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. 2015 Sep 2;97(17):1386-97.
doi: 10.2106/JBJS.N.01141.

Prevalence of Total Hip and Knee Replacement in the United States

Hilal Maradit Kremers  1 , Dirk R Larson  1 , Cynthia S Crowson  1 , Walter K Kremers  1 , Raynard E Washington  2 , Claudia A Steiner  2 , William A Jiranek  3 , Daniel J Berry  1
Affiliations

Prevalence of Total Hip and Knee Replacement in the United States

Hilal Maradit Kremers et al. J Bone Joint Surg Am. .

Abstract

Background: Descriptive epidemiology of total joint replacement procedures is limited to annual procedure volumes (incidence). The prevalence of the growing number of individuals living with a total hip or total knee replacement is currently unknown. Our objective was to estimate the prevalence of total hip and total knee replacement in the United States.

Methods: Prevalence was estimated using the counting method by combining historical incidence data from the National Hospital Discharge Survey and the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 1969 to 2010 with general population census and mortality counts. We accounted for relative differences in mortality rates between those who have had total hip or knee replacement and the general population.

Results: The 2010 prevalence of total hip and total knee replacement in the total U.S. population was 0.83% and 1.52%, respectively. Prevalence was higher among women than among men and increased with age, reaching 5.26% for total hip replacement and 10.38% for total knee replacement at eighty years. These estimates corresponded to 2.5 million individuals (1.4 million women and 1.1 million men) with total hip replacement and 4.7 million individuals (3.0 million women and 1.7 million men) with total knee replacement in 2010. Secular trends indicated a substantial rise in prevalence over time and a shift to younger ages.

Conclusions: Around 7 million Americans are living with a hip or knee replacement, and consequently, in most cases, are mobile, despite advanced arthritis. These numbers underscore the substantial public health impact of total hip and knee arthroplasties.

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Figures

Fig. 1
Fig. 1
A: Age and sex-specific prevalence of total hip replacement (THR) and total knee replacement (TKR) among the total population of the United States in 2010. The lines represent the percentage of the 2010 total U.S. population with total hip and total knee replacement by age group. B: The number of individuals among the 2010 total U.S. population who had undergone total hip replacement (THR) and total knee replacement (TKR) according to age group.
Fig. 1
Fig. 1
A: Age and sex-specific prevalence of total hip replacement (THR) and total knee replacement (TKR) among the total population of the United States in 2010. The lines represent the percentage of the 2010 total U.S. population with total hip and total knee replacement by age group. B: The number of individuals among the 2010 total U.S. population who had undergone total hip replacement (THR) and total knee replacement (TKR) according to age group.
Fig. 2
Fig. 2
Age-specific 2010 prevalence of total hip arthroplasty (THA) (Fig. 2-A) and total knee arthroplasty (TKA) (Fig. 2-B) among the total U.S. population according to duration of time since the initial procedure.
Fig. 2
Fig. 2
Age-specific 2010 prevalence of total hip arthroplasty (THA) (Fig. 2-A) and total knee arthroplasty (TKA) (Fig. 2-B) among the total U.S. population according to duration of time since the initial procedure.
Fig. 3
Fig. 3
Secular changes in the prevalence of total hip arthroplasty (THA) (Fig. 3-A) and total knee arthroplasty (TKA) (Fig. 3-B) in the total U.S. population between 1980 and 2010.
Fig. 3
Fig. 3
Secular changes in the prevalence of total hip arthroplasty (THA) (Fig. 3-A) and total knee arthroplasty (TKA) (Fig. 3-B) in the total U.S. population between 1980 and 2010.
Fig. 4
Fig. 4
2010 prevalence of total hip arthroplasty (THA) (Fig. 4-A) and total knee arthroplasty (THA) (Fig. 4-B) in individual states.
Fig. 4
Fig. 4
2010 prevalence of total hip arthroplasty (THA) (Fig. 4-A) and total knee arthroplasty (THA) (Fig. 4-B) in individual states.
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