Implementing a hip arthroplasty program in Greenland, the autonomous territory of Denmark: challenges and outcomes

Background and purpose Greenland is undergoing rapid societal change, while its healthcare system faces substantial geographic and structural challenges. In January 2024, a routine program was established for elective total hip arthroplasty (THA) and hip replacements following femoral neck fractures. Patients and methods All patients receiving hip replacement from January 2024 to January 2026 were analyzed retrospectively. Demographic parameters, complications, revision rates, one month mortality were evaluated and compared primarily with register data from Denmark, Greenland’s parent country. Results A total of 123 patients (129 procedures) were assessed. Elective THA patients were younger (60 vs 68 years), had a higher body mass index (BMI) (29.9 vs 27.6), similar American Society of Anesthesiologists (ASA) scores, longer operative times (110 vs 92 min), lower blood loss (ΔHb -2.1 vs -2.3 g/dL), longer length of stay (discharge post-OP day 4.2 vs 1) and substantially higher complication rates than Danish controls. Hip fracture patients were younger (74 vs 79 years), had a lower BMI (23.9 vs 26), had a similar ASA distribution, lower blood loss (ΔHb -1.3 vs -3.4 g/dL), a similar post-OP discharge day (7.9 vs 7), and also numerically higher complication rates than Danish controls. Conclusion Hip arthroplasty outcomes in Greenland were less favorable than in Denmark, likely due to various systemic and patient-related factors. Continuous efforts are required to optimize patient safety and clinical outcomes in this setting.