Despite Economic Times, U.S. Demand for Total Joint Replacement Remains Steady

Despite Economic Times, U.S. Demand for Total Joint Replacement Remains Steady

Procedures that restore mobility and enhance quality of life continue growth;
new study supports existing projections

PR Newswire

ROSEMONT, Ill., April 2, 2014

ROSEMONT, Ill., April 2, 2014 /PRNewswire-USNewswire/ -- A new study appearing
in the April issue of the Journal of Bone and Joint Surgery (JBJS) showed that
the economic downturns in the 2000s did not substantially influence the
national growth trends for hip and knee arthroplasty in the United States. The
new data support the authors' existing projections—made in 2007—that predicted
a significant surge in demand for total joint replacement (TJR) through 2030.

Facing criticism that existing model projections of utilization of TJR did not
take into account macroeconomic shifts such as recessions, researchers
revisited the data adding the National Health Expenditure data as an
independent variable. They conducted a historical trend analysis to compare
the original projections with actual TJR rates through 2010 using data from
the Nationwide Inpatient Sample (NIS) and used a linear regression model to
calculate estimates through 2021 (the latest year for which the National
Health Expenditure estimates are available).

The investigators found that the overall growth trend for the incidence of hip
and knee arthroplasty, relative to the total U.S. population, was insensitive
to economic downturns.

From 2009 to 2010, the total number of procedures increased by:

  o6.0 percent for primary total hip arthroplasty;
  o6.1 percent for primary total knee arthroplasty;
  o10.8 percent for revision total hip arthroplasty; and
  o13.5 percent for revision total knee arthroplasty.

"The actual NIS data from 2005 and 2010 correlate strongly with the
predictions made in the previous model, despite the fact that both were
post-recessionary years," said lead author Steven M. Kurtz, PhD, of
Philadelphia-based consulting firm Exponent, Inc. "The results of this new
study support the findings of our previous projections of arthroplasty demand
through at least 2021."

According to the study results, the National Health Expenditure model
projections for primary hip replacement in 2020 were higher than the
previously projected model, whereas the current model estimates for total knee
arthroplasty were lower.

"The available data do not support the hypothesis that the anticipated
long-term national demand for joint replacements has been fundamentally
altered by the current recessionary economic environment," said Dr. Kurtz, who
was also lead author of the 2007 study. "They suggest instead that the
long-term trends for the demand in total joint arthroplasty appear to be

He added that these latest updated projections in the current study provide a
basis for surgeons, hospitals, payers and policy makers to plan for
accommodating the future demand for arthroplasty in the coming decade.

Study Details
Data from the Nationwide Inpatient Sample (1993 to 2010) were used with United
States Census and National Health Expenditure data to quantify historical
trends in total joint replacement rates, including the two economic downturns
in the 2000s. Projections in total joint replacement were estimated using a
regression model incorporating the growth in population and rate of
arthroplasties from 1993 to 2010 as a function of age, sex, race, and census
region using the National Health Expenditure as the independent variable. The
regression model was used in conjunction with government projections of
National Health Expenditure from 2011 to 2021 to estimate future arthroplasty
rates in subpopulations of the United States and to derive national estimates.

Disclosure: One or more of the authors received payments or services, either
directly or indirectly (i.e., via his or her institution), from a third party
in support of an aspect of this work. None of the authors, or their
institution(s), have had any financial relationship, in the thirty-six months
prior to submission of this work, with any entity in the biomedical arena that
could be perceived to influence or have the potential to influence what is
written in this work. Also, no author has had any other relationships, or has
engaged in any other activities, that could be perceived to influence or have
the potential to influence what is written in this work. The complete
Disclosures of Potential Conflicts of Interest submitted by authors are always
provided with the online version of this article.

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SOURCE American Academy of Orthopaedic Surgeons

Contact: For more information, contact: Lauren Pearson Riley 847-384-4031; Kayee Ip 847-384-4035
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