Download - Dislocations of primary THR´s in Denmark
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Luksation af primære hoftealloplastikker i Danmark
Peder Klement Jensen, Orthopædkirurgisk afdeling, Holbæk Sygehus
Jens-Erik Varmarken, Orthopædkirurgisk afdeling, Næstved Sygehus
Søren Paaske Johnsen, Klinisk Epidemiologisk Afdeling, Århus Universitetshospital
Ulf Lucht, Dansk Hoftealloplastik Register, Århus Universitetshospital
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INTRODUKTIONJolles BM, Bogoch ER.
Posterior versus lateral surgical approach for total hip arthroplasty in adults with osteoarthritis.
Cochrane Database Syst Rev. 2006 Jul 19;3:CD003828.
van Stralen GM, Struben PJ, van Loon CJ.
The incidence of dislocation after primary total hip arthroplasty using posterior approach with posterior soft-tissue repair.
Arch Orthop Trauma Surg. 2003 Jun;123(5):219-22. Epub 2003 Apr 9.
Woolson ST, Rahimtoola ZO.
Risk factors for dislocation during the first 3 months after primary total hip replacement.
J Arthroplasty. 1999 Sep;14(6):662-8.
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MATERIALE & METODE
♦ Data fra Landspatientregistret (LPR) for
perioden 1. Januar 2001 til 31. December
2003
♦ Data fra Dansk Hoftealloplastik Register
(DHRR) for perioden 1. Januar 2001 til 31.
December 2003
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Nøgle værdi (Key-Value / Primary Key)
♦ CPR nummer
♦ Operations dato
♦ Sideangivelse
♦ Type af indgreb (operations kode KNF..)
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Type af indgreb
♦ KNFB20 Primær indsættelse af ucementeret totalprotese i
hofteled
♦ KNFB30 Primær indsættelse af hybrid totalprotese i hofteled
♦ KNFB40 Primær indsættelse af cementeret totalprotese i hofteled
♦ KNFH20 Lukket reposition af lukseret ledprotese i hofte
♦ KNFH21 Artroskopisk reposition af lukseret ledprotese i hofte
♦ KNFH22 Åben reposition af lukseret ledprotese i hofte
♦ KNFH00 Lukket reposition af hofteled
♦ KNFH01 Artroskopisk reposition af hofteled
♦ KNFH02 Åben reposition af hofteled
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Fejlkilder
♦ Sideangivelse
♦ Operationsdato
♦ Kode (KNFB.. - KNFC.. - KNGB..)
♦ Reposition på skadestue / sengeafsnit
♦ (Private sygehuse 929)
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RESULTATER
I DHRR er der i perioden 2001 til og med
2003 registreret 18.289 primære
alloplastikker.
I LPR er der registret 18,007 primære THR.
15,722 var registreret i begge registre med
samme sideangivelse og operationsdato.
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RESULTATER
I LPR var der registreret 2285 som ikke kunne
genfindes i DHRR.
I DHRR fandtes 2650 som ikke var registreret
i LPR. Af dem var 929 opereret på
privatsygehuse, som ikke registreres i LPR.
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RESULTATER
Af de 15.722 primære THR som var i begge registre
var der i alt 598 patienter med luksation, som
havde fra en til 11 luksationer i perioden.
Totalt var der 1165 luksationer.
Den totale luksations raten for førstegangs
luksationer var 3.80 %
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Førstegangs luxationer (598)
0
50
100
150
200
250
300
350
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29
Måneder
Patienter med luxation
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Kun 1 luxation (314 af 598)
020406080
100120140160
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29
Måneder
Patienter med kun 1 luxation
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Adgang
adgang Antal Antal luxationer Antal luxationer i %Bagre 14313 573 4,00Forreste 34 1 2,94Lateral 1341 24 1,79
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Kønsfordeling
Køn Antal Antal luxationer Antal luxationer i %Mænd 6572 250 3,80Kvinder 9150 348 3,80
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Alders fordeling
0,00
1,00
2,00
3,00
4,00
5,00
6,00
7,00
8,00
9,00
10,00
25 - 30
30 - 35
35 - 40
40 - 45
45 - 50
50 - 55
55 - 60
60 - 65
65 -70
70 - 75
75 - 80
80 - 85
85 - 90
90 - 95
95 +
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DiagnoseDiagnose Antal Antal luxationer Antal luxationer i %
Acetabulumdysplasi 215 10 4,65Acetabulumfraktur 88 3 3,41Anden artrit 73 2 2,74Andet 153 12 7,84Atraumatisk 425 22 5,18Epifysiolyse 56 1 1,79Frisk proks. 292 23 7,88Kongenit 125 0 0,00Mb. Bekhterew 32 0 0,00Mb. Calve-Legg- 109 1 0,92Primær (idiopatisk) 12520 433 3,46Reumatoid artrit 303 13 4,29Senflg. e. proks. 1292 76 5,88Traumatisk 39 2 5,13
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Alloplastik type
opr Antal Antal luxationer Antal luxationer i %KNFB20 4442 133 2,99KNFB30 4836 233 4,82KNFB40 6444 232 3,60
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Hyppigste protese kombinationer
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Ucementerede KNFB20 (n=3286) førstegangs luksationer
Acetabulum Femur Total %
Trilogy Bi-metric 1882 3,13Mallory-Head Bi-metric 724 2,76Plasmacup SC Bicontact 435 2,30Ranawat-Burstein Bi-metric 198 4,04Universal Bi-metric 47 2,13
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Hybrid KNFB30 (n=3100)førstegangs luksationer
Acetabulum Femur Total %
Trilogy Bi-metric 1111 4,86Universal Bi-metric 559 6,80Mallory-Head Exeter 476 3,36Trilogy CPT 495 3,64Duraloc Exeter 459 4,58
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Cementerede KNFB40 (n=4595)førstegangs luksationer
Acetabulum Femur Total %
Lubinus Lubinus SP II 1680 2,44Exeter Exeter 1175 5,11ZCA CPT 978 3,07Müller Bi-metric 290 4,48Charnley Charnley 472 2,75
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Saturne Cup – (Bipolær cup)
1 luxation ud af 266
(0,38 %)
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KONKLUSION
Det er muligt at anvende offenlige databaser som Landspatientregisteret og Dansk Hoftealloplastik Register til at beregne luksationer af primære hoftealloplastikker i Danmark.
Det er dog påkrævet med yderligere validering af registrene for at kunne drage sikre konklusioner.
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