis knee replacement primary arthroplasty register study |
| title | Impact of Nordic Arthroplasty Register Association (NARA) collaboration on demographics, methods and revision rates in knee arthroplasty: a register-based study from NARA 2000–2017 |
| title_full | Impact of Nordic Arthroplasty Register Association (NARA) collaboration on demographics, methods and revision rates in knee arthroplasty: a register-based study from NARA 2000–2017 |
| title_fullStr | Impact of Nordic Arthroplasty Register Association (NARA) collaboration on demographics, methods and revision rates in knee arthroplasty: a register-based study from NARA 2000–2017 |
| title_full_unstemmed | Impact of Nordic Arthroplasty Register Association (NARA) collaboration on demographics, methods and revision rates in knee arthroplasty: a register-based study from NARA 2000–2017 |
| title_short | Impact of Nordic Arthroplasty Register Association (NARA) collaboration on demographics, methods and revision rates in knee arthroplasty: a register-based study from NARA 2000–2017 |
| title_sort | impact of nordic arthroplasty register association nara collaboration on demographics methods and revision rates in knee arthroplasty a register based study from nara 2000 2017 |
| topic | Incidence of knee arthroplasty knee implants Knee osteoarthritis knee replacement primary arthroplasty register study |
| url | https://actaorthop.org/actao/article/view/5256 |
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