title: Comparison of the Norwegian knee arthroplasty register and a United States arthroplasty registry.
abstract: Several national total joint arthroplasty registries exist outside of the United States (U.S.) and have been used to compare rates and outcomes of total knee arthroplasty. Within the U.S., regional arthroplasty registries provide an opportunity to compare U.S. practices and outcomes with those of other countries. The purpose of this study was to compare the demographics, choice of implants, techniques, and outcomes of total knee arthroplasties in Norway to those from a large, U.S. integrated health-care system and to determine the feasibility of using aggregate-level data for international registry comparisons. The study sample consisted of 25,004 primary total knee arthroplasties performed in Norway and 56,208 from the Kaiser Permanente health-care system. Summary-level data were used to compare the two cohorts. At the time of the seven-year follow-up, the cumulative survival of the total knee prosthesis was 94.8% for the arthroplasties performed in Norway and 96.3% for those performed at Kaiser Permanente. The primary reasons for revision arthroplasty included infection, instability, pain, and aseptic loosening. Patient characteristics, selection of implants, surgical techniques, and outcomes differed between the cohorts. Harmonization of data elements and definitions is necessary for future international research.
authors.affiliation: Department of Surgical Outcomes and Analysis, Kaiser Permanente, 3033 Bunker Hill Street, San Diego, CA 92109, USA. liz.w.paxton@kp.org
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Paxton
authors.forename: Ove
authors.initials: O
authors.lastname: Furnes
authors.forename: Robert S
authors.initials: RS
authors.lastname: Namba
authors.forename: Maria C S
authors.initials: MC
authors.lastname: Inacio
authors.forename: Anne M
authors.initials: AM
authors.lastname: Fenstad
authors.forename: Leif I
authors.initials: LI
authors.lastname: Havelin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007391:International Cooperation; D007720:Knee Prosthesis / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009664:Norway; D018579:Patient Selection; D011358:Product Surveillance, Postmarketing / Q000706:statistics & numerical data*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012042:Registries / Q000706:statistics & numerical data*; D012086:Reoperation; D016019:Survival Analysis; D014481:United States