Total hip and total knee replacements are on the rise

Use rates of total hip arthroplasty (THA) and total knee arthroplasty (TKA) have increased steadily since the procedures were introduced, and they continue to increase in all age-groups. Use has increased for patients with osteoarthritis (OA) but decreased for those with rheumatoid arthritis.

Singh and coworkers studied epidemiological data from patients who had arthroplasty between 1969 and 2008. They examined temporal trends in these surgeries according to sex and age and determined how the patient’s underlying diagnosis influenced the need for arthroplasty.

THA and TKA increased with time, escalating by 20% and 32% between 2001 and 2004 and by 43% and 24% between 2005 and 2008, respectively. Advanced age was linked with a significant increase in THA and TKA, although 42% and 38% of the recent THAs and TKAs, respectively, were in persons younger than 65 years. The need for THA was unaffected by sex, but women were significantly more likely than men to need TKA.

The authors noted that a much higher increase in TKA compared with THA rates in this study and others probably is the result of the increasing prevalence of obesity, which has a strong association with knee OA but a weak association with hip OA.