Article

Kurtz SM, Mowat F, Ong K, et al. Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002

Exponent Inc., 3401 Market Street, Suite 300, Philadelphia, PA 19104, USA.
The Journal of Bone and Joint Surgery (Impact Factor: 5.28). 08/2005; 87(7):1487-97. DOI: 10.2106/JBJS.D.02441
Source: PubMed

ABSTRACT

The purpose of this study was to quantify the procedural rate and revision burden of total hip and knee arthroplasty in the United States and to determine if the age or gender-based procedural rates and overall revision burden are changing over time.
The National Hospital Discharge Survey (NHDS) for 1990 through 2002 was used in conjunction with United States Census data to quantify the rates of primary and revision arthroplasty as a function of age and gender within the United States with use of methodology published by the American Academy of Orthopaedic Surgeons. Poisson regression analysis was used to evaluate the procedural rate and to determine year-to-year trends in primary and revision arthroplasty rates as a function of both age and gender.
Both the number and the rate of total hip and knee arthroplasties (particularly knee arthroplasties) increased steadily between 1990 and 2002. Over the thirteen years, the rate of primary total hip arthroplasties per 100,000 persons increased by approximately 50%, whereas the corresponding rate of primary total knee arthroplasties almost tripled. The rate of revision total hip arthroplasties increased by 3.7 procedures per 100,000 persons per decade, and that of revision total knee arthroplasties, by 5.4 procedures per 100,000 persons per decade. However, the mean revision burden of 17.5% for total hip arthroplasty was more than twice that for total knee arthroplasty (8.2%), and this did not change substantially over time.
The number and prevalence of primary hip and knee replacements increased substantially in the United States between 1990 and 2002, but the trend was considerably more pronounced for primary total knee arthroplasty.
The reported prevalence trends have important ramifications with regard to the number of joint replacements expected to be performed by orthopaedic surgeons in the future. Because the revision burden has been relatively constant over time, we can expect that a greater number of primary replacements will result in a greater number of revisions unless some limiting mechanism can be successfully implemented to reduce the future revision burden.

Download full-text

Full-text

Available from: Steven M Kurtz, Jan 08, 2014
  • Source
    • "[14] TKA procedures in the United States are estimated to rise by 673% or more by 2030. [14] [17] In the past, there have been numerous studies on the epidemiology and efficacy of TKA in the elderly population (patients over 65 years); however, few studies looked at the epidemiology and use of TKA in the young adult or pediatric populations. [5] [9] [11] [15] [18] [19] Although TKA procedure frequency has been increasing in the adolescent population, information regarding this population's primary indications and demographics is still limited . "

    Full-text · Article · Sep 2015
  • Source
    • "Most patients experience dramatic pain relief, increased activity in daily life, and restored quality of life after THA. Because of the aging global population, the number of primary and revised THA procedures performed each year has increased significantly [1]. Moreover, the number of revision surgeries has increased annually, despite advances in surgical techniques and implant designs [2]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: In the construction of artificial hip joint replacements, the surface and substrate of a cross-linked polyethylene (CLPE) liner are designed to achieve high wear resistance and prevent infection by bacteria. In this study, we fabricated a highly hydrophilic and antibiofouling poly(2-methacryloyloxyethyl phosphorylcholine [MPC]) (PMPC)-graft layer on the vitamin E-blended CLPE (HD-CLPE(VE)) surface. The 100-nm-thick, smooth, and electrically neutral PMPC layer was successfully fabricated on the HD-CLPE(VE) surface using photoinduced graft polymerization. The PMPC-grafted HD-CLPE(VE) was found to prevent bacterial adherence and biofilm formation on the surface because of the formation of a highly hydrophilic polyzwitterionic layer on the surface of HD-CLPE(VE), which can serve as an extremely efficient antibiofouling layer. The number of bacterial adhered on the PMPC-grafted HD-CLPE(VE) surface was reduced by 100-fold or more by PMPC grafting, regardless of the biofilm-production characteristics of the strains. In contrast, vitamin E blending did not affect bacterial adhesion. Moreover, the number of planktonic bacteria did not differ significantly, regardless of PMPC grafting and vitamin E blending. In conclusion, the PMPC-grafted HD-CLPE(VE) provided bacteriostatic effects associated with smooth, highly hydrophilic surfaces with a neutral electrostatic charge owing to the zwitterionic structure of the MPC unit. Thus, this modification may prove useful for the production of artificial hip joint replacement materials. Copyright © 2015. Published by Elsevier Ltd.
    Full-text · Article · Jun 2015 · Acta biomaterialia
  • Source
    • "The higher revision rate found in the current study in MB-TKA has also been described by Gupta et al[33], with five years follow-up. Longer follow-up is necessary to provide a complete picture of the revision rates, since revision rates become higher as time progresses after placement[2]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: New insert types have been developed to improve clinical and functional outcome in mobile bearing (MB-TKA) and fixed bearing total knee arthroplasty (FB-TKA). A prospective single blinded randomised controlled clinical trial was performed to evaluate 2 types of MB-TKA inserts and 2 types of FB-TKA inserts of the Genesis II prosthesis (Smith & Nephew) in 146 patients with 5-years follow-up. A significant difference (P=.042) between the MB-TKA inserts was found in KSS function scores, but clinical significance is expected to be limited. Goniometry, temporal gait parameters and QoL were similar in all groups. Survival was significantly better (P=.047) for FB-TKA. The comparable outcome and higher revision rate in MB-TKA indicate that FB-TKA may be preferential for the Genesis II implant system. Copyright © 2015. Published by Elsevier Inc.
    Full-text · Article · May 2015 · The Journal of Arthroplasty
Show more