丹麦、挪威和瑞典的膝关节置换术。来自北欧关节置换登记协会的一项试点研究。

Knee arthroplasty in Denmark, Norway and Sweden. A pilot study from the Nordic Arthroplasty Register Association.

机构信息

The Swedish Knee Arthroplasty Register, Dept of Orthopedics, Clinical Sciences, Lund, Lund University, Sweden.

出版信息

Acta Orthop. 2010 Feb;81(1):82-9. doi: 10.3109/17453671003685442.

BACKGROUND AND PURPOSE

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).

INTERPRETATION

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.

背景与目的

国家关节置换登记处的数量正在增加。然而，登记、分类和分析的方法往往不同。

方法

我们结合了 3 个北欧膝关节置换登记处的数据，比较了人口统计学、方法和总体结果。纳入了 1997-2007 年期间的原发性关节置换术。每个登记处都产生了一组预定义变量的数据集，然后对数据进行组合，并生成描述性和生存统计数据。

结果

所有 3 个国家的膝关节置换术发病率都有所增加，但丹麦增加最多。挪威每所医院的手术数量最少，不到瑞典和丹麦的一半。对植入物品牌的偏好也有所不同，只有 3 个总品牌和 1 个单髁品牌在所有 3 个国家都很常见。丹麦（76%）流行使用髌骨扣固定全膝关节置换术，但挪威（11%）和瑞典（14%）不流行。丹麦（22%）较挪威（14%）和瑞典（2%）更频繁地使用非骨水泥或混合固定组件。对于骨关节炎的全膝关节置换术后，瑞典的累积翻修率（CRR）最低，丹麦和挪威的相对风险（RR）分别为 1.4（95%CI：1.3-1.6）和 1.6（CI：1.4-1.7）倍。当仅包括在所有 3 个国家中使用超过 200 例的品牌时，结果也是相似的（AGC、Duracon 和 NexGen）。对于骨关节炎的单髁置换术后，所有模型的 CRR 也以瑞典最低，丹麦和挪威的 RR 分别为 1.7（CI：1.4-2.0）和 1.5（CI：1.3-1.8）。然而，当仅分析牛津植入物时，CRR 相似，RR 分别为 1.2（CI：0.9-1.7）和 1.3（CI：1.0-1.7）。