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Dramatic increase in total knee replacement utilization rates cannot be fully explained by a disproportionate
Orthopedics
|July 15, 2014
Summary
Total knee replacement procedures more than doubled, but the growth was not disproportionately higher in younger patients. The primary increase in knee replacement surgeries occurred in patients aged 65 and older.
Area of Science:
- Orthopedic surgery
- Health services research
- Epidemiology
Background:
- Total knee replacement (TKR) incidence in the US more than doubled between 1999 and 2008.
- A notable increase in TKR procedures was observed, prompting investigation into contributing factors.
Purpose of the Study:
- To evaluate the claim of a disproportionate rise in knee replacements among younger patients.
- To determine the primary drivers behind the overall increase in TKR utilization.
Main Methods:
- Utilized US census data for population demographics across age groups (18-44, 45-64, 65+).
- Acquired annual TKR data from the Agency for Healthcare Research and Quality.
- Calculated per-capita incidence rates and compared observed vs. predicted TKR numbers based on population growth.
Main Results:
- In 2008, approximately 305,000 TKR procedures exceeded predictions based on population growth alone.
- The highest growth in TKR procedures was observed in patients aged 65 and older, increasing from 5.2 to 9.1 per 1,000 individuals.
- The per-capita growth rate was also highest in the 65+ age group.
Conclusions:
- A disproportionate increase in knee replacements among younger patients does not fully explain the overall utilization growth.
- The primary driver of increased TKR procedures is the traditional patient population aged 65 and older.
