Total hip arthroplasty (THA) or total hip replacement is one of the most cost effective and reliable surgical operation. This operation consists in replacing the hip joint by prosthetic components allowing the patient suffering from hip pathology (ex: osteoarthritis) to restore painless motion and improve quality of life. For this surgical procedure, different models of implants are available (materials, shape, size and fixation methods) and surgeons decide depending on the age, pathology and medical history of the patient which implant characteristics would suit best. Joint implants are made to stay viable for the longest time possible in the body without revision surgery (second surgery related to an earlier inserted hip prosthesis). Revision surgery can occur after different complications like: repeated dislocation, infection or loosening of the implant and periprosthetic fracture [1].
In order to identify factor contributing to revision surgery and improve surgery procedure, national patient registries have been used in several countries. In 1979, Sweden was the first country to establish a national quality register collecting data on hip arthroplasty: the Swedish Hip Arthroplasty Register (SHAR). Nowadays a lot of countries possess regional and or national Hip Arthroplasty registers like Finland (1980), Norway (1989), Denmark (1995), Australia (1999), England, Wales, Northern Ireland and the Isle of Man (2002). The main objective is to centralize information within the country to follow the evolution of the number of total hip surgery, revision surgery as well as the prevalence in certain age group. Indeed, annual report are published to summarize data collected.
More importantly, registries are used to collect data on the patient, the surgical procedure and operation outcomes. The principal advantage is the possibility to investigate adverse outcomes of primary THA leading to revision surgery and improve surgical procedure. National registries play a major role in documenting the quality of THA to describe best practices and report outlier implants [2]. The 2019 Swedish Hip Arthroplasty Register report mention that “Never have so many hip arthroplasties been undertaken and never have so many research papers using data from the register been published during one operational year” [3].
References
[1] Varacallo M, Luo TD, Johanson NA. Total Hip Arthroplasty Techniques. 2022 Jul 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
[2] Varnum C, Pedersen AB, Rolfson O, Rogmark C, Furnes O, Hallan G, Mäkelä K, de Steiger R, Porter M, Overgaard S. Impact of hip arthroplasty registers on orthopaedic practice and perspectives for the future. EFORT Open Rev. 2019 Jun; 4(6):368-376. doi: 10.1302/2058-5241.4.180091.
[3] Kärrholm J, Rogmark C, Naucler E, Nåtman J, Vinblad J, Mohaddes M, Rolfson O. Swedish Hip Arthroplasty Register Annual report 2019. 2021 Feb. doi: 10.18158/H1BdmrOWu.
This article was written by Marie Moulin as part of an ongoing series of scientific communications written and curated by BioTrib’s Early Stage Researchers.
Marie is researching the Bioprinting of Bone and Cartilage at Uppsala University, Sweden.