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Impact of the 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 arthropla...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9707384/ https://www.ncbi.nlm.nih.gov/pubmed/36445098 http://dx.doi.org/10.2340/17453674.2022.5256 |
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author | IRMOLA, Tero PONKILAINEN, Ville MÄKELÄ, Keijo T ROBERTSSON, Otto W-DAHL, Annette FURNES, Ove FENSTAD, Anne M PEDERSEN, Alma B SCHRØDER, Henrik M NIEMELÄINEN, Mika J ESKELINEN, Antti |
author_facet | IRMOLA, Tero PONKILAINEN, Ville MÄKELÄ, Keijo T ROBERTSSON, Otto W-DAHL, Annette FURNES, Ove FENSTAD, Anne M PEDERSEN, Alma B SCHRØDER, Henrik M NIEMELÄINEN, Mika J ESKELINEN, Antti |
author_sort | IRMOLA, Tero |
collection | PubMed |
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 10(5) person-years, while it was less than 150 per 10(5) 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. |
format | Online Article Text |
id | pubmed-9707384 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation |
record_format | MEDLINE/PubMed |
spelling | pubmed-97073842022-11-30 Impact of the Nordic Arthroplasty Register Association (NARA) collaboration on demographics, methods and revision rates in knee arthroplasty: a register-based study from NARA 2000–2017 IRMOLA, Tero PONKILAINEN, Ville MÄKELÄ, Keijo T ROBERTSSON, Otto W-DAHL, Annette FURNES, Ove FENSTAD, Anne M PEDERSEN, Alma B SCHRØDER, Henrik M NIEMELÄINEN, Mika J ESKELINEN, Antti Acta Orthop Article 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 10(5) person-years, while it was less than 150 per 10(5) 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. Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation 2022-11-28 /pmc/articles/PMC9707384/ /pubmed/36445098 http://dx.doi.org/10.2340/17453674.2022.5256 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work. |
spellingShingle | Article IRMOLA, Tero PONKILAINEN, Ville MÄKELÄ, Keijo T ROBERTSSON, Otto W-DAHL, Annette FURNES, Ove FENSTAD, Anne M PEDERSEN, Alma B SCHRØDER, Henrik M NIEMELÄINEN, Mika J ESKELINEN, Antti Impact of the Nordic Arthroplasty Register Association (NARA) collaboration on demographics, methods and revision rates in knee arthroplasty: a register-based study from NARA 2000–2017 |
title | Impact of the 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 the 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 the 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 the 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 the 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 the nordic arthroplasty register association (nara) collaboration on demographics, methods and revision rates in knee arthroplasty: a register-based study from nara 2000–2017 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9707384/ https://www.ncbi.nlm.nih.gov/pubmed/36445098 http://dx.doi.org/10.2340/17453674.2022.5256 |
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