Projected burden of femoral fracture surgeries in Japan through 2035: a nationwide population-based modeling study

This study aimed to calculate short- to mid-term projections of the number of bipolar hemiarthroplasty (BHA) and open reduction and internal fixation (ORIF) procedures for femoral fractures in Japan from 2025.

We conducted a nationwide population-based modeling study to predict the number of BHA and ORIF procedures to be performed for femoral fractures in Japan between 2025 and 2035. BHA and ORIF data between 2018 and 2022 were obtained from the National Database of Health Insurance Claims and Specific Health Checkups of Japan Open Data. Population data were sourced from the Population Census and the National Institute of Population and Social Security Research. Poisson regression models were fitted by sex and 10-year age strata (aged ≥ 40 years), with procedure year as an explanatory variable and population size as an offset.

The projected numbers of BHA in women and men are 61,799 (prediction interval [PI], 60,154-63,507) and 20,715 (PI, 19,697-21,802) in 2025, 72,545 (PI, 68,921-76,414) and 26,179 (PI, 23,770-28,894) in 2030, and 82,713 (PI, 76,127-88,804) and 31,743 (PI, 27,452-36,845) in 2035, respectively. The projected numbers of ORIF in women and men are 95,525 (PI, 93,556-97,554) and 25,545 (PI, 24,411-26,741) in 2025, 94,731 (PI, 91,031-98,653) and 26,050 (PI, 23,847-28,492) in 2030, and 91,422 (PI, 86,149-97,170) and 26,046 (PI, 22,770-29,868) in 2035, respectively.

The projected increases in BHA and generally stable ORIF numbers with fluctuations through 2035, with more reliable short-term estimates, will inform timely healthcare planning.

This modeling study projected the number of femoral fracture surgeries in Japan between 2025 and 2035. The number of bipolar hemiarthroplasty procedures in Japan is projected to increase over the next decade. In contrast, the number of open reduction and internal fixation procedures is projected to remain stable, with fluctuations.