RT Journal Article
SR Electronic
T1 Rates of Total Joint Replacement in the United States: Future Projections to 2020–2040 Using the National Inpatient Sample
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.170990
DO 10.3899/jrheum.170990
A1 Jasvinder A.  Singh
A1 Shaohua Yu
A1 Lang Chen
A1 John D.  Cleveland
YR 2019
UL http://www.jrheum.org/content/early/2019/04/09/jrheum.170990.abstract
AB Objective To project future total hip and knee joint arthroplasty (THA, TKA) use in the United States to 2040. Methods We used the 2000–2014 US National Inpatient Sample (NIS) combined with Census Bureau data to develop projections for primary THA and TKA from 2020 to 2040 using polynomial regression to account for the nonlinearity and interactions between the variables, assuming the underlying distribution of the number of THA/TKA to be Poisson distributed. We performed sensitivity analyses using a negative binomial regression to account for overdispersion. Results Predicted total annual counts (95% prediction intervals) for THA in the United States by 2020, 2025, 2030, and 2040 are (in thousands): 498 (475, 523), 652 (610, 696), 850 (781, 925), and 1429 (1265, 1615), respectively. For primary TKA, predicted total annual counts for 2020, 2025, 2030, and 2040 are (in thousands): 1065 (937, 1211), 1272 (1200, 1710), 1921 (1530, 2410), and 3416 (2459, 4745), respectively. Compared to the available 2014 NIS numbers, the percent increases in projected total annual US use for primary THA and TKA in 2020, 2025, 2030, and 2040 are as follows: primary THA, by 34%, 75%, 129%, and 284%; and primary TKA, 56%, 110%, 182%, and 401%, respectively. Primary THA and TKA use is projected to increase for both females and males, in all age groups. Conclusion Significant increases in use of THA and TKA are expected in the United States in the future, if the current trend continues. The increased use is evident across age groups in both females and males. A policy change may be needed to meet increased demand.