Variation in rates of TKA across the US suggests overuse in some areas
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After adjusting for expected ratios and patient characteristics across the United States, investigators found regional variation in rates of total knee arthroplasty remained, suggesting overuse of the procedure in some areas.
Researchers collected data from more than 24 million Medicare beneficiaries annually from 2011 to 2015 and used estimates from demographic and clinical characteristics to derive an expected ratio of primary TKA from the national rate.
From the 218, 282 TKA procedures in 2011, researchers found the rate of arthroplasty during the 5-year period was 9.3 per 1000 person-years.
“However, substantial variation remained, with observed to expected ratios that ranged from 0.61 in Newark, New Jersey, to 1.82 in Idaho Falls, Idaho. High ratios were primarily present in the upper Midwest, Great Plains and Mountain West regions,” the researchers wrote in their abstract.
Higher ratios of TKA were found in regions with fewer outpatient visits and more qualified surgeons per capita. Higher ratios linked with higher rates of TKA included beneficiaries with dementia, peripheral vascular disease and skin ulcers, which investigators noted are contraindications to arthroplasty.
Researchers concluded that the observed regional variation in TKA rates – even after adjustment – signified overuse of knee arthroplasty procedures in various regions of the United States. – by Max R. Wursta
Disclosures: The authors report no relevant financial disclosures.
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