The Finnish Arthroplasty Register: Report of the hip register

Abstract

The Finnish Arthroplasty Register was established in 1980. Between 1980 and 1999, 62,841 primary and 12,224 revision total hip arthroplasties (THA) were recorded. The annual number of both primary and revision THA has increased: in 1999, the incidence of primary THAs was 93/100,000. 174 implant designs have been used, but the 6 commonest implants comprised 82% in 1999. Since the late 1980s, more than 40% of the hips were inserted without cement. Over 47% of the cementless primary hip prostheses were used in patients younger than 60 years and over 93% of the cemented primary hips were used in patients 60 years or older. The 10-year survival rate was 72 (95% CI 67-76)% in patients younger than 55 years and 90 (89-91)% in patients older than 70 years. The commonest reasons for revision were aseptic loosening (65%), dislocation (9%) and infection (7%). In revisions, the 5-year survival of the cementless hip prosthesis improved over time: it was 85 (82-87)% in 1985-1989, 89 (88-91)% in 1990-1994 and 92 (88-95)% in 1995-1999. There are striking differences between the Arthroplasty Registers of Scandinavia as regards the end-point definition of survival. The Finnish Arthroplasty Register considers all reasons for revisions as the end-point of survival, but the Swedish register takes into account only aseptic loosening, so direct comparisons between registers are not possible. Recent data from the Finnish Arthroplasty Register indicate that the results of total hip replacements are improving in Finland. With the civic registration number, one can link and match data files. For example, with use of the Finnish Cancer Register, we found no increase in the risk of cancer after a THA.