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Projections of Primary and Revision Hip and Knee Arthroplasty in the
United States from 2005 to 2030
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Steven Kurtz, PhD1, Kevin Ong, PhD1, Edmund Lau, MS2, Fionna Mowat, PhD2 and
Michael Halpern, MPH, MD, PhD3
1 Exponent Inc., 3401 Market Street, Suite 300, Philadelphia, PA 19104. E-mail
address for K. Ong: kong@exponent.com
2 Exponent Inc., 149 Commonwealth Drive, Menlo Park, CA 94025
3 Exponent Inc., 1800 Diagonal Road, Suite 355, Alexandria, VA 22314
Investigation performed at Exponent Inc., Philadelphia, Pennsylvania
Disclosure: The authors did not receive any outside funding or grants in support
of their research for or preparation of this work. Neither they nor a member of
their immediate families received payments or other benefits or a commitment or
agreement to provide such benefits from a commercial entity. No commercial
entity paid or directed, or agreed to pay or direct, any benefits to any
research fund, foundation, division, center, clinical practice, or other
charitable or nonprofit organization with which the authors, or a member of
their immediate families, are affiliated or associated.
Background: Over the past decade, there has been an increase in the number of
revision total hip and knee arthroplasties performed in the United States. The
purpose of this study was to formulate projections for the number of primary and
revision total hip and knee arthroplasties that will be performed in the United
States through 2030.
Methods: The Nationwide Inpatient Sample (1990 to 2003) was used in
conjunction with United States Census Bureau data to quantify primary and
revision arthroplasty rates as a function of age, gender, race and/or ethnicity,
and census region. Projections were performed with use of Poisson regression on
historical procedure rates in combination with population projections from 2005
to 2030.
Results: By 2030, the demand for primary total hip arthroplasties is estimated
to grow by 174% to 572,000. The demand for primary total knee arthroplasties is
projected to grow by 673% to 3.48 million procedures. The demand for hip
revision procedures is projected to double by the year 2026, while the demand
for knee revisions is expected to double by 2015. Although hip revisions are
currently more frequently performed than knee revisions, the demand for knee
revisions is expected to surpass the demand for hip revisions after 2007.
Overall, total hip and total knee revisions are projected to grow by 137% and
601%, respectively, between 2005 and 2030.
Conclusions: These large projected increases in demand for total hip and knee
arthroplasties provide a quantitative basis for future policy decisions related
to the numbers of orthopaedic surgeons needed to perform these procedures and
the deployment of appropriate resources to serve this need.
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