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The Norwegian Joint Registry.

¹Department of Orthopaedic Surgery at Haukeland University Hospital, Bergen, Norway.

Bulletin (Hospital for Joint Diseases (New York, N.Y.))

|January 22, 2000

Summary

The Norwegian Arthroplasty Register monitors joint replacement outcomes, enabling early detection of implant failures. This data has led to the withdrawal of several problematic prostheses and cements from the market.

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Area of Science:

Orthopaedic Surgery
Biomaterials Science
Public Health Surveillance

Background:

The Norwegian Arthroplasty Register was established in 1987, initially for hip prostheses, and expanded in 1994 to include all artificial joints.
Participation is mandatory for orthopaedic surgeons across Norway, ensuring comprehensive data collection.
Over 60,000 total hip replacements have been registered, covering both primary surgeries and revisions.

Purpose of the Study:

To survey and analyze the outcomes of joint replacement surgeries in Norway.
To perform survival analysis of artificial joint implants and components.
To identify and assess reasons for revision surgeries, such as aseptic loosening, infection, wear, and osteolysis.

Main Methods:

Utilizing patients' national identification numbers to link revisions to primary operations.
Conducting survival analysis adjusted for confounding factors like age, gender, and diagnosis.
Registering individual prosthesis components (cup, stem) to calculate separate survival rates.
Recording specific reasons for revision surgery.

Main Results:

The system allows for the early detection of inferior implant results, sometimes as early as three years post-implantation.
Several brands of uncemented prostheses and two cement brands have been withdrawn from the market based on register findings.
The register provides data on revision rates due to various complications, including aseptic loosening, infection, dislocation, wear, and osteolysis.

Conclusions:

The Norwegian Arthroplasty Register is a valuable tool for monitoring the safety and efficacy of joint replacement implants.
The register's findings have directly contributed to improved patient safety by identifying and removing substandard products.
The system demonstrates the effectiveness of national joint registries in ensuring the quality of orthopaedic implants and surgical outcomes.

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