High prevalence of total knee replacement revealed

By Liam Davenport, medwireNews Reporter

Research highlights the growing use of total knee replacement (TKR) in the USA among patients with osteoarthritis and the associated healthcare burden.

The team, led by Elena Losina, from Brigham and Women's Hospital in Boston, Massachusetts, comments: "Individuals who have undergone total knee replacement are at risk for several costly and debilitating outcomes, including periprosthetic fracture and joint infection, and are at risk for revision surgery."

The team used the Osteoarthritis Policy Model, a computer simulation of the natural history of knee osteoarthritis, along with data from two national surveys. Two observational, longitudinal studies were also used to estimate the incidence of TKR in patients with end-stage knee osteoarthritis, and registry data was examined to derive rates of TKR failure leading to revision.

The overall prevalence of TKR in adults aged 50 years and over was estimated to be 4.2%, at 4.8% in females and 3.4% in males. The prevalence of TKR increased with each additional decade in age for both males and females. Symptomatic knee osteoarthritis had been diagnosed in 11.5% of adults aged 50 years and over, at 13.3% in females and 9.4% in males.

Using US Census data, the authors estimate that 4,007,400 US adults currently live with TKR, of whom 536,100 have a revised TKR. Nearly 1.5 million of these primary TKRs were among those aged 50-69 years old.

And, of 11,059,800 adults diagnosed with symptomatic knee osteoarthritis, 31.6% of males and 31.3% of females have an intact primary TKR, and 4.4% of males and 5.1% of females have a revised TKR.

The lifetime risk of primary TKR was estimated to be 7.0% from the age of 25 years in males, and 9.5% in females. The lifetime risk of being diagnosed with knee osteoarthritis was 13.3% in males and 18.8% in females.

The authors conclude in the Journal of Bone and Joint Surgery: "While total knee replacement is a remarkably successful treatment for individuals with end-stage knee osteoarthritis, our findings emphasize the large public health burden posed by the millions of adults in the U.S. living with total knee replacement."

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