Lifetime Risk of Total Hip Replacement Surgery and Temporal Trends in Utilization: A Population-Based Analysis
Version of Record online: 28 JUL 2014
Copyright © 2014 by the American College of Rheumatology
Arthritis Care & Research
Volume 66, Issue 8, pages 1213–1219, August 2014
How to Cite
Bohensky, M., Ackerman, I., de Steiger, R., Gorelik, A. and Brand, C. (2014), Lifetime Risk of Total Hip Replacement Surgery and Temporal Trends in Utilization: A Population-Based Analysis. Arthritis Care Res, 66: 1213–1219. doi: 10.1002/acr.22279
- Issue online: 28 JUL 2014
- Version of Record online: 28 JUL 2014
- Accepted manuscript online: 27 JAN 2014 01:45PM EST
- Manuscript Accepted: 31 DEC 2013
- Manuscript Received: 8 OCT 2013
- National Health and Medical Research Council of Australia Public Health (Australian) Early Career Fellowship. Grant Number: 520004
To investigate lifetime risk of total hip replacement (THR) surgery in the state of Victoria, Australia and to describe temporal trends in THR incidence.
We analyzed a retrospective population-based longitudinal cohort of patients who received a primary THR in Victoria from 1998–2009. The factors potentially contributing to changes in lifetime risk were also examined, including temporal changes in THR incidence according to health care setting (public versus private), socioeconomic status, and geographic location (regional versus metropolitan).
We identified 45,775 patients receiving THR over the time period. For a woman age 20–29 years, the mortality-adjusted lifetime risk rose significantly over time, from 8.49% (95% confidence interval [95% CI] 8.23–8.69%) in 1999–2000 to 10.30% (95% CI 10.07–10.49%) in 2007–2008. For a man age 20–29 years, the mortality-adjusted lifetime risk also increased significantly, from 9.29% (95% CI 8.97–9.58%) in 1999–2000 to 10.27% (95% CI 9.95–10.48%) in 2004–2005, but in contrast to the pattern observed for women, it decreased slightly in 2007–2008 (9.90% [95% CI 9.60–10.16%]). We also identified an increasing number of THRs in private hospitals, in people in middle and low socioeconomic groups, and in rural areas.
The lifetime risk of THR for women was similar to men, despite a higher burden of hip osteoarthritis, and this warrants further investigation. However, increases in the number of THR procedures performed for patients in regional areas and in lower socioeconomic groups suggest some reductions over time in known disparities.