The Epidemiology of Joint Replacements Across Western Victoria, Australia: a Cross-sectional Study

Contemporary data are required to plan interventions and identify gaps in health service provision. As part of the larger Ageing, Chronic Disease and Injury study, we mapped joint replacements across the western region of the Australian state of Victoria. Primary total joint replacement data were extracted from the Australian Orthopaedic Association National Joint Replacement Registry for men and women aged ≥ 40 years during 2010–2013, inclusive. Crude and age-adjusted rates (per 10,000 population/year) of primary total joint replacements at the hip, knee and ‘other’ were determined for the entire region, and separately for each local government area (LGA). The reason and distance travelled for replacement were determined. Age-adjusted rates of joint replacements per 10,000 population/year in men and women (combined) were 39.3 (95% CI 37.9–40.6) for the hip, 42.2 (95% CI 40.8–43.6) for the knee and 3.7 (95% CI 3.3–4.1) for ‘other’ joint replacements. Age-adjusted incidence rates varied across rural LGAs. For residents of Ballarat, Greater Geelong and Warrnambool, most procedures (> 80%) were performed in the LGA of patient residence. For other LGAs, the percentage varied from 0 to 44.2%. Outside major population centres, the distance travelled ranged from 2.9 to 1111.0 km (median 97.5, IQR 61.2–190.0). Overall, rural LGAs had higher rates of joint replacements. Distance travelled for replacement procedures varied. The methods used in this study provide a model for similar research in rural environments, as well as providing important policy direction in the planning of health service provision across rural and regional communities.