Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Aug;475(8):2130-2137.
doi: 10.1007/s11999-017-5377-7. Epub 2017 May 9.

Increase in Total Joint Arthroplasty Projected from 2014 to 2046 in Australia: A Conservative Local Model With International Implications

Maria C S Inacio  1 , Stephen E Graves  2 , Nicole L Pratt  3 , Elizabeth E Roughead  3 , Szilard Nemes  4
Affiliations

Increase in Total Joint Arthroplasty Projected from 2014 to 2046 in Australia: A Conservative Local Model With International Implications

Maria C S Inacio et al. Clin Orthop Relat Res. 2017 Aug.

Abstract

Background: The incidence of joint arthroplasty is increasing worldwide. International estimates of future demand for joint arthroplasty have used models that propose either an exponential future increase, despite obvious system constraints, or static increases, which do not account for past trends. Country-specific projection estimates that address limitations of past projections are necessary. In Australia, a high-income country with the 7th highest incidence of TKA and 15th highest incidence of THA of the Organization for Economic Cooperation and Development (OECD) countries, the volume of TKAs and THAs increased 198% between 1994 and 2014.

Questions/purpose: To determine the projected incidence and volume of primary TKAs and THAs from 2014 to 2046 in the Australian population older than 40 years.

Methods: Australian State and Territory Health Department data were used to identify TKAs and THAs performed between 1994 and 1995 and 2013 and 2014. The Australian Bureau of Statistics was the source of the population estimates for the same periods and population-projected estimates until 2046. The incidence rate (IR), 95% CI, and prediction interval (PI) of TKAs and THAs per 100,000 Australian citizens older than 40 years were calculated. Future IRs were estimated using a logistic model, and volume was calculated from projected IR and population. The logistic growth model assumes the existence of an upper limit of the TKA and THA incidences and a growth rate directly related to this incidence. At the beginning, when the observed incidence is much lower than the asymptote, the increase is exponential, but it decreases as it approaches the upper limit.

Results: A 66% increase in the IR of primary THAs between 2013 and 2046 is projected for Australia (2013: IR = 307 per 100,000, [95% CI, 262-329 per 100,000] compared with 2046: IR= 510 per 100,000, [95% PI, 98-567 per 100,000]), which translates to a 219% increase in the volume during this period. For TKAs the IR is expected to increase by 26% by 2046 (IR = 575 per 100,000; 95% PI, 402-717 per 100,000) compared with 2013 (IR = 437 per 100,000; 95% CI, 397-479 per 100,000) and the volume to increase by 142%.

Conclusion: A large increase in the volume of arthroplasties is expected using a conservative projection model that accounts for past surgical trends and future population changes in Australia. These findings have international implications, as they show that using country- specific, conservative projection approaches, a substantial increase in the number of these procedures is expected. This increase in joint arthroplasty volume will require appropriate workforce planning, resource allocation, and budget planning so that demand can be met.

Level of evidence: Level II, economic and decision analysis.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
The incidence rate (per 100,000) of primary THAs in Australian citizens 40 years and older is presented.
Fig. 2
Fig. 2
The incidence rate (per 100,000) of primary TKAs in Australian citizens 40 years and older is shown.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ackerman IN, Bohensky MA, de Steiger R, Brand CA, Eskelinen A, Fenstad AM, Furnes O, Garellick G, Graves SE, Haapakoski J, Havelin LI, Makela K, Mehnert F, Pedersen AB, Robertsson O. Substantial rise in the lifetime risk of primary total knee replacement surgery for osteoarthritis from 2003 to 2013: an international, population-level analysis. Osteoarthritis Cartilage. 2017;25:455–461. doi: 10.1016/j.joca.2016.11.005. - DOI - PubMed
    1. Ackerman IN, Bohensky MA, de Steiger R, Brand CA, Eskelinen A, Fenstad AM, Furnes O, Graves SE, Haapakoski J, Makela K, Mehnert F, Nemes S, Overgaard S, Pedersen AB, Garellick G. Lifetime risk of primary total hip replacement surgery for osteoarthritis from 2003-2013: a multi-national analysis using national registry data. Arthritis Care Res (Hoboken). 2017 Feb 2. [Epub ahead of print] - PubMed
    1. Australian Bureau of Statistics. Population Projections, Australia, 2012 (base) to 2016. Available at: http://www.abs.gov.au/Ausstats/abs@.nsf/mf/3222.0. Accessed June 23, 2016.
    1. Australian Government Department of Human Services. Medicare services. Available at: http://www.humanservices.gov.au/customer/subjects/medicare-services. Accessed October 30, 2015.
    1. Australian Orthopaedic Association National Joint Replacement Registry. Annual reports, 2014. Available at: https://aoanjrr.sahmri.com/documents/10180/172286/Annual%20Report%202014. Accessed March 31, 2017.