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
. 2023 Sep;105(7):645-652.
doi: 10.1308/rcsann.2022.0101.

Hip arthroplasty practice across the Organisation for Economic Co-operation and Development (OECD) over the last decade

T Jennison  1 , A MacGregor  2 , A Goldberg  3   4
Affiliations

Hip arthroplasty practice across the Organisation for Economic Co-operation and Development (OECD) over the last decade

T Jennison et al. Ann R Coll Surg Engl. 2023 Sep.

Abstract

Introduction: There are large variations in the number of hip replacements performed between countries, demonstrating large health inequalities; however, there has been limited research on this variation. The aims of this paper were to compare rates of hip replacements using Organisation for Economic Co-operation and Development (OECD) data for the period 2008-2018. The study also compared changes in the number of hip replacements in the total population and in only those aged over 65, and looked for a correlation of health expenditure and gross domestic product (GDP) with rates of hip replacements.

Methods: The OECD collects annual data from all member countries on the numbers of hip replacements, healthcare expenditure and GDP. Data analysis was undertaken using STATA. Descriptive statistics and Pearson's correlation coefficient were performed.

Results: The mean number of hip replacements performed in OECD countries in 2018 was 191.5 per 100,000 population per year. The largest number was 310.6 in Germany and the lowest was 8.6 in Mexico. There has been a 21.7% increase in the mean number of hip replacements across OECD countries. There was a moderate and significant Pearson coefficient of 0.468 (p = 0.009) between the number of hip replacements performed per 100,000 population in 2018 and GDP per person, and a strong and significant correlation with health expenditure (R = 0.784, p < 0.001). There was a moderate correlation (R = 0.645, p = 0.003) between the percentage change in the number of hip replacements performed per 100,000 population and the percentage change in healthcare expenditure per person between 2008 and 2018.

Conclusions: There is 36-fold variation in the practice of hip replacements across the OECD and the number of hip replacements has increased by more than 20% over the past decade. The number of hip replacements performed appears to be correlated with health expenditure in each country and may indicate a need that can only be met by increasing health expenditure.

Keywords: Epidemiology; Health inequalities; Hip arthroplasty; Incidence.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Total procedures per 100,000 population per country in 2018
Figure 2
Figure 2
Total procedures per 100,000 population over 65 by country in 2018
Figure 3
Figure 3
Percentage change in the number of hip replacements in people aged over 65 and in the total population
Figure 4
Figure 4
Health expenditure per person (US dollars) in 2018
Figure 5
Figure 5
Percentage change in health expenditure per person between 2008 and 2018
Figure 6
Figure 6
Comparison of number of hip replacements performed per 100,000 population and gross domestic product per person
Figure 7
Figure 7
Comparison of number of hip replacements performed per 100,000 population and healthcare expenditure per person
Figure 8
Figure 8
Comparison of change in number of hip replacements performed per 100,000 population and change in health expenditure per person between 2008 and 2018
See this image and copyright information in PMC

References

    1. Lodata E, Kaplan W. Osteoarthritis. In: Priority Medicines for Europe and the World: 2013 Update Report. Geneva: World Health Organization; 2013. pp. 68–74.
    1. Cross M, Smith E, Hoy Det al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 2014; 73: 1323–1330. - PubMed
    1. United Nations. World Population to 2300. https://www.un.org/development/desa/pd/sites/www.un.org.development.desa... (cited August 2023).
    1. Evans JT, Evans JP, Walker RWet al. How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet 2019; 393: 647–654. - PMC - PubMed
    1. Ben-Shlomo Y, Blom A, Boulton C et al. The National Joint Registry 17th Annual Report 2020 [Internet]. London: National Joint Registry; 2020 Sep. PMID: 33439585. - PubMed

MeSH terms