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An international comparison of THA patients, implants, techniques, and survivorship in Sweden, Australia, and the United States.
- Source :
-
Acta orthopaedica [Acta Orthop] 2019 Apr; Vol. 90 (2), pp. 148-152. Date of Electronic Publication: 2019 Feb 11. - Publication Year :
- 2019
-
Abstract
- Background and purpose - International comparisons of total hip arthroplasty (THA) practices and outcomes provide an opportunity to enhance the quality of care worldwide. We compared THA patients, implants, techniques, and survivorship in Sweden, Australia, and the United States. Patients and methods - Primary THAs due to osteoarthritis were identified using Swedish (n = 159,695), Australian (n = 279,693), and US registries (n = 69,641) (2003-2015). We compared patients, practices, and implant usage across the countries using descriptive statistics. We evaluated time to all-cause revision using Kaplan-Meier survival curves. We assessed differences in countries' THA survival using chi-square tests of survival probabilities. Results - Sweden had fewer comorbidities than the United States and Australia. Cement fixation was used predominantly in Sweden and cementless in the United States and Australia. The direct anterior approach was used more frequently in the United States and Australia. Smaller head sizes (≤ 32 mm vs. ≥ 36 mm) were used more often in Sweden than the United States and Australia. Metal-on-highly cross-linked polyethylene was used more frequently in the United States and Australia than in Sweden. Sweden's 5- (97.8%) and 10-year THA survival (95.8%) was higher than the United States' (5-year: 97.0%; 10-year: 95.2%) and Australia (5-year: 96.3%; 10-year: 93.5%). Interpretation - Patient characteristics, surgical techniques, and implants differed across the 3 countries, emphasizing the need to adjust for demographics, surgical techniques, and implants and the need for global standardized definitions to compare THA survivorship internationally.
- Subjects :
- Australia
Equipment Failure Analysis
Female
Hip Joint surgery
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Prosthesis Design
Sweden
United States
Arthroplasty, Replacement, Hip adverse effects
Arthroplasty, Replacement, Hip instrumentation
Arthroplasty, Replacement, Hip methods
Hip Prosthesis classification
Hip Prosthesis standards
Hip Prosthesis statistics & numerical data
Osteoarthritis diagnosis
Osteoarthritis epidemiology
Osteoarthritis etiology
Osteoarthritis surgery
Postoperative Complications diagnosis
Postoperative Complications epidemiology
Postoperative Complications surgery
Reoperation statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1745-3682
- Volume :
- 90
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Acta orthopaedica
- Publication Type :
- Academic Journal
- Accession number :
- 30739548
- Full Text :
- https://doi.org/10.1080/17453674.2019.1574395