Future Young Patient Demand for Primary and Revision Joint Replacement: National Projections from 2010 to 2030

Abstract

Previous projections of total joint replacement (TJR) volume have not quantified demand for TJR surgery in young patients (\ 65 years old). We developed projections for demand of TJR for the young patient population in the United States. The Nationwide Inpatient Sample was used to identify primary and revision TJRs between 1993 and 2006, as a function of age, gender, race, and census region. Surgery prevalence was modeled using Poisson regression, allowing for different rates for each population subgroup over time. If the historical growth trajectory of joint replacement surgeries continues, demand for primary THA and TKA among patients less than 65 years old was projected to exceed 50% of THA and TKA patients of all ages by 2011 and 2016, respectively. Patients less than 65 years old were projected to exceed 50% of the revision

Wear and Lysis is the Problem in Modular TKA in the Young OA Patient at 10 Years

“…Most mid-and longterm studies on knee arthroplasty in younger patients have a relatively large percentage of rheumatoid patients who were somewhat inactive (Table 2) [4,7,12,13]. There is comparatively little information on cohorts of younger patients with only OA [5,6,17,19,[22][23][24] although this young OA group has the largest growth projections in the future [16]. The purpose of this study was to evaluate the minimum 10-year followup of TKA performed in more active patients with osteoarthritis, using modular tibial components, to determine (1) survivorship; (2) revision rates; (3) functional scores; and (4) rates of radiographic failure.…”

“…One study projected that between 2006 and 2030 there will be a 17-fold increase in the number of TKAs performed in this age group [16] and a demand for nearly a million knee arthroplasties for patients between 45 and 54 years old in 2030. Proper technique, component design, and materials for long-term durability in this age group are paramount due to the magnitude of the loads and the cycles of service these knees will be required to perform.…”

The Chitranjan Ranawat Award: Running Subcuticular Closure Enables the Most Robust Perfusion After TKA: A Randomized Clinical Trial

“…Results have varied based on the characteristics studied and to date there is no consensus on a superior wound closure technique for TKA. The number of TKAs performed each year is on the rise, and a greater percentage of these patients have comorbidities that can impair wound healing such as diabetes, a history of smoking, previous surgery about the knee, chronic infection, peripheral arterial disease, and anticoagulant or corticosteroid use [7][8][9]14]. These comorbidities in conjunction with relatively thin skin anterior to the knee makes wound complications an issue of growing concern [19,20].…”

What is the Prognosis of Revision Total Hip Arthroplasty in Patients 55 Years and Younger?

“…Its use, particularly among younger patients, has increased substantially and is expected to continue to increase [5,13,14]. Additionally, the prevalence of revision THAs is expected to increase.…”