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

Abstract

Objective: To study the rates of use of total hip arthroplasty (THA) and total knee arthroplasty (TKA) during the past 4 decades.

Methods: The Rochester Epidemiology Project was used to identify all Olmsted County, Minnesota, residents who underwent THA or TKA from January 1, 1969, through December 31, 2008. We used a population-based approach because few data are available on long-term trends in the use of THA and TKA in the United States. Rates of use were determined by age- and sex-specific person-years at risk. Poisson regression was used to assess temporal trends by sex and age group.

Results: The age- and sex-adjusted use of THA increased from 50.2 (95% confidence interval [CI], 40.5-59.8) per 100,000 person-years in 1969-1972 to 145.5 (95% CI, 134.2-156.9) in 2005-2008, whereas TKA increased markedly from 31.2 (95% CI, 25.3-37.1) per 100,000 person-years in 1971-1976 to 220.9 (95% CI, 206.7-235.0) in 2005-2008. For both procedures, use was greater among females, and the rate generally increased with age.

Conclusion: In this community, TKA and THA use rates have increased steadily since the introduction of the procedures and continue to increase for all age groups. On the basis of these population-based data, the probable need for TKA and THA exceeds current federal agency projections.

FIGURE 1.

Use rates of total hip arthroplasty among Olmsted County, MN, residents from 1969 to 2008, overall by sex (left) and age (right).

FIGURE 2.

Use rates of total knee arthroplasty among Olmsted County, MN, residents from 1971 to 2008, by age group (left) and age-adjusted rates for women, men, and all patients (right).