National joint registries show differences in utilization of ankle replacements
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Published results showed marked differences in the utilization of ankle replacement across six countries with national registries.
For their study, Thomas A. Perry, BSc, PhD, and colleagues used aggregate data and summary statistics on ankle replacements from national joint replacement registries in Australia, Finland, New Zealand, Norway, Sweden and the United Kingdom between 1993 and 2019. Researchers extracted demographic data on patient age, sex and indications for primary ankle replacement from the annual recorded counts of procedures and obtained registry-level summary results on data completeness, counts of hospitals/units and health care providers performing ankle replacements annually and data collection processes. Researchers calculated the annual ankle replacement incidence for all diagnoses and by indication categories per 100,000 residential population for patients aged 18 years and older.
Results showed New Zealand had the largest annual incidence with approximately 3.3 ankle replacement procedures per 100,000 population for the 2010 to 2015 period when data were available from all six countries. Similarly, researchers found New Zealand had the greatest number of hospitals/units and surgeons performing ankle surgery per 100,000 population. Finland reported the lowest annual incidence of ankle replacement procedures during the 2010 to 2015 time period, while Sweden reported the fewest number of hospital/units and surgeons performing ankle surgery, according to results.
Researchers noted no common temporal trends in the utilization of ankle replacements. Results showed the United Kingdom, Australia and New Zealand reported osteoarthritis as the predominant indication for ankle replacement, while Scandinavia reported rheumatoid arthritis as the most common indication.
“Using data from six national joint registries with ankle data for the period 1993 to 2019, we found marked differences between countries in the utilization of ankle replacements. Most countries initially showed an exponential growth in ankle replacement from registry inception; however, in more recent years there has been a decline,” Perry told Healio Orthopedics. “Changes in the use of ankle replacement are likely driven by registry-related factors including data completeness, number of hospitals/surgeons performing surgery and national coverage, and go beyond changes in the incidence of diseases (ie, osteoarthritis, rheumatoid arthritis, trauma). These data describe the current demand for ankle replacement and will help inform the provision of orthopedic and rheumatologic care.”
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