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Increases in the rates of primary and revision knee replacement are reducing : a 15-year registry study across 3 continents

Lewis, Peter L. LU ; Graves, Stephen E. ; Robertsson, Otto LU ; Sundberg, Martin LU orcid ; Paxton, Elizabeth W. ; Prentice, Heather A. and W-Dahl, Annette LU (2020) In Acta Orthopaedica 91(4). p.414-419
Abstract

Background and purpose — Rates of knee replacement (KR) are increasing worldwide. Based on population and practice changes, there are forecasts of a further exponential increase in primary knee replacement through to 2030, and a corresponding increase in revision knee replacement. We used registry data to document changes in KR over the past 15 years, comparing practice changes across Sweden, Australia, and the United States. This may improve accuracy of future predictions. Patients and methods — Aggregated data from the Swedish Knee Arthroplasty Register (SKAR), the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), and the Kaiser Permanente Joint Replacement Registry (KPJRR) were used to compare surgical... (More)

Background and purpose — Rates of knee replacement (KR) are increasing worldwide. Based on population and practice changes, there are forecasts of a further exponential increase in primary knee replacement through to 2030, and a corresponding increase in revision knee replacement. We used registry data to document changes in KR over the past 15 years, comparing practice changes across Sweden, Australia, and the United States. This may improve accuracy of future predictions. Patients and methods — Aggregated data from the Swedish Knee Arthroplasty Register (SKAR), the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), and the Kaiser Permanente Joint Replacement Registry (KPJRR) were used to compare surgical volume of primary and revision KR from 2003 to 2017. Incidence was calculated using population census statistics from Statistics Sweden and the Australian Bureau of Statistics, as well as the yearly active membership numbers from Kaiser Permanente. Further analysis of KR by age < 65 and ≥ 65 years was carried out. Results — All registries recorded an increase in primary and revision KR, with a greater increase seen in the KPJRR. The rate of increase slowed during the study period. In Sweden and Australia, there was a smaller increase in revision surgery compared with primary procedures. There was consistency in the mean age at surgery, with a steady small decrease in the proportion of women having primary KR. The incidence of KR in the younger age group remained low in all 3 registries, but the proportional increases were greater than those seen in the ≥ 65 years of age group. Interpretation — There has been a generalized deceleration in the rate of increase of primary and revision KR. While there are regional differences in KR incidence, and rates of change, the rate of increase does not seem to be as great as previously predicted.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
91
issue
4
pages
6 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85083593450
  • pmid:32285749
ISSN
1745-3674
DOI
10.1080/17453674.2020.1749380
language
English
LU publication?
yes
id
366c3fd8-6fdf-4ca1-980e-43a2aa00286d
date added to LUP
2021-01-08 14:33:39
date last changed
2024-04-17 22:56:16
@article{366c3fd8-6fdf-4ca1-980e-43a2aa00286d,
  abstract     = {{<p>Background and purpose — Rates of knee replacement (KR) are increasing worldwide. Based on population and practice changes, there are forecasts of a further exponential increase in primary knee replacement through to 2030, and a corresponding increase in revision knee replacement. We used registry data to document changes in KR over the past 15 years, comparing practice changes across Sweden, Australia, and the United States. This may improve accuracy of future predictions. Patients and methods — Aggregated data from the Swedish Knee Arthroplasty Register (SKAR), the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), and the Kaiser Permanente Joint Replacement Registry (KPJRR) were used to compare surgical volume of primary and revision KR from 2003 to 2017. Incidence was calculated using population census statistics from Statistics Sweden and the Australian Bureau of Statistics, as well as the yearly active membership numbers from Kaiser Permanente. Further analysis of KR by age &lt; 65 and ≥ 65 years was carried out. Results — All registries recorded an increase in primary and revision KR, with a greater increase seen in the KPJRR. The rate of increase slowed during the study period. In Sweden and Australia, there was a smaller increase in revision surgery compared with primary procedures. There was consistency in the mean age at surgery, with a steady small decrease in the proportion of women having primary KR. The incidence of KR in the younger age group remained low in all 3 registries, but the proportional increases were greater than those seen in the ≥ 65 years of age group. Interpretation — There has been a generalized deceleration in the rate of increase of primary and revision KR. While there are regional differences in KR incidence, and rates of change, the rate of increase does not seem to be as great as previously predicted.</p>}},
  author       = {{Lewis, Peter L. and Graves, Stephen E. and Robertsson, Otto and Sundberg, Martin and Paxton, Elizabeth W. and Prentice, Heather A. and W-Dahl, Annette}},
  issn         = {{1745-3674}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{414--419}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Orthopaedica}},
  title        = {{Increases in the rates of primary and revision knee replacement are reducing : a 15-year registry study across 3 continents}},
  url          = {{http://dx.doi.org/10.1080/17453674.2020.1749380}},
  doi          = {{10.1080/17453674.2020.1749380}},
  volume       = {{91}},
  year         = {{2020}},
}