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    Total Knee Replacement Is the Top Inpatient Procedure in the US

    Data from the National Hospital Discharge Survey show trends in the rate of hospitalizations for TKA, mean age , and discharge status for inpatients age 45 and over.

    A recent report from the U.S. National Center for Health Statistics quantifies what joint replacement surgeons already know: Total knee replacement is commonplace operation, and patients who undergo the procedure are getting younger.

    The report uses data from the National Hospital Discharge Survey (NHDS) to show trends in the rate of hospitalizations for total knee replacement, mean age at hospitalization, and discharge status for inpatients age 45 and over from 2000 through 2010.

    During that 11-year period, total knee replacement was among the 5 most frequent of all inpatient procedures in the U.S., and it was the most frequent procedure in 2008, 2009, and 2010.

    An estimated 5.2 million total knee replacements were performed between 2000 and 2010, with more than 693,000 procedures in 2010 alone. Adults age 45 and over comprised 98.1% of those surgeries.

    More key findings from the report:

    • The rate of total knee replacement increased for both men (86%) and women (99%) age 45 and over from 2000 through 2010.
    • For both 2000 and 2010, women had a higher rate of total knee replacement (33.0 and 65.5 per 10,000 population, respectively) than men (24.3 and 45.3 per 10,000, respectively).
    • The mean age at total knee replacement decreased from 2000 through 2010 for both men and women age 45 and over.
    • Higher percentages of men and women age 45 and over who were hospitalized for total knee replacement were discharged home in 2010 (69.8% and 54.1%) than in 2000 (53.5% and 40.8%).
    • In both 2000 and 2010, a lower percentage of women age 45 and over (40.8% and 54.1%, respectively) were discharged home after total knee replacement than men aged 45 and over (53.5% and 69.8%, respectively).

    Did the rate of total knee replacement in the population aged 45 and over vary by sex from 2000 through 2010?

    The rate of total knee replacement increased for both men and women. Among men, the rate increased from 24.3 per 10,000 population in 2000 to 45.3 per 10,000 in 2010 (an 86% increase).(Figure 1) Among women, the rate almost doubled from 33.0 per 10,000 in 2000 to 65.5 per 10,000 in 2010 (a 99% increase).

    The rate of total knee replacement was higher for women compared with men for each year of the 11-year period. In 2000, the rate of total knee replacement for women was 35.8% higher than for men (33.0 and 24.3, respectively). In 2010, the rate of total knee replacement for women was 45.6% higher than for men (65.5 and 45.3, respectively).

    Did the rate of total knee replacement vary by sex and age in 2000 and 2010?

    Women ages 45 to 64 had higher rates (16.4 and 46.6) than men ages 45 to 64 (8.7 and 28.6) in both 2000 and 2010 (Figure 2).

    In 2000, there was no difference in the rate of total knee replacement between men and women age 65 and over, while in 2010, women had a higher rate (99.3) than men (82.6).

    Those age 65 and over had higher rates of total knee replacement than those ages 45 to 64 in both 2000 and 2010 (58.0 and 92.1, respectively for those age 65 and over compared with 12.7 and 37.8 for those aged 45–64).

    Higher rates of total knee replacement were found for both men and women age 65 and over compared with those ages 45 to 64 in both 2000 and 2010.

    Has the mean age at which inpatients aged 45 and over have total knee replacement changed from 2000 through 2010?

    Overall, the mean age for having a total knee replacement was lower in 2010 compared with 2000 by 3.9%, decreasing from 68.9 in 2000 to 66.2 in 2010(Figure 3).

    Among men, the mean age decreased from 69.3 to 66.5, and among women, the mean age decreased from 68.7 to 66.0.

    Did being discharged home after a total knee replacement vary by age and sex?

    The percentages of men and women age 45 and over discharged home after hospitalization for total knee replacement were higher in 2010 (69.8% and 54.1%, respectively) than in 2000 (53.5% and 40.8%, respectively)(Figure 4).

    In both 2000 and 2010, lower percentages of women than men were discharged home after total knee replacement.

    In 2010, nearly two-thirds of men age 65 and over (62.3%) were discharged home, while less than one-half of women age 65 and over (42.5%) were discharged home.

    Source

    Williams SN, Wolford ML, Bercovitz A. Hospitalization for total knee replacement among inpatients aged 45 and over: United States, 2000–2010. NCHS data brief, no 210. Hyattsville, MD: National Center for Health Statistics. 2015. http://www.cdc.gov/nchs/data/databriefs/db210.htm Accessed September 3, 2015.