Projections of the annual rates of total hip arthroplasty (THA) and total knee arthroplasty between the years 2020 and 2040 indicate that a significant increase is expected overall, as well as across age groups and both sexes, according to a study published in The Journal of Rheumatology.

Researchers analyzed data from the US National Inpatient Sample from 2000 to 2014 in tandem with Census Bureau data to develop projections for the use of total hip arthroplasty and total knee arthroplasty from 2020 to 2040, and then examined these projections by age and sex. Demographic characteristics and joint replacement information were extracted from the database.

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Based on their review of the data, researchers predicted that the total annual counts (95% prediction intervals) of total hip arthroplasty may increase by 34% in 2020 to 498,000 replacements; by 75% in 2025 to 652,000 replacements; by 129% in 2030 to 850,000 replacements, and by 284% in 2040 to 1,429,000 replacements. The annual number of total knee arthroplasty is predicted to increase by 56% in 2020 to 1,065,000 replacements; by 110% in 2025 to 1,272,000 replacements; by 182% in 2030 to 1,921,000 replacements; and by 401% in 2040 to 3,416,000 replacements. Trends were similar for both total hip and total knee arthroplasty, with replacements occurring slightly more frequently in women and in individuals aged 45 to 64 years and 65 to 84.

Limitations of this study include the assumption that joint replacements will continue to increase, the possibility that significant breakthroughs in technology could lower replacement rates, and the potential for changes in healthcare policy that could affect replacement surgeries.

The researchers concluded that these significantly higher predictions of total joint replacements could indicate that “[a] policy change may be needed to meet increased demand.”

Reference

Singh JA, Yu S, Chen L, Cleveland JD. Rates of total joint replacement in the United States: future projections to 2020–2040 using the National Inpatient Sample [published online April 15, 2019]. J Rheumatol. doi: 10.3899/jrheum.170990