The increase in total knee replacement surgery in Taiwan

Abstract

Total knee replacement (TKR) is considered as one of the most success among clinical interventions for patients with who suffering from knee osteoarthritis (OA). We sought to estimate the incidence of TKR using demographics, incidence rates, lengths of hospital stay, and costs from 1996 to 2010 by analyzing Taiwan's National Health Insurance Research Database. A total of 154,553 patients obtained primary TKR surgery between 1996 and 2010. The diagnosis code for knee OA and the procedure code for TKR were selected from the records. To compare the rate of TKR between covariables, we calculated the TKR risk ratios and 95% confidence interval (CI) of these variables (gender, age, age group, and primary diagnoses). A 2-tailed P-value of .05 was considered statistically significant. The statistical package SPSS version 20.0 (SPSS, Chicago, IL) was used to conduct all the statistical analyzes. We analyzed 154,553 TKRs performed by surgeons in Taiwan from 1996 to 2010. The overall crude incidence increased from 26.4 to 74.55 TKR per 100,000 inhabitants from 1996 to 2010. TKR incidence for the 70 to 79 years age group increased from 227 to 505 per 100,000 people from 1996 to 2010. The age-standardized rate ratios for TKR of women to men ranged from 2.5 to 3.0. The mean average length of stay in hospital was 15 days in 1996 and decreased to 8 days in 2010. During the study period, the adjusted mean cost per patient decreased from US$7485 to US$4827. Health expenditures for TKR were 5% of total National Health Insurance expenditure every year. Over the 15-year period, Taiwan's TKR incidence tripled, which is consistent with population ageing. Arthritis will be a major public health issue in the ageing population in the future.

Analysis of the following Related Surgeries of Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty: A Taiwanese National Health Insurance Research Database Population‐Based Study

“…This could possibly be explained by more male workers that were younger than in TKA. Lin and colleagues showed a similar trend from their previous study of a 15-year retrospective study in Taiwan [ 2 ]. Their demographic trend also showed the rates increased were much higher in women than in men, where men were increased by 2.7 times, from 13.56 to 37.09 per 100,000, and women were increased 3.1 times, from 36.35 to 112.36 per 100,000 [ 2 ].…”

“…Severe stages of osteoarthritis (OA) and osteonecrosis (ON) often lead to hip or knee arthroplasty [ 1 ]. In Taiwan, the current prevalence of OA among the elderly population over 50 years old is approximately 37% [ 2 ], in which this statistic will likely continue to increase. Currently, ON is one of the leading indications for primary total hip arthroplasty (THA) accounting for 46.9% [ 3 ].…”

“…In Taiwan, previous studies were conducted using Taiwan's national database focused more on TKA, such as the cost comparison between staged versus simultaneous bilateral TKA [ 11 ] and a 15-year retrospective study in cancer patients [ 2 ] analyzing mortality and periprosthetic infection rates after TKA [ 12 ]. Therefore, to the best of our knowledge, this study will be the first to examine the following related analyses of surgeries from patients receiving UKA and TKA in Taiwan.…”

Interaction of Osteoarthritis and BMI on Leptin Promoter Methylation in Taiwanese Adults

“…According to the United Nations classification, Taiwan is an aging society [40]. The percentage of adults over 65 years old in Taiwan is forecast to surpass 20% by 2025 [7].…”

“…Osteoarthritis also called degenerative joint disease is the commonest form of arthritis and is the main cause of pain, disability, and poor quality of life among older adults [7,8]. In Taiwan, about 37 % of individuals over 50 years old have OA [7]. Obesity is a well-established risk factor for OA [9].…”