Total knee arthroplasty in France: Male-driven rise in procedures in 2009-2019 and projections for 2050

被引:23
作者
Le Stum, Mathieu [1 ]
Gicquel, Thomas [2 ]
Dardenne, Guillaume [3 ]
Le Goff-Pronost, Myriam [4 ]
Stindel, Eric [3 ,5 ]
Clave, Arnaud [5 ,6 ]
机构
[1] Inst Natl Sante & Rech Med Inserm, Lab Traitement Informat Med LATIM, UMR1101, 22 Ave Camille Desmoulins, F-29200 Brest, France
[2] Clin Mutualiste Porte Orient, 3 Rue Robert De La Croix, F-56324 Lorient, France
[3] CHRU Brest, Ctr Hosp Univ Brest, LATIM, UMR 1101, 2 Ave Foch, F-29200 Brest, France
[4] Inst Mines Telecom, IMT Atlantique, LATIM, Inserm UMR 1101,Mrsouin, 655 Ave Technopole, F-29280 Plouzane, France
[5] Univ Bretagne Occidentale, UBO, LATIM, UMR 1101, 22 Ave Camille Desmoulins, F-29200 Brest, France
[6] Clin St George, Serv Orthopedie, 2 Ave Rimiez, F-06100 Nice, France
关键词
Total knee arthroplasty; Knee; Projection; Epidemiology; Comorbidity; TOTAL JOINT ARTHROPLASTY; UTILIZATION RATES; UNITED-STATES; TOTAL HIP; REPLACEMENT; TRENDS; INCREASE; DEMAND;
D O I
10.1016/j.otsr.2022.103463
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: The number of Total Knee Arthroplasty (TKA) procedures has been rising steadily for several decades in Europe and the USA. The increase varies in pace across countries, with a gradual climb in northern and central Europe, a slowing in the USA, and an exponential surge in the UK. In France, a 32.2% rise in the number of TKA and unicompartmental knee arthroplasty procedures was documented between 2012 and 2018. However, no study has focussed specifically on changes in both TKA procedures and the features of TKA patients. The objective of this study was to use the French national healthcare database to evaluate (1) increases in TKA procedures according to sex and age, (2) whether TKA is being performed at increasingly younger ages, (3) whether the comorbidity profile at TKA is changing, and (4) whether the TKA incidence rate will stabilise in the future, with a projection for 2050. Hypothesis: In France, the number of TKA procedures is rising in both males and females but the pace of the increases differs between sexes. Material and method: This study used data collected in France in 2009-2019, separately for different age groups and for males and females, in the French national healthcare database (Systeme national des donnees de sante, SNDS) that collects information on all surgical procedures performed nationwide. Based on information about the TKA procedures, we determined (1) the TKA incidence rates with their time trends and (2) indirectly, the comorbidity profiles of the patients at TKA. Linear, Poisson, and logistic models were built to predict incidence rates in 2030, 2040, and 2050. Results: Between 2009 and 2019, the TKA incidence rate showed a steeper increase in males than in females (from 71.2 to 122.9 [+73%] vs. 124.2 to 181.0 [+46%], respectively). Although this increase was replicated in all age groups, it was sharper in patients younger than 65 years, in both males and females (from 20.9 to 37.9 [+82%] and 33.6 to 51.3 [+53%], respectively). During the study period, the number and proportion of patients increased in the group with mild comorbidities (from 40 093 to 67 430 TKAs, i.e., from 53.1% to 65.7% of all TKAs) but not in the other comorbidity groups. All projection models were validated. Nonetheless, the most likely scenario, provided by the logistic model, is a 33% rise by 2050 in both males and females (i.e., to 151 575 TKA procedures) with a plateau starting around 2030. Conclusion: Although the increase in TKA procedures is more marked in males than in females, the trends are similar in both sexes, with a sharper rise in the group younger than 65 years and a shift toward patients with milder comorbidities. In the longer term, incidence rate trends follow logistic dynamics, with a plateau starting around 2030. To meet the increasing demand, a corresponding development in relevant healthcare resources must be planned. (c) 2022 Elsevier Masson SAS. All rights reserved.
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