| Staff and Boards | Publications | About the Register |
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The Norwegian Arthroplasty Register The Norwegian Cruciate Ligament Register The Norwegian Hip Fracture Register
Department of Orthopedic Surgery Tel : +47 - 55 97 37 42 |
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THE NORWEGIAN ARTHROPLASTY REGISTER
The Norwegian Arthroplasty Register started registration of total hip replacements in 1987. In 1994, registration was extended to include insertion of all types of artificial joints. The main reason for establishing a nation-wide register was that throughout the 1970ies, new hip implants had been introduced without documentation from clinical studies. After being used for more than 10 years, several of the prostheses were identified with high failure rates, but had at the time already been used on large numbers of patients. The main purpose of the register is to function as a surveillance tool to identify inferior implants as early as possible.
The orthopaedic surgeons provide information on all primary joint replacements, including an accurate description of the different parts of the implant. If the prosthesis is later revised (the implant is removed or exchanged), the register receives a new report with information about the reason for and the type of revision. Information regarding the two procedures is linked using the personal identification number assigned to all inhabitants of Norway. The quality of an implant can then be evaluated based on the time periods from implantation to revision.
Throughout the registration period 1987 to 2005, information has been registered on about 114.400 hip replacements, 25.000 knee replacements and more than 7.300 prostheses in other joints than hip and knee. With 4.56 million inhabitants in 2003, the overall incidence per 100,000 persons was 152 primary total hip replacements and 67 primary knee replacements.
CENTRE OF EXCELLENCE
The Norwegian Ministry of Health approved the Norwegian Arthroplasty Register as a national centre of excellence of joint replacements in 2002.
THE NORWEGIAN CRUCIATE LIGAMENT REGISTER
The Norwegian Cruciate Ligament Register was established in June 2004 after an initiative from the Oslo Sports Trauma Research Center. The new register is located at the Norwegian Arthroplasty Register.
There are large variations in how anterior cruciate ligament (ACL) injuries are treated and long-term outcomes are uncertain, especially when it comes to the effect of ACL surgery on the development of osteoarthritis in the knee. There is currently no agreement on whether an athlete should return to his or her sport after injury, or if returning, when this should happen. These are questions that may be answered based on information reported to the register.
THE NORWEGIAN HIP FRACTURE REGISTER
About 10.000 hip fractures are treated annually in Norway, but knowledge on outcome following the different treatment options is scarce. This was the background for establishing a national hip fracture register. The Norwegian Hip Fracture register is located at the Norwegian Arthroplasty Register and started collecting information January 2005.
Annual reports: The register publishes annual reports with mainly descriptive information regarding national data on operating volumes, use of different types of prostheses and cements, and other characteristics of the procedure. In addition, annual reports are sent to each hospital with confidential information on intern production and results from analyses showing the duration of the implants. The information is compared against the average results for all hospitals.
Peer-reviewed papers: Comparative studies, for instance of the quality of different types of prostheses, are presented in scientific lectures and journals. Our list of publications can be seen here. Main research findings are presented in the following slides.
Please click on the images below to view our latest national annual reports.
You need Adobe Reader to view these pdf-files.
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| Report published May 2000 | Report published June 2001 | Report published June 2002 | Report published June 2003 | |||||
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English version, 965 kB
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English version, 831 kB
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| Report published June 2004 | Report published June 2005 | Report published June 2006 | Report published June 2007 | |||||
| Norwegian version, 1529 kB |
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| English version, 870 kB | English version, 949 kB | English version, 3854 kB | English version, 15013 kB | |||||
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| Report published July 2008 | Scientific Exhibition at the 67th Annual Meeting of the American Academy of Orthopaedic Surgeons. March 2000, USA (8 pages, 703 kB) | Scientific Exhibition at the 72nd Annual Meeting of the American Academy of Orthopaedic Surgeons. February 2005, USA (8 pages, 1634 kB) | Early postoperative mortality after insertion of hip and knee prostheses (poster, 436 kB) | |||||
| Norwegian version, 3821 kB |
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Boards (In norwegian)
Staff (In norwegian)
Facts about the Norwegian Arthroplasty Register
The registration comprises information regarding both primary insertions of prostheses and later revisions, i.e. exchanges or removals of previously inserted prostheses. Information is provided on a standard form filled in by the orthopaedic surgeons.
Information on around 8,000 hip replacements and 5,500 replacements of other joints are reported to the register every year.
It is not compulsory to report joint replacements to the Norwegian Arthroplasty Register. Investigations have, however, shown that at least 95% of all joint replacements performed are reported to the register. A permission to collect this information is obtained from each patient.
In the early 1980’s several hip prosthesis brands common in use in Norway, were reported with largely inferior clinical results. Unfortunately, these prostheses were used to a large number of patients both in Norway and in other countries before their inferior results were known. To avoid similar situations in the future, a nation-wide register was set up to provide a continuous surveillance of the quality of joint replacements.
The main objective of the register is to maintain and possibly improve the quality of joint arthroplasty. The specific aims of the register are to describe the epidemiology of joint arthroplasty and to identify factors associated with an increased risk for revision.
Information is given on a regular basis to each hospital performing orthopaedic surgery in Norway. Another important channel of information is through scientific papers made public in journals related to orthopaedic research.
The quality of joint replacements is evaluated based on the survival time of the prostheses, where survival time is defined as the time period from insertion of the prosthesis to its revision. A premature termination of follow-up (so called censored observations) will be registered if the study is closed, or the patient dies or emigrates with the prosthesis still intact. Information on revisions is linked to the data already collected on earlier operations using the unique identification number assigned to each inhabitant of Norway. Thus, ordinarily statistical methods related to analyses of failure times are applied.
During the period when the register has been in function, results on several research projects have been reported. Most of these have been related to studies on the survival of total hip replacements, but future studies will also focus on the quality of other joint replacements.
Among many studies, investigations have been performed on the effect on total hip replacement survival of using uncemented or cemented prostheses, and major differences have been reported among commonly used uncemented prosthesis types. Important differences in survivorship have also been reported among prostheses performed with different cement types. Based on information in the register and additional information retrieved from the patients, an association has been indicated between revision risk and factors related to patient lifestyle. Furthermore, the quality of hip replacements has also been evaluated based on the opinion of the patient.
Please take a look at our list of publications.
Together with other registers in Bergen, Norway, the Norwegian Arthroplasty Register forms a part of the organization LOCUS (Locus for Registry-Based Epidemiology) established by the University of Bergen in Norway.
