Arthroplasty Rates Not Increasing in Young Patients With Rheumatoid Arthritis: A National Database Review, 2005...

Area of Science:

• Orthopedic Surgery
• Rheumatology
• Health Services Research

Background:

• Authors have long predicted increased total knee arthroplasty (TKA) and total hip arthroplasty (THA) utilization.
• Biological disease-modifying antirheumatic drugs have transformed rheumatoid arthritis (RA) treatment, aiming to prevent joint damage and reduce the need for prosthetic surgery.

Purpose of the Study:

• To compare TKA and THA utilization trends in young patients (<65 years) with RA versus osteoarthritis (OA) between 2005 and 2014.

Main Methods:

• The Truven MarketScan Database, encompassing over 46 million individuals, was queried using ICD-9 and CPT codes.
• Incidence rates of THA and TKA were determined for RA and OA patients under 65 during the final decade of ICD-9 coding.
• Statistical analyses included t-tests, chi-square tests, and Breslow-Day tests, with exclusion of patients with potentially confounding codes.

Main Results:

• For osteoarthritis patients, TKA rates rose by 42.9% (0.07% to 0.1%) and THA rates by 66.0% (0.04% to 0.06%) from 2005 to 2014 (P < .001 for both).
• In contrast, TKA rates for rheumatoid arthritis patients remained stable at 1.06% in 2005 and 1.04% in 2014 (P = .65).
• THA rates for RA patients also showed minimal change, from 0.44% to 0.48% (P = .14).

Conclusions:

• A significant increase in THA and TKA rates was observed in osteoarthritis patients under 65 between 2005 and 2014.
• These trends were not mirrored in the rheumatoid arthritis population, where arthroplasty rates remained unchanged.