Knee arthroplasty in Denmark, Norway and Sweden. A pilot study from the Nordic Arthroplasty Register Association.
OBJECTIVE
The number of national arthroplasty registries is increasing. However, the methods of registration, classification, and analysis often differ.


METHODS
We combined data from 3 Nordic knee arthroplasty registers, comparing demographics, methods, and overall results. Primary arthroplasties during the period 1997-2007 were included. Each register produced a dataset of predefined variables, after which the data were combined and descriptive and survival statistics produced.


RESULTS
The incidence of knee arthroplasty increased in all 3 countries, but most in Denmark. Norway had the lowest number of procedures per hospital-less than half that of Sweden and Denmark. The preference for implant brands varied and only 3 total brands and 1 unicompartmental brand were common in all 3 countries. Use of patellar button for total knee arthroplasty was popular in Denmark (76%) but not in Norway (11%) or Sweden (14%). Uncemented or hybrid fixation of components was also more frequent in Denmark (22%) than in Norway (14%) and Sweden (2%). After total knee arthroplasty for osteoarthritis, the cumulative revision rate (CRR) was lowest in Sweden, with Denmark and Norway having a relative risk (RR) of 1.4 (95% CI: 1.3-1.6) and 1.6 (CI: 1.4-1.7) times higher. The result was similar when only including brands used in more than 200 cases in all 3 countries (AGC, Duracon, and NexGen). After unicompartmental arthroplasty for osteoarthritis, the CRR for all models was also lowest in Sweden, with Denmark and Norway having RRs of 1.7 (CI: 1.4-2.0) and 1.5 (CI: 1.3-1.8), respectively. When only the Oxford implant was analyzed, however, the CRRs were similar and the RRs were 1.2 (CI: 0.9-1.7) and 1.3 (CI: 1.0-1.7).


CONCLUSIONS
We found considerable differences between the 3 countries, with Sweden having a lower revision rate than Denmark and Norway. Further classification and standardization work is needed to permit more elaborate studies.
Robertsson
Otto
O
The Swedish Knee Arthroplasty Register, Dept of Orthopedics, Clinical Sciences, Lund, Lund University, Sweden. otto.robertsson@med.lu.se
Bizjajeva
Svetlana
S
Fenstad
Anne Marie
AM
Furnes
Ove
O
Lidgren
Lars
L
Mehnert
Frank
F
Odgaard
Anders
A
Pedersen
Alma Becic
AB
Havelin
Leif Ivar
LI
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D003718:Denmark; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D009664:Norway; D010865:Pilot Projects; D012042:Registries; D013548:Sweden; D016896:Treatment Outcome