Variation in hip replacement rates and surgical workforce across Nordic European countries.

purposeCare-seeking behaviour for osteoarthritis is shaped by more than radiographic severity. Psychosocial factors and resource availability also play key roles. This study explores two questions: (1) How do hip replacement rates vary among Nordic European countries? (2) What is the relationship between hip replacement rates and factors such as the surgeon-to-inhabitant ratio and a country’s GDP (Gross Domestic Product)?

methodsThis quantitative analysis examined orthopaedic surgeon numbers, hip replacement rates, and GDP per capita in the Nordic European countries using data from the Nordic Orthopedic Federation (NOF) and national registries. Descriptive statistics and regression analyses assessed correlations.

resultsWe identified an annual average of 205.5 hip replacements per 100,000 inhabitants (SD: ±28.4), with Sweden reporting the highest rate of 261.3 and Denmark the lowest, 171.5. The average number of orthopaedic surgeons per 100,000 inhabitants was 8.9 (SD: ±4.0), with Sweden having the highest ratio (13.8) and the Netherlands the lowest (4.4).The annual average number of hip replacements per surgeon, was 27.9 (SD: ±13.4), with Lithuania demonstrating the highest value, 48.0, and Norway the lowest, 14.0. Neither an increased surgeon-to-inhabitant ratio nor a higher GDP are associated with an increase in hip replacement rates.

conclusionThere is a considerable variation in hip replacement rates, surgeon availability, and surgeon productivity across Nordic European countries. Given the comparable prevalence of radiographic hip osteoarthritis across these nations and our finding that a higher surgeon-to-inhabitant ratio does not correlate with increased hip replacement rates, it is likely that cultural differences in psychosocial traits may be key drivers of the observed variation.