Literature DB >> 23344005

Estimating the burden of total knee replacement in the United States.

Alexander M Weinstein1, Benjamin N Rome, William M Reichmann, Jamie E Collins, Sara A Burbine, Thomas S Thornhill, John Wright, Jeffrey N Katz, Elena Losina.   

Abstract

BACKGROUND: In the last decade, the number of total knee replacements performed annually in the United States has doubled, with disproportionate increases among younger adults. While total knee replacement is a highly effective treatment for end-stage knee osteoarthritis, total knee replacement recipients can experience persistent pain and severe complications. We are aware of no current estimates of the prevalence of total knee replacement among adults in the U.S.
METHODS: We used the Osteoarthritis Policy Model, a validated computer simulation model of knee osteoarthritis, and data on annual total knee replacement utilization to estimate the prevalence of primary and revision total knee replacement among adults fifty years of age or older in the U.S. We combined these prevalence estimates with U.S. Census data to estimate the number of adults in the U.S. currently living with total knee replacement. The annual incidence of total knee replacement was derived from two longitudinal knee osteoarthritis cohorts and ranged from 1.6% to 11.9% in males and from 2.0% to 10.9% in females.
RESULTS: We estimated that 4.0 million (95% confidence interval [CI]: 3.6 million to 4.4 million) adults in the U.S. currently live with a total knee replacement, representing 4.2% (95% CI: 3.7% to 4.6%) of the population fifty years of age or older. The prevalence was higher among females (4.8%) than among males (3.4%) and increased with age. The lifetime risk of primary total knee replacement from the age of twenty-five years was 7.0% (95% CI: 6.1% to 7.8%) for males and 9.5% (95% CI: 8.5% to 10.5%) for females. Over half of adults in the U.S. diagnosed with knee osteoarthritis will undergo a total knee replacement.
CONCLUSIONS: Among older adults in the U.S., total knee replacement is considerably more prevalent than rheumatoid arthritis and nearly as prevalent as congestive heart failure. Nearly 1.5 million of those with a primary total knee replacement are fifty to sixty-nine years old, indicating that a large population is at risk for costly revision surgery as well as possible long-term complications of total knee replacement.

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Year:  2013        PMID: 23344005      PMCID: PMC3748969          DOI: 10.2106/JBJS.L.00206

Source DB:  PubMed          Journal:  J Bone Joint Surg Am        ISSN: 0021-9355            Impact factor:   5.284


  33 in total

1.  A population-based study of trends in the use of total hip and total knee arthroplasty, 1969-2008.

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2.  A prospective study of 80,000 total joint and 5000 anterior cruciate ligament reconstruction procedures in a community-based registry in the United States.

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3.  Is physical activity a risk factor for primary knee or hip replacement due to osteoarthritis? A prospective cohort study.

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Review 4.  OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009.

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7.  Forecasting the burden of advanced knee osteoarthritis over a 10-year period in a cohort of 60-64 year-old US adults.

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8.  Younger age increases the risk of early prosthesis failure following primary total knee replacement for osteoarthritis. A follow-up study of 32,019 total knee replacements in the Finnish Arthroplasty Register.

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10.  Differences in self-reported health in the Osteoarthritis Initiative (OAI) and Third National Health and Nutrition Examination Survey (NHANES-III).

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  124 in total

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2.  Sex differences in patients with different stages of knee osteoarthritis.

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4.  Loss of cement-bone interlock in retrieved tibial components from total knee arthroplasties.

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5.  Use of Physical Therapy Following Total Knee Replacement Surgery: Implications of Orthopedic Surgeons' Ownership of Physical Therapy Services.

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Review 6.  WITHDRAWN: Peripheral nerve blocks for postoperative pain after major knee surgery.

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7.  In vivo loss of cement-bone interlock reduces fixation strength in total knee arthroplasties.

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8.  The KSS 2011 reflects symptoms, physical activities, and radiographic grades in a Japanese population.

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9.  Total joint replacement outcomes in patients with concomitant comorbidities: a glass half empty or half full?

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10.  Pain Relief for an Osteoarthritic Knee in the Elderly: A Practical Guide.

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