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The number of total knee replacement surgeries performed in the U.S. has doubled in the last decade, exceeding 600,000 in 2009, according to data from the Healthcare Cost & Utilization Project, Agency for Healthcare Research and Quality. In a study presented at this year’s American Academy of Orthopaedic Surgeons annual meeting, BWH researchers set out to track the overall public health impact resulting from this growing number of surgeries.
Using a computer-simulation model, along with U.S. Census and published data, a group of researchers led by Elena Losina, PhD, co-director, Orthopaedic and Arthritis Center for Outcomes Research, BWH Department of Orthopaedic Surgery, conducted a study tracking total knee replacement surgery in the U.S. She found that roughly 4.7 percent of the population aged 50 years or older, or 4.5 million Americans, have had total knee replacement surgery.
Women were more likely to have had a total knee replacement than men, 5.3 percent vs. 4.1 percent, respectively. For Americans aged 60 to 69, 4.9 percent of women and 4.1 percent of men have had at least one knee replaced. The numbers jump to 8.2 percent in women and 7.1 percent in men aged 70 to 79. Most total knee replacements are performed to treat osteoarthritis.
The researchers note that total knee replacement surgery has increased among younger individuals. According to data from the Healthcare Cost & Utilization Project, in 2000 the average age of a person having total knee replacement surgery was 68. In 2009, the average age dropped to 66.
Impact on Care
Given that Americans are having knee replacements at a younger age and that people are living longer, the number of Americans living with a knee replacement will increase further. This may lead to higher health care costs, as well as risk of prosthetic infections and wear-and-tear over time.
According to Losina, the study findings will be helpful as health care systems plan services for younger patients with prosthetic knees. Services may include preventing and managing fractures and infections surrounding the prosthetic, as well as planning for follow-up knee surgeries.
The findings also provide an outlet for health care providers to evaluate the pros and cons of prescribing total knee replacements to younger patients.
“This data could help physicians and surgeons have discussions about consequences of having total knee replacement earlier in life with respect to balancing the likely improvement in quality of life and function during active years, and potentially living long enough to require revision surgery,” said Losina.
The study was funded by the National Institute of Arthritis, Musculoskeletal and Skin Diseases at the National Institutes of Health.