Page 18 - The value of total hip and knee arthroplasties for patients

Chapter 1
Total hip and knee arthroplasty (THA andTKA)
THA and TKA are proven effective interventions to reduce pain and stiffness and improve the performance of daily activities and overall quality of life (QoL) in patients with end-stage hip or knee osteoarthritis.24 In 2009,the numbers of patients undergoing total hip or knee arthroplasty were 1.6 and 1.2 per 1000 per year in Western countries.These numbers are expected to rise further in the coming years due to the abovementioned ageing society and the growing prevalence of obesity.5,25 To monitor the safety and effectiveness of THA and TKA, national arthroplasty registers are instituted. Currently, 40 national, regional, or institutional registries are member of the International Society of Arthroplasty Registers (ISAR).26 By tradition, arthroplasty registries mainly comprise procedure-related data, including the characteristics of the implants and surgical techniques as well as their functional outcomes, the focus regarding the latter being mainly on implant survival.27 In the Netherlands, the Landelijke Registratie Orthopedische Implantaten (LROI, Dutch Implant Registry) was founded in 2007. In this register about 60.000 hip and knee prostheses are registered annually, with 100 contributing orthopaedic centers/ hospitals and the completeness being over 98%.28,29
Hip arthroplasty in the Netherlands
The annual number of primary THA in the Dutch Implant Register was 29.520 in 2016, whereas there were 3.836 hip arthroplasty revisions.The large majority (86%) of the patients underwent THA because of OA. The average age of THA patients in 2016 was 68.8 (SD: 10.5) years, with 65% of them being women. The most frequently used surgical approach was posterolateral (60%). Most procedures were uncemented (64%).30
Knee arthroplasty in the Netherlands
In 2016, the number of registered primary TKA was 27.918 whereas 2.886 knee revision arthroplasties were registered.The primary diagnosis leading to a primary knee arthroplasty was mainly OA (96%).The average age of the patients was 68.6 (SD 9.1) years and 64% of them were female30
Patient Reported Outcome Measures collected alongside national implant registries
As mentioned before, joint implant registries have long been mainly focused on technical aspects of the prosthesis in particular its survival. However, despite the overall favourable results, previous studies have estimated that between 7%-15%
16