Department of Orthopedic Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Mayo Clin Proc. 2010 Oct;85(10):898-904. doi: 10.4065/mcp.2010.0115. Epub 2010 Sep 7.
To study the rates of use of total hip arthroplasty (THA) and total knee arthroplasty (TKA) during the past 4 decades.
The Rochester Epidemiology Project was used to identify all Olmsted County, Minnesota, residents who underwent THA or TKA from January 1, 1969, through December 31, 2008. We used a population-based approach because few data are available on long-term trends in the use of THA and TKA in the United States. Rates of use were determined by age- and sex-specific person-years at risk. Poisson regression was used to assess temporal trends by sex and age group.
The age- and sex-adjusted use of THA increased from 50.2 (95% confidence interval [CI], 40.5-59.8) per 100,000 person-years in 1969-1972 to 145.5 (95% CI, 134.2-156.9) in 2005-2008, whereas TKA increased markedly from 31.2 (95% CI, 25.3-37.1) per 100,000 person-years in 1971-1976 to 220.9 (95% CI, 206.7-235.0) in 2005-2008. For both procedures, use was greater among females, and the rate generally increased with age.
In this community, TKA and THA use rates have increased steadily since the introduction of the procedures and continue to increase for all age groups. On the basis of these population-based data, the probable need for TKA and THA exceeds current federal agency projections.
研究过去 40 年来全髋关节置换术（THA）和全膝关节置换术（TKA）的使用率。
利用罗切斯特流行病学项目，确定了 1969 年 1 月 1 日至 2008 年 12 月 31 日期间明尼苏达州奥姆斯特德县所有接受过 THA 或 TKA 的居民。我们采用了基于人群的方法，因为在美国，THA 和 TKA 使用的长期趋势数据很少。使用率通过按年龄和性别划分的风险人群年来确定。采用泊松回归评估性别和年龄组的时间趋势。
经年龄和性别调整后，THA 的使用率从 1969-1972 年的每 100,000 人年 50.2（95%置信区间 [CI]，40.5-59.8）增加到 2005-2008 年的 145.5（95% CI，134.2-156.9），而 TKA 的使用率则从 1971-1976 年的每 100,000 人年 31.2（95% CI，25.3-37.1）显著增加到 2005-2008 年的 220.9（95% CI，206.7-235.0）。对于这两种手术，女性的使用率更高，且使用率通常随年龄增长而增加。
在本社区，自手术引入以来，TKA 和 THA 的使用率稳步上升，并且所有年龄段的使用率仍在继续上升。基于这些基于人群的数据，TKA 和 THA 的实际需求超过了当前联邦机构的预测。
