Epidemiological Evolution of Hip and Knee Arthroplasties over the Course of 17 Years in a Single Hospital in Chile

Abstract

Introduction Total hip arthroplasty (THA) is considered the surgery of the twentieth century due to its impact on quality of life, and knee arthroplasty (KA) has been proven to be a cost-effective procedure in cases of gonarthrosis.

Objective To describe the evolution of THA and KA in a general hospital in terms of number of procedures and the average age and gender of the patients.

Method Analytical cross-sectional study. All procedures performed in a single center, between January 2002 and December 2018, that were registered by the Chilean National Health Fund (Fondo Nacional de Salud, FONASA, in spanish) codes for surgeries 2104129 and 2104153 were included. All revision surgeries, as well as tumor- or fracture-related procedures were excluded. The following data were obtained from the registry: patients' gender and age at the time of surgery and year of the procedure. A Spearman correlation analysis was performed, and the significance level was set at 0.05.

Results A total of 3,270 procedures were included: 1,975 THAs (60.4%) and 1,295 KAs (39.6%). The number of THAs has increased over time, with a total of 122 procedures in 2002 and 164 in 2018. In addition, the number of KAs has also increased, from 40 in 2002 to 155 in 2018. The ratio between THA and KA has been decreasing significantly. The average age of patients undergoing KAs has decreased, while that of patients undergoing THAs has increased, without statistical significance. Regarding THAs, we observed an increase in the proportion of men submitted to the procedure.

Conclusions The epidemiological profile of the patients undergoing arthroplasties has changed significantly. The epidemiology of the studies in the world literature, as well as that of the present study, show a significant increase in the number of patients who require KAs; therefore, it seems important to include this procedure in the development of new public healthcare policies.

Keywords

hip arthroplasty - knee arthroplasty - osteoarthritis - epidemiology

Note

The present study was approved by the Ethics Committee at Hospital Clínico of Universidad de Chile. All authors agreed with the publication of this manuscript in its current state, and authorized Maximiliano Barahona to send it to RCHOT for review. Moreover, the present study is not being reviewed by another journal and it did not have any external funding.

Publikationsverlauf

Eingereicht: 01. Juni 2020

Angenommen: 25. September 2020

Artikel online veröffentlicht:
30. September 2021

• Bibliografía

• 1 Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet 2007; 370 (9597): 1508-1519
• 2 Price AJ, Alvand A, Troelsen A. et al. Knee replacement. Lancet 2018; 392 (10158): 1672-1682
• 3 Evans JT, Evans JP, Walker RW, Blom AW, Whitehouse MR, Sayers A. 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 (10172): 647-654
• 4 Evans JT, Walker RW, Evans JP, Blom AW, Sayers A, Whitehouse MR. How long does a knee 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 (10172): 655-663
• 5 Chile MdSd. Guía Clínica 2010 Endoprótesis Total de Cadera en personas de 65 años y más con Artrosis de Cadera con Limitación Funcional Severa. 2010
• 6 Chile. MdSd. Guía Clínica 2009 Tratamiento Médico en Personas de 55 años y más con Artrosis de Cadera y/o Rodilla, Leve o Moderada. 2009
• 7 Association. AO. Australian Orthopaedic Association National Joint Replacement Registry 2017
• 8 Welfare NIfHa. Finnish Arthroplasty Register. 2019
• 9 Huang T, Wang W, George D, Mao X, Graves S. What can we learn from Australian Orthopaedic Association National Joint Replacement Registry 2016 annual report?. Ann Joint 2017;2(04):
• 10 Julin J, Jämsen E, Puolakka T, Konttinen YT, Moilanen T. Younger age increases the risk of early prosthesis failure following primary total knee replacement for osteoarthritis. A follow-up study of 32,019 total knee replacements in the Finnish Arthroplasty Register. Acta Orthop 2010; 81 (04) 413-419
• 11 Bayliss LE, Culliford D, Monk AP. et al. The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study. Lancet 2017; 389 (10077): 1424-1430
• 12 Ueda K, Sasaki N, Goren A. et al. Treatment satisfaction with pharmaceutical interventions in Japanese adults with osteoarthritis and chronic knee pain: an analysis of a web-based survey. Clin Interv Aging 2018; 13: 2179-2191
• 13 Wilson R, Blakely T, Abbott JH. Radiographic knee osteoarthritis impacts multiple dimensions of health-related quality of life: data from the Osteoarthritis Initiative. Rheumatology (Oxford) 2018; 57 (05) 891-899
• 14 Willis-Owen CA, Brust K, Alsop H, Miraldo M, Cobb JP. Unicondylar knee arthroplasty in the UK National Health Service: an analysis of candidacy, outcome and cost efficacy. Knee 2009; 16 (06) 473-478
• 15 Fabre-Aubrespy M, Ollivier M, Pesenti S, Parratte S, Argenson J-N. Unicompartmental knee arthroplasty in patients older than 75 results in better clinical outcomes and similar survivorship compared to total knee arthroplasty. A matched controlled study. J Arthroplasty 2016; 31 (12) 2668-2671
• 16 Siman H, Kamath AF, Carrillo N, Harmsen WS, Pagnano MW, Sierra RJ. Unicompartmental knee arthroplasty vs total knee arthroplasty for medial compartment arthritis in patients older than 75 years: comparable reoperation, revision, and complication rates. J Arthroplasty 2017; 32 (06) 1792-1797
• 17 Johan Karrholm MMDO. Johanna Vinblad, Cecilia Rogmark, Ola Rolfson. Annual Report 2017, Swedish Hip Arthroplasty Register. 2018
• 18 Robertsson OLL, Sundberg M, Dahl A. The Swedish Knee Arthroplasty Register Annual Report 2017. 2017
• 19 Basques BA, Bell JA, Fillingham YA, Khan JM, Della Valle CJ. Gender Differences for Hip and Knee Arthroplasty: Complications and Healthcare Utilization. J Arthroplasty 2019; 34 (08) 1593-1597.e1
• 20 Hughes RE, Batra A, Hallstrom BR. Arthroplasty registries around the world: valuable sources of hip implant revision risk data. Curr Rev Musculoskelet Med 2017; 10 (02) 240-252
• 21 Lübbeke A, Silman AJ, Barea C, Prieto-Alhambra D, Carr AJ. Mapping existing hip and knee replacement registries in Europe. Health Policy 2018; 122 (05) 548-557
• 22 Serra-Sutton V, Allepuz A, Espallargues M, Labek G, Pons JM. Arthroplasty registers: a review of international experiences. Int J Technol Assess Health Care 2009; 25 (01) 63-72