First outcome results after total knee and hip replacement from the Lithuanian arthroplasty register.

BACKGROUND AND OBJECTIVE: In 2010, the Lithuanian Association of Arhtroplasty was established and on January 1, 2011, initiated a national study of all reoperations after total knee (TKR) and total hip replacement (THR) in Lithuania. The aim of the study was to investigate the revision rates after TKR and THR at two years follow-up. MATERIALS AND METHODS: Lithuanian patients undergoing primary TKR and THR from January 1, 2011, to December 31, 2012, were included in the study. The patient, surgery and prosthetic implantation data were collected via internet database. For reoperations we recorded the reason and type of revision, primary implantation date. We analyzed implant survival rates using any revision as an endpoint on included primary procedures, performed until September 1, 2013. RESULTS: The completeness of the register verified with state patients fund data reached 85% of all replacements. Out of 3823 primary TKR during the study period 25 revisions were performed with overall implant survival rate 99%. The main reason for knee revision was infections. During the inclusion period we registered 6072 primary THR and 149 revisions with overall implant survival rate 97%. Recurrent dislocation of prosthetic component was the main reason for hip revision. Significantly inferior survival results for femoral neck fracture patients were observed as compared with patients operated for osteoarthritis. Posterior approach as compared to others significantly affected inferior implant survival rates for femoral neck fracture patients. CONCLUSIONS: The overall survival after total knee and hip replacements revealed a high treatment quality of this surgery in Lithuania.

Femoral neck fractures in Lithuania and Sweden. The differences in care and outcome.

PURPOSE: Hip fractures constitute a serious and common health problem from both individual and public health perspectives. Unified data collection and comparison between countries is recognised as an effective tool for care improvements. However, the variation in patients' demography, treatment methods and other local cultural aspects in different countries should be considered. The aim of our study was to compare femoral neck fracture patients treated in Kaunas and Lund, concerning functional outcome and quality of life. METHODS: We investigated 99 patients treated by arthroplasty in Kaunas Clinics and 117 patients in Lund University Hospital. Patients were investigated according to the National Swedish Hip Fracture Register model and were followed up for a period of four months after the injury. The patient's place of residence, mobility, complaints of pain and additional hospital stay were recorded. The EQ-5D questionnaire was used to evaluate quality of life. RESULTS: Patients in Kaunas were significantly younger, had lower ASA grade and were more mobile before trauma and at four moths follow-up. However, when comparing quality of life at four months follow-up between the institutions, Lund patients reported significantly better self care, felt less pain and discomfort, and had less symptoms of anxiety and depression. CONCLUSIONS: The difference observed in quality of life rating between institutions might be related to local cultures of the countries and should be considered when comparing the data.

Factors affecting health-related quality of life in patients after femoral neck fracture.

Quality of life in patients with femoral neck fracture is an issue frequently discussed in the literature. There is ongoing research on identifying factors that have an impact on quality of life in this particular group of patients. A great variety of factors affecting quality of life and lack of information on their importance encouraged us to perform a systematic literature review analyzing quality of life of patients who sustained femoral neck fracture. The search was performed in the PubMed and Medline databases according to the selected key words. In our systematic review, we included clinical and clinical randomized trials investigating patients with femoral neck fracture and their quality of life. Our analysis showed that treatment of femoral neck fracture with hip replacement was superior to osteosynthesis with regard to patients' quality of life. The data regarding the impact of different rehabilitation programs on quality of life were controversial; a few reports showed that special rehabilitation programs were associated with better health-related quality life. However, other studies did not report any differences in patients' quality of life when different rehabilitation programs were applied. Patient's nutrition may be an important factor affecting the quality of life in patients with femoral neck fractures; however, data supporting this fact are insufficient.