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The benefits of collaboration: the Nordic Arthroplasty Register Association

Journal article
Authors K. T. Makela
O. Furnes
G. Hallan
A. M. Fenstad
Ola Rolfson
Johan Kärrholm
C. Rogmark
A. B. Pedersen
O. Robertsson
A. W-Dahl
A. Eskelinen
H. M. Schroder
V. Aarimaa
J. V. Rasmussen
B. Salomonsson
R. Hole
S. Overgaard
Published in Efort Open Reviews
Volume 4
Issue 6
Pages 391-400
ISSN 2058-5241
Publication year 2019
Published at Institute of Clinical Sciences, Department of Orthopaedics
Pages 391-400
Language en
Keywords Nordic Arthroplasty Register Association (NARA), total joint arthroplasty, minimal dataset, statistical, total hip-arthroplasty, knee arthroplasty, statistical-analysis, increased risk, revision, replacements, survival, thas, infection, countries
Subject categories Orthopedics


The Nordic Arthroplasty Register Association (NARA) was established in 2007 by arthroplasty register representatives from Sweden, Norway and Denmark with the overall aim to improve the quality of research and thereby enhance the possibility for quality improvement with arthroplasty surgery. Finland joined the NARA collaboration in 2010. NARA minimal hip, knee and shoulder datasets were created with variables that all countries can deliver. They are dynamic datasets, currently with 25 variables for hip arthroplasty, 20 for knee arthroplasty and 20 for shoulder arthroplasty. NARA has published statistical guidelines for the analysis of arthroplasty register data. The association is continuously working on the improvement of statistical methods and the application of new ones. There are 31 published peer-reviewed papers based on the NARA databases and 20 ongoing projects in different phases. Several NARA publications have significantly affected clinical practice. For example, metal-on-metal total hip arthroplasty and resurfacing arthroplasty have been abandoned due to increased revision risk based on i.a. NARA reports. Further, the use of uncemented total hip arthroplasty in elderly patients has decreased significantly, especially in Finland, based on the NARA data. The NARA collaboration has been successful because the countries were able to agree on a common dataset and variable definitions. The collaboration was also successful because the group was able to initiate a number of research projects and provide answers to clinically relevant questions. A number of specific goals, set up in 2007, have been achieved and new one has emerged in the process.

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