title: Changes in implant choice and surgical technique for hemiarthroplasty. 21,346 procedures from the Swedish Hip Arthroplasty Register 2005-2009.
abstract: OBJECTIVE
  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%.
  
  
  CONCLUSIONS
  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.
authors: Department of Ortopaedics, Lund University, Skåne University Hospital, Malmö, Sweden. olof.leonardsson@skane.se
authors: Olof
authors: O
authors: Leonardsson
authors: Göran
authors: G
authors: Garellick
authors: Johan
authors: J
authors: Kärrholm
authors: Kristina
authors: K
authors: Akesson
authors: Cecilia
authors: C
authors: Rogmark
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005265:Femoral Neck Fractures / Q000473:pathology / Q000601:surgery*; D005270:Femur Head / Q000293:injuries / Q000473:pathology / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D008297:Male; D012042:Registries; D013548:Sweden; D017211:Treatment Failure; D016896:Treatment Outcome