Kurtz Steven M, Lau Edmund, Ong Kevin, Zhao Ke, Kelly Michael, Bozic Kevin J
Exponent Inc, Philadelphia, PA 19104, USA.
Clin Orthop Relat Res. 2009 Oct;467(10):2606-12. doi: 10.1007/s11999-009-0834-6. Epub 2009 Apr 10.
Previous projections of total joint replacement (TJR) volume have not quantified demand for TJR surgery in young patients (< 65 years old). We developed projections for demand of TJR for the young patient population in the United States. The Nationwide Inpatient Sample was used to identify primary and revision TJRs between 1993 and 2006, as a function of age, gender, race, and census region. Surgery prevalence was modeled using Poisson regression, allowing for different rates for each population subgroup over time. If the historical growth trajectory of joint replacement surgeries continues, demand for primary THA and TKA among patients less than 65 years old was projected to exceed 50% of THA and TKA patients of all ages by 2011 and 2016, respectively. Patients less than 65 years old were projected to exceed 50% of the revision TKA patient population by 2011. This study underscores the major contribution that young patients may play in the future demand for primary and revision TJR surgery.
Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
以往对全关节置换（TJR）手术量的预测未对年轻患者（<65岁）的TJR手术需求进行量化。我们对美国年轻患者群体的TJR需求进行了预测。利用全国住院患者样本确定了1993年至2006年间初次和翻修TJR手术情况，作为年龄、性别、种族和人口普查区域的函数。使用泊松回归对手术患病率进行建模，考虑到不同人群亚组随时间的不同发生率。如果关节置换手术的历史增长轨迹持续下去，预计到2011年和2016年，65岁以下患者对初次全髋关节置换（THA）和全膝关节置换（TKA）的需求将分别超过各年龄段THA和TKA患者的50%。预计到2011年，65岁以下患者将超过翻修TKA患者群体的50%。本研究强调了年轻患者在未来初次和翻修TJR手术需求中可能发挥的主要作用。
II级，预后研究。有关证据水平的完整描述，请参阅作者指南。
