Total Joint Replacement Educational Series: Distinguishing Fact from Fiction

TOPIC 6: SURPRISING STATISTICS ABOUT
KNEE AND HIP REPLACEMENT SURGERY

• The upward trends in the utilization of total hip and knee replacement between 1969 and 2003 detail the national need for these procedures.
• The age and gender-adjusted incidence per 100,000 person-years significantly increased from 1971 to 2003, representing a >400% increase in the incidence of total knee replacement (as compared with a 55% increase in total hip replacement during the same period).
• There was a significantly higher utilization rate for women.
• The incidence increased with the patient's age for total knee replacement, except in patients more than eighty years old.
• The largest percentage increase was in patients less than fifty years old.
• There was a significant increase in the proportion of total knee replacements performed for the treatment of osteoarthritis, from 51% during 1971-1975 to 92% in 2000- 2003.
• This also reflects a reduction in the incidence of total knee replacements performed for the treatment of rheumatoid arthritis over the same period.
• It is projected that the number of primary total knee replacements will increase from 450,400 to 3.48 million by 2030, compared with a growth in the number of primary total hip replacements from 208,600 to 572,100 during the same interval.
• The volume of revision total hip replacements is projected to grow from 40,800 in 2005 to 96,700 in 2030 (a 137% increase).
• The volume of revision total knee replacements is projected to grow from 38,300 in 2005 to 268, 200 in 2030 (a 600% increase).
• The continued and rapid growth of utilization of total knee replacement reflects a trend that will require additional resources in the future.
• This dramatically increased demand for replacement procedures will require additional discussions regarding the distribution of economic resources; the allocation of surgeons, facilities and resources; and improved operative efficiency.
• Additionally, given the growth in the number of procedures in the younger, more active patients, implant longevity will require further enhancement.