ORIGINAL ARTICLEA Population-Based Study of Trends in the Use of Total Hip and Total Knee Arthroplasty, 1969-2008
Section snippets
METHODS
Olmsted County is situated in southeastern Minnesota and is composed of approximately 124,000 people (2000 US Census), of whom 86,000 reside in the county's urban center, Rochester; more than 80% of the county population resides within 5 miles of the city. In 2000, 89% of the population was white and not of Hispanic origin (vs 69% nationwide). Although 25% of the county residents are employed in health care services (vs 8% nationwide) and the level of education is correspondingly higher (30%
RESULTS
From 1969 (when THA was first introduced) through 2008, a total of 2742 primary THAs were performed on 2209 Olmsted County residents. From 1971 (when TKA was first introduced) through 2008, 3488 primary TKAs were performed on 2479 residents. No patient had simultaneous bilateral THA, but 533 patients had both hips replaced on different dates. Three hundred thirty-nine patients had simultaneous bilateral TKA, whereas 670 others had both knees replaced on different dates.
DISCUSSION
This population-based study provides detailed data on trends in the use of THA and TKA among all age groups during a period exceeding 35 years in the United States. The age- and sex-adjusted primary THA use rate increased almost 2-fold between 1969-1972 and 2005-2008. Likewise, the age- and sex-adjusted use of primary TKA among Olmsted County residents increased markedly from 31.2 per 100,000 person-years in 1971-1976 to 220.9 per 100,000 person-years in 2005-2008, a more than 7-fold increase.
CONCLUSION
Our study demonstrates that, in a single US county where access to THA and TKA has been widely available, use rates have increased steadily since the introduction of the procedures, and they continue to increase in all age groups. Use has decreased for patients with rheumatoid arthritis and increased for patients with osteoarthritis. On the basis of these data, the probable need for THA and TKA in the United States exceeds national projections based on the NIS.10
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Cited by (0)
This study was supported in part by research grant AR30582 from the National Institutes of Health, US Public Health Service, and a National Institutes of Health CTSA Award 1 KL2 RR024151-01 (Mayo Clinic Center for Clinical and Translational Research).
An earlier version of this article appeared Online First.
- 1
Dr Singh is now with the Birmingham VA Medical Center and University of Alabama, Birmingham.
- 2
Dr Vessely is now with the Willamette Valley Medical Center, McMinnville, OR
- 3
Dr Berry receives royalties on selected hip and knee implants from DePuy, a Johnson & Johnson Company. Dr Singh has received speaker honoraria from Abbott; research and travel grants from Takeda, Savient, Wyeth, and Amgen; and consultant fees from Savient and URL Pharmaceuticals.