Article

Treatment of displaced femoral neck fractures in Sweden
has shifted towards more arthroplasties, especially hemiarthroplasties. We
describe the hemiarthroplasty population in Sweden 2005 through 2009. METHODS:
Since 2005, the Swedish Hip Arthroplasty Register has registered
hemiarthroplasties on a national basis. We assessed hemiarthroplasty procedures
in the Register 2005-2009 regarding patient details, implants, and surgical
techniques. Completeness of recordings was calculated compared to the Swedish
National Patient Register. RESULTS: Completeness increased from 89% to 96% during
the study period. 21,346 hemiarthroplasty procedures were assessed. The relative
number of patients with femoral neck fracture as diagnosis increased from 91% to
94%; the proportion of men increased from 27% to 30%. The median age increased
from 83 to 84 years in men and from 84 to 85 years in women. Patients classified
as having evident cognitive impairment increased from 19% to 22%. More men than
women were ASA 4. The proportion of monoblock-type implants (Austin-Moore and
Thompson) decreased from 18% to 0.9%. Modular implants increased generally, but
in 2009 bipolar implants decreased in favor of unipolar implants. Lubinus and
Exeter stems, and Mega Caput and Vario Cup implant heads were most common. The
use of uncemented implants decreased from 10% to 3%. Use of the anterolateral
approach increased from 47% to 56%. INTERPRETATION: Important changes in surgical
technique and implant choice occurred during the observation period. We interpret
these changes as being reflections of the continuing effort by Swedish orthopedic
surgeons to improve the quality of treatment, because the changes are consistent
with recent findings in the Swedish Hip Arthroplasty Register and in other scientific studies.
- Suède

Langue : ANGLAIS