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Trends in Medicare Arthroplasty Procedure Volume: Projecting From 2025 to 2040
Conor M Jones1, Ajay S Potluri1, Vincent P Federico1
1Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
Background:
Characterizing and forecasting trends in total joint arthroplasty (TJA) utilization among Medicare beneficiaries has important implications for resource allocation. This study reports and predicts trends in primary and revision TJA among Medicare patients.
Methods:
Patients were retrospectively identified from 2013 to 2022, which were published by the Centers for Medicare and Medicaid Services. Procedure volume was adjusted for Medicare Advantage enrollment. Primary and revision TJA patients were identified by Current Procedural Terminology codes. Linear and Poisson regression modeling was used to predict TJA volume from 2025 to 2040. Annual growth rates were calculated using historic and predicted data.
Results:
The annual adjusted primary total knee arthroplasty (TKA) volume increased from 603,704 in 2013 to 1,013,533 in 2022 and is projected to reach 2,793,919 by 2040, with an annual growth rate of 5.9% from 2023 to 2040. Annual primary total hip arthroplasty (THA) volume increased from 305,082 in 2013 to 594,981 in 2022 and is projected to reach 2,174,382 by 2040 with an annual growth rate of 7.6% from 2023 to 2040. Revision TKA volume increased from 53,446 in 2013 to 78,937 in 2022 and is projected to reach 227,515 by 2040, with an annual growth rate of 5.7% from 2023 to 2040. Revision THA volume increased from 44,872 in 2013 to 49,471 in 2022 and is projected to increase to 67,620 by 2040, with an annual growth rate of 1.6% from 2023 to 2040.
Conclusion:
Growth in primary TKA and THA is expected to continue and outpace national health expenditure. Revision THA volume is expected to increase modestly but underperform primary THA, suggesting that improvements in primary THA care may be reducing revision rates. The COVID pandemic does not seem to have had lasting impacts on TJA utilization.
Level Of Evidence:
Therapeutic level III.
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