Presentation Abstract

Session: P001-P110-Adult Reconstruction Hip Posters
Date/Time: Tuesday, Mar 11, 2014, 8:00 AM - 3:00 PM
Presentation Number: P057
Posterboard Number: P057
Title: Prevalence of Total Hip (THA) and Total Knee (TKA) Arthroplasty in the United States
Classification: +Primary THA (Hip)
Keywords: Miscellaneous; Miscellaneous
Author(s): Hilal Maradit-Kremers, MD, MSc, Rochester, Minnesota
Cynthia S. Crowson, Rochester, Minnesota
Dirk Larson, Rochester, Minnesota
William A. Jiranek, MD, Richmond, Virginia
Daniel J. Berry, MD, Rochester, Minnesota
Abstract: BACKGROUND: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) procedure rates have increased in recent years. So far, studies on descriptive epidemiology of THA and TKA have mainly focused on annual procedures volumes (incidence). However, incidence is an incomplete account of the growing societal and economic burden of THA and TKA. The prevalence of the growing number of patients living with an artificial hip or knee joint in the United States (U.S.) is currently unknown.
OBJECTIVE: To estimate the current prevalence of THA and TKA in the general population.
METHODS: Prevalence was calculated by combining THA-TKA incidence rates, mortality rates for the general population and relative mortality rates (i.e., difference in survival between THA-TKA patients and the general population) following THA and TKA. Calendar year-, state-, sex- and age-specific estimates of THA-TKA incidence rates were gathered dating back to 1969 using population-based data sources and the Dartmouth Atlas. Poisson regression models with smoothing splines were used to model incidence rates over time. Relative mortality rates were obtained from a population-based cohort by comparing the survival distribution among THA and TKA patients and the general population. THA-TKA prevalence estimates were then combined with calendar year-, state-, sex- and age-specific United States Census data to calculate the number of people with THA and TKA in the United States.
RESULTS: We estimate that the 2010 prevalence of THA and TKA in the entire U.S. population is 1.5% and 2.2%, respectively. Prevalence of THA and TKA among adults 50 years or older is 4.4% and 6.7%, respectively. Prevalence of both the THA and TKA is higher in women than in men. Prevalence increases with increasing age, especially for TKA. At 50 years of age, prevalence of THA and TKA is 0.7% and 0.6% respectively. THA prevalence increases to 1.9% at 60 years, 4.6% at 70 years and 10%% at 80 years. TKA prevalence increases to 2.9% at 60 years, 8.4% at 70 years and 16%% at 80 years. These prevalence estimates translate into 4.5 million people (2.5 million women, 2 million men) living with an artificial hip and 6.7 million people (4.1 million women, 2.6 million men) living with an artificial knee in the United States in 2010. The three states with the highest number of prevalent THA and TKA patients are California, Florida and Texas. The two states with the lowest prevalence are Alaska and Hawaii.
CONCLUSION: A total of 4.5 and 6.7 million people in the US are currently living with an artificial hip or knee. If current trends continue, this number is likely to increase in the coming decades and will create significant challenges for provision of specialized healthcare services, and for management of revision surgeries and long-term complications.

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