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Lifetime risk of total hip replacement likely to increase for patients with OA
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Results from this study demonstrated that during a 10-year period in five different countries there was a statically significant increase in the lifetime risk of total hip replacement among patients with osteoarthritis.
“Previous publications to assess the burden of [total hip replacement] THR within and between countries have largely focused on the traditional THR incidence or utilization rates,” Stephen E. Graves, DPhil, told Healio Rheumatology. “These are based purely on the observed numbers of procedures performed and the population size. The standardized lifetime risk approach is in many ways more informative as it is a cumulative measure of risk that incorporates population life expectancy and also enables the age structure of populations to be taken into account. It is expressed as an easily understood percentage. A lifetime risk of 10% means that one in 10 persons will have a primary THR for [osteoarthritis] OA in their lifetime.”
He added, “This study is the first to use this approach to compare the use of THR between countries. Although it is known that THR is a common procedure, I think readers may be surprised by just how common it is.”
Graves and colleagues performed a multinational, population-level analysis of patients who underwent primary THR for OA between 2003 and 2013. Investigators collected data on the number of surgeries and number of patients who underwent either THR or hip resurfacing surgery from registries from Australia, Sweden, Finland, Norway and Denmark. Patients were categorized into the following age groups for assessment: younger than 40 years; 40 years to 49 years; 50 years to 59 years; 60 years to 69 years; 70 years to 79 years; and 80 years or older. Investigators then calculated the lifetime risk of THR for each group.
Results showed in 2003 the lifetime risk of THR for women ranged from 8.7% to 15.9%, while it ranged from 6.3% to 8.6% in men. Investigators noted from 2003 to 2013, there was a significant increase in the lifetime risk of THR for both women and men, except for women in Norway. In both 2003 and 2013, women had the highest lifetime risk of THR. Women in Norway had approximately double the lifetime risk compared with men for both 2003 and 2013.
“While it can be argued that this gender difference, increasing use of THR and intercountry variation has been previously identified, it is my view that the methodology used in this study provides a more useful, more comprehensive and more easily understood approach to determine how the use of THR is changing and how this varies between countries,” he said. ‒ by Monica Jaramillo
Disclosure: Graves reports no relevant financial disclosures.
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