Increased incidence of primary total hip replacement in rural communities

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Abstract
Using data from operating theatre registers and the Scottish Morbidity Record, we identified 2053 patients who had undergone a primary total hip arthroplasty between 1 September 1991 and 28 February 1993 in the 16 hospitals in the west of Scotland that performed such surgery. Reasons for surgery included all diagnoses except fractured neck of femur. We reviewed 2035 (98%) case notes, verified the type of operation, and identified the patient's postcode of residence. We determined whether each postcode sector was urban or rural according to census data from the registrar general, using the definition that an urban postcode contains at least five people per hectare while a rural postcode contains four or fewer.3

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