Session 9: Hip I
Torsdag den 24. oktober
09:30 - 10:30
Lokale: Vingsal 3
Chairmen: Claus Varnum og Alma Pedersen
Julie Sandell Jacobsen, Stig Storgaard Jakobsen, Kjeld Søballe, Per Hölmich, Kristian Thorborg
Department of Physiotherapy and Research Centre in Health and Welfare Technology, VIA University College; Department of Orthopaedic Surgery, Aarhus University Hospital; Department of Orthopaedic Surgery, Aarhus University Hospital; Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre; Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre
Background: Hip dysplasia is a pathological development of the hip joint with reduced acetabular weight-bearing area. The clinical presentation of hip dysplasia is groin pain, low patient-reported function and impaired hip muscle strength. Patient-reported pain and function improve after periacetabular osteotomy (PAO). However, little is known about hip muscle strength after PAO.
Purpose / Aim of Study: We aimed to investigate changes in isometric hip muscle strength from before to 1 year after PAO in patients with hip dysplasia and to compare the muscle strength values of the patients to the values of a reference group with no hip problems.
Materials and Methods: Muscle strength was assessed before and after PAO in 100 patients with a mean age of 30 years (SD 9); while the muscle strength of 50 references with a mean age of 31 (SD 9) was assessed at one time point. Isometric hip muscle strength was assessed in flexion, extension, abduction and adduction with a hand-held dynamometer using a standardised procedure. Changes in muscle strength from before to 1 year after PAO and differences between patients and references were analysed with a univariate repeated measurement model.
Findings / Results: From before to 1 year after PAO, patients improved their isometric hip muscle strength in flexion and abduction, 0.13 Nm/kg (CI 0.06 - 0.20) and 0.10 Nm/kg (CI 0.02 - 0.18). Hip muscle strength in adduction did not change and muscle strength in hip extension failed to reach statistical significance (0.09 Nm/kg (CI -0.05 - 0.23), p=0.188). However, despite improvements in hip flexion and abduction, the hip muscle strength values of the patients were 13-34% lower than the hip muscle strength values of the healthy references at both time points (p<0.01).
Conclusions: One year after PAO, patients improved their maximal isometric hip muscle strength in flexion and abduction. However, patients’ pre- and postoperative hip muscle strength values were low compared to the hip muscle strength values of the healthy references. Consequently, future studies should focus on the measured strength deficits and investigate if strength training can improve hip muscle strength in patients with hip dysplasia.
Department of Physiotherapy and Research Centre in Health and Welfare Technology, VIA University College; Department of Orthopaedic Surgery, Aarhus University Hospital; Department of Orthopaedic Surgery, Aarhus University Hospital; Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre; Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre
Background: Hip dysplasia is a pathological development of the hip joint with reduced acetabular weight-bearing area. The clinical presentation of hip dysplasia is groin pain, low patient-reported function and impaired hip muscle strength. Patient-reported pain and function improve after periacetabular osteotomy (PAO). However, little is known about hip muscle strength after PAO.
Purpose / Aim of Study: We aimed to investigate changes in isometric hip muscle strength from before to 1 year after PAO in patients with hip dysplasia and to compare the muscle strength values of the patients to the values of a reference group with no hip problems.
Materials and Methods: Muscle strength was assessed before and after PAO in 100 patients with a mean age of 30 years (SD 9); while the muscle strength of 50 references with a mean age of 31 (SD 9) was assessed at one time point. Isometric hip muscle strength was assessed in flexion, extension, abduction and adduction with a hand-held dynamometer using a standardised procedure. Changes in muscle strength from before to 1 year after PAO and differences between patients and references were analysed with a univariate repeated measurement model.
Findings / Results: From before to 1 year after PAO, patients improved their isometric hip muscle strength in flexion and abduction, 0.13 Nm/kg (CI 0.06 - 0.20) and 0.10 Nm/kg (CI 0.02 - 0.18). Hip muscle strength in adduction did not change and muscle strength in hip extension failed to reach statistical significance (0.09 Nm/kg (CI -0.05 - 0.23), p=0.188). However, despite improvements in hip flexion and abduction, the hip muscle strength values of the patients were 13-34% lower than the hip muscle strength values of the healthy references at both time points (p<0.01).
Conclusions: One year after PAO, patients improved their maximal isometric hip muscle strength in flexion and abduction. However, patients’ pre- and postoperative hip muscle strength values were low compared to the hip muscle strength values of the healthy references. Consequently, future studies should focus on the measured strength deficits and investigate if strength training can improve hip muscle strength in patients with hip dysplasia.
Anna Bohman, Sören Overgaard, Carl-Johan Tiderius, Cecilia Rogmark
Dept of Orthop Surg, Skane University Hospital Malmö-Lund; Ortopædkirurgisk afd.O/Klinisk Institut, Odense Universitetshospital/Syddansk Universitet; Dept of Orthop Surg, Skane University Hospital Malmö-Lund/Lund University; Dept of Orthop Surg, Skane University Hospital Malmö-Lund/Lund University
Background: Hip dysplasia (HD) is commonly defined as a center-edge angle (CE) ≤20 degrees on pelvic radiographs. A 5% prevalence is suggested by a Danish population study. Patients with HD may develop symptoms which can be treated non-surgically, by joint preserving surgery, or total hip replacement. Thus, early diagnosis is important for the patients’ treatment.
Purpose / Aim of Study: To describe a) prevalence of HD in our catchment area; b) concordance between original assessment and dedicated measurement of dysplasia angles c) association of pain and HD.
Materials and Methods: Retrospective study of individuals 20-70 years; 1501 hip/pelvis radiographs taken 2007 in Malmö. 808 of these permitted both hips to be measured. CE was measured according to Wiberg and acetabular index angle (AIA) according to Tönnis. Radiological dysplasia was defined as CE ≤20 degrees. One researcher performed all measurements, read x-ray referrals and assessments. Patients had either planned or acute x-ray. T- test and chi2-test.
Findings / Results: In the 245 acute cases, 10 had uni- or bilateral dysplasia (4.1%). In 563 planned cases, the result was 29 (5.2%). The AIA angles were significantly higher in HD cases, right side 18 versus 7 degrees (SD 6 and 5), left 17 vs 6 (SD 5 and 4). According to the referral, 22 of the 39 HD cases had pain. Men had dysplasia in 5.5% of the acute cases, and in 5.7% of the planned cases, women 3.0 and 4.8%. The radiologists’ assessments mentioned dysplasia (or similar) in 4 of the 39 cases.
Conclusions: The hip dysplasia prevalence was 5% in a adult population with no gender difference. A majority of the patients with radiological dysplasia did actually have pain, but the radiology assessment described acetabular dysplasia just in a few cases. If patients are not detected in routine health care, individuals with symptoms may miss out on treatment.
Dept of Orthop Surg, Skane University Hospital Malmö-Lund; Ortopædkirurgisk afd.O/Klinisk Institut, Odense Universitetshospital/Syddansk Universitet; Dept of Orthop Surg, Skane University Hospital Malmö-Lund/Lund University; Dept of Orthop Surg, Skane University Hospital Malmö-Lund/Lund University
Background: Hip dysplasia (HD) is commonly defined as a center-edge angle (CE) ≤20 degrees on pelvic radiographs. A 5% prevalence is suggested by a Danish population study. Patients with HD may develop symptoms which can be treated non-surgically, by joint preserving surgery, or total hip replacement. Thus, early diagnosis is important for the patients’ treatment.
Purpose / Aim of Study: To describe a) prevalence of HD in our catchment area; b) concordance between original assessment and dedicated measurement of dysplasia angles c) association of pain and HD.
Materials and Methods: Retrospective study of individuals 20-70 years; 1501 hip/pelvis radiographs taken 2007 in Malmö. 808 of these permitted both hips to be measured. CE was measured according to Wiberg and acetabular index angle (AIA) according to Tönnis. Radiological dysplasia was defined as CE ≤20 degrees. One researcher performed all measurements, read x-ray referrals and assessments. Patients had either planned or acute x-ray. T- test and chi2-test.
Findings / Results: In the 245 acute cases, 10 had uni- or bilateral dysplasia (4.1%). In 563 planned cases, the result was 29 (5.2%). The AIA angles were significantly higher in HD cases, right side 18 versus 7 degrees (SD 6 and 5), left 17 vs 6 (SD 5 and 4). According to the referral, 22 of the 39 HD cases had pain. Men had dysplasia in 5.5% of the acute cases, and in 5.7% of the planned cases, women 3.0 and 4.8%. The radiologists’ assessments mentioned dysplasia (or similar) in 4 of the 39 cases.
Conclusions: The hip dysplasia prevalence was 5% in a adult population with no gender difference. A majority of the patients with radiological dysplasia did actually have pain, but the radiology assessment described acetabular dysplasia just in a few cases. If patients are not detected in routine health care, individuals with symptoms may miss out on treatment.
Bjarke Viberg, Kate Andersen, Ole Ovesen, Morten F. Bøgehøj, Søren Overgaard
Orthopaedic Surgery and Traumatology / Regional Health Research, Kolding Hospital / University of Southern Denmark; Health Science and Technology, Aalborg University; Orthopaedic Surgery and Traumatology, Odense University Hospital; Orthopaedic Surgery and Traumatology, Odense University Hospital; Orthopaedic Surgery and Traumatology / Orthopaedic Research Unit, Department of Clinical Research, Odense University Hospital / University of Southern Denmark
Background: Periacetabular osteotomy (PAO) is a treatment option in symptomatic acetabular retroversion (AR) where non-surgical treatment has failed. Very few studies have been published on patient reported outcome measure (PROM). The present study reports on the largest series of patients until today.
Purpose / Aim of Study: Assess PROMs and complications after PAO surgery in adult patients with AR.
Materials and Methods: From June 2007 to May 2018, 214 patients with AR were retrieved from a prospective local database. Patients were followed at baseline, 1, 2, and 5 years after surgery and answered Oxford Hip Score (OHS), EuroQol-5 dimensions index (EQ-5D), University of California at Los Angeles Activity score (UCLA), pain Verbal Rating Scale (pVRS), and Harris Hip Score (HHS). Complications are entered into the database but were also retrieved from the Danish National Patient Registry. Two follow-up periods were defined as 2 years (1-2.2 years postoperatively) and 5 years (2.3-6 years). STROBE guidelines were followed.
Findings / Results: The 214 patients had a mean (SD) age of 23.7 (24) years, 165 (77%) were female, and the mean (SD) BMI was 24.7 (16.9). From baseline to 2 and 5 years after surgery, there was statistical significant improvement in all PROMs. Preoperatively and median (InterQuartileRange) delta value improvements: pVRS was 8 (7-9) preoperatively and was reduced with 7 (5-8) points after 2 years and 7 (5-8) after 5 years. EQ5D was preoperatively 0.72 (0.56-0.72) and increased with 0.21 (0.05-0.32) points after 2 years and 0.12 (0-0.28) after 5 years. UCLA was preoperatively 5 (4-7) and increased with 2 (0-4) points after 2 years and 1 (0-4) after 5 years (non-significant after 5 years). OHS was preoperatively 30 (24-35) and increased with 10 (4.5-17) points after 2 years and 7 (4-15) after 5 years. HHS was preoperatively 69 (63-74) and increased with 27 (22-34) points after 2 years and 26 (24-30) after 5 years. Apart from screw removal of fixation material in 20.1% of the patients 2 hips (0.9%) were converted to total hip arthroplasty.
Conclusions: PAO for AR surgery leads to favorable outcomes in all PROMs suggesting PAO as an effective treatment of acetabular retroversion with a low frequency of severe complications.
Orthopaedic Surgery and Traumatology / Regional Health Research, Kolding Hospital / University of Southern Denmark; Health Science and Technology, Aalborg University; Orthopaedic Surgery and Traumatology, Odense University Hospital; Orthopaedic Surgery and Traumatology, Odense University Hospital; Orthopaedic Surgery and Traumatology / Orthopaedic Research Unit, Department of Clinical Research, Odense University Hospital / University of Southern Denmark
Background: Periacetabular osteotomy (PAO) is a treatment option in symptomatic acetabular retroversion (AR) where non-surgical treatment has failed. Very few studies have been published on patient reported outcome measure (PROM). The present study reports on the largest series of patients until today.
Purpose / Aim of Study: Assess PROMs and complications after PAO surgery in adult patients with AR.
Materials and Methods: From June 2007 to May 2018, 214 patients with AR were retrieved from a prospective local database. Patients were followed at baseline, 1, 2, and 5 years after surgery and answered Oxford Hip Score (OHS), EuroQol-5 dimensions index (EQ-5D), University of California at Los Angeles Activity score (UCLA), pain Verbal Rating Scale (pVRS), and Harris Hip Score (HHS). Complications are entered into the database but were also retrieved from the Danish National Patient Registry. Two follow-up periods were defined as 2 years (1-2.2 years postoperatively) and 5 years (2.3-6 years). STROBE guidelines were followed.
Findings / Results: The 214 patients had a mean (SD) age of 23.7 (24) years, 165 (77%) were female, and the mean (SD) BMI was 24.7 (16.9). From baseline to 2 and 5 years after surgery, there was statistical significant improvement in all PROMs. Preoperatively and median (InterQuartileRange) delta value improvements: pVRS was 8 (7-9) preoperatively and was reduced with 7 (5-8) points after 2 years and 7 (5-8) after 5 years. EQ5D was preoperatively 0.72 (0.56-0.72) and increased with 0.21 (0.05-0.32) points after 2 years and 0.12 (0-0.28) after 5 years. UCLA was preoperatively 5 (4-7) and increased with 2 (0-4) points after 2 years and 1 (0-4) after 5 years (non-significant after 5 years). OHS was preoperatively 30 (24-35) and increased with 10 (4.5-17) points after 2 years and 7 (4-15) after 5 years. HHS was preoperatively 69 (63-74) and increased with 27 (22-34) points after 2 years and 26 (24-30) after 5 years. Apart from screw removal of fixation material in 20.1% of the patients 2 hips (0.9%) were converted to total hip arthroplasty.
Conclusions: PAO for AR surgery leads to favorable outcomes in all PROMs suggesting PAO as an effective treatment of acetabular retroversion with a low frequency of severe complications.
Christina Nielsen Bræmer, Sarah Ankjær Langberg, Stig Storgaard Jakobsen, Søren Reinhold Jakobsen, Hugo Aleixo, Kjeld Søballe, Inger Mechlenburg
Department of Ortopaedics, Aarhus University Hospital ; Department of Ortopaedics, Aarhus University Hospital ; Department of Ortopaedics, Aarhus University Hospital; Department of Ortopaedics, Aarhus University Hospital; , Hospital Pedro Hispano, Matosinhos, Portugal; Department of Ortopaedics, Aarhus University Hospital; Department of Ortopaedics, Aarhus University Hospital
Background: Outcome in patients with acetabular retroversion (AR) treated with reverse periacetabular osteotomy (reverse PAO) is sparsely reported.
Purpose / Aim of Study: The aim of this study was to investigate changes in pain and hip function among patients with AR two years after reverse PAO and to examine whether ‘changes in pain’ is associated with ‘changes in hip function’. In addition, to evaluate patient satisfaction and changes in quality of life (QoL).
Materials and Methods: This was a follow-up study with patient reported outcome data from Aarhus University Hospital Denmark. Pain at rest and during activity was measured with Visual Analogue Scale (VAS), hip function with Hip disability and Osteoarthritis Outcome Score (HOOS) and QoL with Short-Form 36 (SF-36) both preoperatively and two years after reverse PAO in 74 patients. Changes were analyzed using paired t-test. Multiple linear regressions were applied.
Findings / Results: Significant (P < 0.05) and clinically relevant mean improvements in pain and hip function were found. Proportion of responders achieving a minimal detectable important change varied from 51-73%. Positive significant association between ‘changes in pain’ and ‘changes in hip function’ were found (P < 0.05). Significant mean improvement in QoL were found (P < 0.05). The study had a loss to follow-up of 23%.
Conclusions: Two years after reverse PAO, patients diagnosed with AR showed significant and clinically relevant mean improvements in pain and hip function and decreased pain was significantly associated with improved hip function. The majority of patients were satisfied with the results of reverse PAO and QoL were improved towards mean values for the Danish population.
Department of Ortopaedics, Aarhus University Hospital ; Department of Ortopaedics, Aarhus University Hospital ; Department of Ortopaedics, Aarhus University Hospital; Department of Ortopaedics, Aarhus University Hospital; , Hospital Pedro Hispano, Matosinhos, Portugal; Department of Ortopaedics, Aarhus University Hospital; Department of Ortopaedics, Aarhus University Hospital
Background: Outcome in patients with acetabular retroversion (AR) treated with reverse periacetabular osteotomy (reverse PAO) is sparsely reported.
Purpose / Aim of Study: The aim of this study was to investigate changes in pain and hip function among patients with AR two years after reverse PAO and to examine whether ‘changes in pain’ is associated with ‘changes in hip function’. In addition, to evaluate patient satisfaction and changes in quality of life (QoL).
Materials and Methods: This was a follow-up study with patient reported outcome data from Aarhus University Hospital Denmark. Pain at rest and during activity was measured with Visual Analogue Scale (VAS), hip function with Hip disability and Osteoarthritis Outcome Score (HOOS) and QoL with Short-Form 36 (SF-36) both preoperatively and two years after reverse PAO in 74 patients. Changes were analyzed using paired t-test. Multiple linear regressions were applied.
Findings / Results: Significant (P < 0.05) and clinically relevant mean improvements in pain and hip function were found. Proportion of responders achieving a minimal detectable important change varied from 51-73%. Positive significant association between ‘changes in pain’ and ‘changes in hip function’ were found (P < 0.05). Significant mean improvement in QoL were found (P < 0.05). The study had a loss to follow-up of 23%.
Conclusions: Two years after reverse PAO, patients diagnosed with AR showed significant and clinically relevant mean improvements in pain and hip function and decreased pain was significantly associated with improved hip function. The majority of patients were satisfied with the results of reverse PAO and QoL were improved towards mean values for the Danish population.
Josefine Beck Larsen, Stig Storgaard Jakobsen, Theis Muncholm Thillemann, Inger Mechlenburg, Kjeld Søballe
Orthopaedic Surgery, Aarhus University Hospital; Orthopaedic Surgery, Aarhus University Hospital; Orthopaedic Surgery, Aarhus University Hospital; Orthopaedic Surgery, Aarhus University Hospital; Orthopaedic Surgery, Aarhus University Hospital
Background: Only few studies have evaluated long- and mid- term outcomes after periacetabular osteotomy (PAO).
Purpose / Aim of Study: The aim of this study was to investigate: (1) the long-term hip survival rate after PAO; (2) the risk of complications after PAO and (3) the hip function at different follow-up points.
Materials and Methods: We retrospectively reviewed 1385 hips (1126 patients) undergoing PAO between January 2004 and December 2017. Through inquiry to the Danish National Patient Registry we identified conversions to total hip arthroplasty (THA) and complications after PAO. We evaluated the Hip disability and Osteoarthritis Outcome Score (HOOS) obtained preoperatively, and at 6 months, 2, 5, and 10 years follow-up.
Findings / Results: The overall Kaplan Meier hip survival rate was 80.2% (CI: 68.0-88.1) at 14 years. There was a significant difference between age groups. 0.43% had deep vein thrombosis after PAO. The most common complication was PAO screw removal (12.5%). 11.1% had additional hip arthroscopy. At 2-year follow-up, HOOS pain improved by a mean of 25.7 points (CI 23.6- 27.9) and a HOOS pain score ≤50 was observed in 14%.
Conclusions: The three outcomes used in this study allows for a more distinct description of PAO surgery outcome, which can possibly help surgeons in the selection of patients and enable them to inform the patients about the expected PAO outcome.
Orthopaedic Surgery, Aarhus University Hospital; Orthopaedic Surgery, Aarhus University Hospital; Orthopaedic Surgery, Aarhus University Hospital; Orthopaedic Surgery, Aarhus University Hospital; Orthopaedic Surgery, Aarhus University Hospital
Background: Only few studies have evaluated long- and mid- term outcomes after periacetabular osteotomy (PAO).
Purpose / Aim of Study: The aim of this study was to investigate: (1) the long-term hip survival rate after PAO; (2) the risk of complications after PAO and (3) the hip function at different follow-up points.
Materials and Methods: We retrospectively reviewed 1385 hips (1126 patients) undergoing PAO between January 2004 and December 2017. Through inquiry to the Danish National Patient Registry we identified conversions to total hip arthroplasty (THA) and complications after PAO. We evaluated the Hip disability and Osteoarthritis Outcome Score (HOOS) obtained preoperatively, and at 6 months, 2, 5, and 10 years follow-up.
Findings / Results: The overall Kaplan Meier hip survival rate was 80.2% (CI: 68.0-88.1) at 14 years. There was a significant difference between age groups. 0.43% had deep vein thrombosis after PAO. The most common complication was PAO screw removal (12.5%). 11.1% had additional hip arthroscopy. At 2-year follow-up, HOOS pain improved by a mean of 25.7 points (CI 23.6- 27.9) and a HOOS pain score ≤50 was observed in 14%.
Conclusions: The three outcomes used in this study allows for a more distinct description of PAO surgery outcome, which can possibly help surgeons in the selection of patients and enable them to inform the patients about the expected PAO outcome.
Nissa Khan, Henrik Morville Schrøder, Michael Mørk Petersen, Kim Lyngby Mikkelsen
Department of Orthopaedic Surgery, Holbæk Hospital; Department of Orthopaedic Surgery, Næstved Hospital; Department of Orthopaedic Surgery, Rigshospitalet; The Danish Patient Compensation Association,
Background: In Denmark, 107.837 primary total hip arthroplasties (THA) were performed during 2005-2016. As patient safety awareness increases, a source of insight is data on health care-related injuries from patient compensation administration. Studies show a rise in claims due to higher expectations of treatment and outcomes, greater awareness of medical errors, and hence, lower levels of confidence and trust in the health care system. The majority of filed orthopaedics claims are from elective surgery, and many successful claims might have a preventable cause.
Purpose / Aim of Study: We examined the Danish Patient Compensation Association (DPCA) database to outline the frequency and financial burden of compensation claims after primary THA in Denmark.
Materials and Methods: This was a retrospective study of closed compensation claims following THA reported to DPCA between 1st of January 2005 and 31st of December 2016. The primary cause for claim was included.
Findings / Results: There were 29.370 orthopaedic patient claims in the DPCA from which 9.4% was due to primary THA (2759 cases i.e. 2.6% of all THAs performed in this period). The approval rate was 54%. Despite an increase in the number of THAs being carried out, the number of claims filed was stagnant, except for a spike of MoM prosthesis-cases. The total pay-out was DKK 192,494,484, and 87% of this was due to nerve damage (DKK 58,137,721), infection (DKK 38,611,026), MoM prosthesis (DKK 31,343,184), insufficient or incorrect treatment (DKK 25,788,714), and fracture (DKK 13,707,826). Nerve injury (17%), insufficient or incorrect treatment (16%) and MoM- prosthesis (15%) were the three most common causes for hip claims. However, those most likely to result in pay-out were nerve damage (84%), tendon injury (75%) and equipment failure during treatment (73%).
Conclusions: 2.6% of all primary THAs resulted in a compensation claim reported to DPCA and 54% of these were approved. The majority of pay-outs were due to nerve damage, infection, MoM prostheses, insufficient or incorrect treatment, and fracture. Although DPCA manages claims for patients, the data can also provide beneficial feedback to arthroplasty surgeons with the aim of improving patient care.
Department of Orthopaedic Surgery, Holbæk Hospital; Department of Orthopaedic Surgery, Næstved Hospital; Department of Orthopaedic Surgery, Rigshospitalet; The Danish Patient Compensation Association,
Background: In Denmark, 107.837 primary total hip arthroplasties (THA) were performed during 2005-2016. As patient safety awareness increases, a source of insight is data on health care-related injuries from patient compensation administration. Studies show a rise in claims due to higher expectations of treatment and outcomes, greater awareness of medical errors, and hence, lower levels of confidence and trust in the health care system. The majority of filed orthopaedics claims are from elective surgery, and many successful claims might have a preventable cause.
Purpose / Aim of Study: We examined the Danish Patient Compensation Association (DPCA) database to outline the frequency and financial burden of compensation claims after primary THA in Denmark.
Materials and Methods: This was a retrospective study of closed compensation claims following THA reported to DPCA between 1st of January 2005 and 31st of December 2016. The primary cause for claim was included.
Findings / Results: There were 29.370 orthopaedic patient claims in the DPCA from which 9.4% was due to primary THA (2759 cases i.e. 2.6% of all THAs performed in this period). The approval rate was 54%. Despite an increase in the number of THAs being carried out, the number of claims filed was stagnant, except for a spike of MoM prosthesis-cases. The total pay-out was DKK 192,494,484, and 87% of this was due to nerve damage (DKK 58,137,721), infection (DKK 38,611,026), MoM prosthesis (DKK 31,343,184), insufficient or incorrect treatment (DKK 25,788,714), and fracture (DKK 13,707,826). Nerve injury (17%), insufficient or incorrect treatment (16%) and MoM- prosthesis (15%) were the three most common causes for hip claims. However, those most likely to result in pay-out were nerve damage (84%), tendon injury (75%) and equipment failure during treatment (73%).
Conclusions: 2.6% of all primary THAs resulted in a compensation claim reported to DPCA and 54% of these were approved. The majority of pay-outs were due to nerve damage, infection, MoM prostheses, insufficient or incorrect treatment, and fracture. Although DPCA manages claims for patients, the data can also provide beneficial feedback to arthroplasty surgeons with the aim of improving patient care.