Long-term registration has improved the quality of hip replacement - A review of the Swedish THR Register comparing 160,000 cases

The Swedish Hip Register has defined the epidemiology of total hip replacem ent in Sweden. Most hip implants are fully cemented. Serious complications and rates of revision have declined significantly despite an increasing num ber of patients at risk. During the past 5 years, only 8-9% of hip replacem ents are revisions. Aseptic loosening with or without osteolysis is the maj or problem and constitutes 71% of the revisions, but the incidence had decr eased three times during the past 15 years to less than 3% at 10 years. The effectiveness of the surgical technique is the most important factor for r educing the risk of revision because of aseptic loosening, but choice of im plant is also important. In practice, total hip replacement in Sweden has i mproved, as judged by information from this Register about individualized p atient risks, implant safety, and the greater efficacy of surgical and ceme nting techniques.