Prevalence of Total Hip and Knee Replacement in the United States.

BACKGROUND Descriptive epidemiology of total joint replacement procedures is limited to annual procedure volumes (incidence). The prevalence of the growing number of individuals living with a total hip or total knee replacement is currently unknown. Our objective was to estimate the prevalence of total hip and total knee replacement in the United States. METHODS Prevalence was estimated using the counting method by combining historical incidence data from the National Hospital Discharge Survey and the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 1969 to 2010 with general population census and mortality counts. We accounted for relative differences in mortality rates between those who have had total hip or knee replacement and the general population. RESULTS The 2010 prevalence of total hip and total knee replacement in the total U.S. population was 0.83% and 1.52%, respectively. Prevalence was higher among women than among men and increased with age, reaching 5.26% for total hip replacement and 10.38% for total knee replacement at eighty years. These estimates corresponded to 2.5 million individuals (1.4 million women and 1.1 million men) with total hip replacement and 4.7 million individuals (3.0 million women and 1.7 million men) with total knee replacement in 2010. Secular trends indicated a substantial rise in prevalence over time and a shift to younger ages. CONCLUSIONS Around 7 million Americans are living with a hip or knee replacement, and consequently, in most cases, are mobile, despite advanced arthritis. These numbers underscore the substantial public health impact of total hip and knee arthroplasties.

[1]  S. Vollset,et al.  Mortality after total hip replacement: 0-10-year follow-up of 39,543 patients in the Norwegian Arthroplasty Register , 2000, Acta orthopaedica Scandinavica.

[2]  Russell S. Kirby,et al.  The Dartmouth Atlas of Health Care , 1998 .

[3]  Fulton Pn,et al.  Population estimates and projections , 1978 .

[4]  A. Mushlin,et al.  Appropriateness criteria and elective procedures--total joint arthroplasty. , 2012, The New England journal of medicine.

[5]  Scott M. Brue,et al.  Data resource profile: the Rochester Epidemiology Project (REP) medical records-linkage system. , 2012, International journal of epidemiology.

[6]  J. Wright,et al.  Demographic variation in the rate of knee replacement: a multi-year analysis. , 1996, Health services research.

[7]  Steven Kurtz,et al.  Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. , 2005, The Journal of bone and joint surgery. American volume.

[8]  B. Yawn,et al.  Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester Epidemiology Project. , 2012, Mayo Clinic proceedings.

[9]  B. Yawn,et al.  American Journal of Epidemiology Practice of Epidemiology Use of a Medical Records Linkage System to Enumerate a Dynamic Population over Time: the Rochester Epidemiology Project , 2022 .

[10]  J. Ranstam,et al.  Increased long-term mortality in patients less than 55 years old who have undergone knee replacement for osteoarthritis: results from the Swedish Knee Arthroplasty Register. , 2007, The Journal of bone and joint surgery. British volume.

[11]  B. Yawn,et al.  History of the Rochester Epidemiology Project: half a century of medical records linkage in a US population. , 2012, Mayo Clinic proceedings.

[12]  D. Midthune,et al.  Two Approaches for Estimating Disease Prevalence from Population‐Based Registries of Incidence and Total Mortality , 1999, Biometrics.

[13]  Kevin Ong,et al.  The epidemiology of revision total hip arthroplasty in the United States. , 2009, The Journal of bone and joint surgery. American volume.

[14]  S M Kurtz,et al.  Economic Burden of Revision Hip and Knee Arthroplasty in Medicare Enrollees , 2006, Clinical orthopaedics and related research.

[15]  Mark D. Huffman,et al.  Heart disease and stroke statistics--2013 update: a report from the American Heart Association. , 2013, Circulation.

[16]  Elena Losina,et al.  Estimating the burden of total knee replacement in the United States. , 2013, The Journal of bone and joint surgery. American volume.

[17]  Graves Ej,et al.  National Hospital Discharge Survey , 2004 .

[18]  Brian R Wolf,et al.  Total knee arthroplasty volume, utilization, and outcomes among Medicare beneficiaries, 1991-2010. , 2012, JAMA.

[19]  Joseph D Zuckerman,et al.  Increasing use of total knee replacement and revision surgery. , 2012, JAMA.

[20]  S. Kurtz,et al.  Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. , 2007, The Journal of bone and joint surgery. American volume.

[21]  Eric R. Ziegel,et al.  The Elements of Statistical Learning , 2003, Technometrics.

[22]  J. Baron,et al.  Short- and long-term mortality following primary total hip replacement for osteoarthritis: a Danish nationwide epidemiological study. , 2011, The Journal of bone and joint surgery. British volume.

[23]  J. Skinner,et al.  Racial, ethnic, and geographic disparities in rates of knee arthroplasty among Medicare patients. , 2003, The New England journal of medicine.

[24]  R. Bourne,et al.  The fate of the remaining knee(s) or hip(s) in osteoarthritic patients undergoing a primary TKA or THA. , 2013, The Journal of arthroplasty.