Culliford D, Maskell J, Judge A, Cooper C, Prieto-Alhambra D, Arden N K
Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK; NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Oxford OX3 7LD, UK.
Public Health Sciences and Medical Statistics, Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK.
Osteoarthritis Cartilage. 2015 Apr;23(4):594-600. doi: 10.1016/j.joca.2014.12.022. Epub 2015 Jan 9.
To estimate the future rate of primary total hip (THR) or knee (TKR) replacement in the UK to 2035 allowing for changes in population demographics and obesity.
Using age/gender/body mass index (BMI)-specific incidence rates from a population-based cohort study of 50,000 THR and 45,609 TKR patients from the UK Clinical Practice Research Datalink (CPRD) between 1991 and 2010, we projected future numbers of THR and TKR using two models: a static, estimated rate from 2010 applied to population growth forecasts to 2035, and a log-linear rate extrapolation over the same period. Both scenarios used population forecast data from the UK Office for National Statistics (ONS).
Assuming rates of THR and TKR for 2010, and given projected population changes in age, gender and BMI, the number of THRs and TKRs performed in the UK in 2035 is estimated to be, respectively: 95,877 and 118,666. By comparison, an exponential extrapolation of historical rates using a log-linear model produces much higher estimates of THR and TKR counts in 2035 at 439,097 and 1,219,362 respectively. Projected counts were higher for women than men. Assuming a changing (rather than fixed) future BMI distribution increases TKRs by 2035 but not THRs.
Using historical rates and population forecasts we have projected the number of THR/TKR operations in the UK up to 2035. This study will inform policymakers requiring estimates of future demand for surgery. Incorporating future forecasts for BMI into projections of joint replacement may be more relevant for TKR rather than THR.
估计到2035年英国初次全髋关节置换术（THR）或全膝关节置换术（TKR）的未来发生率，同时考虑人口结构和肥胖情况的变化。
利用1991年至2010年间英国临床实践研究数据链（CPRD）中50,000例THR患者和45,609例TKR患者的基于人群队列研究的年龄/性别/体重指数（BMI）特定发病率，我们使用两种模型预测THR和TKR的未来数量：一种是静态模型，将2010年的估计发病率应用于2035年的人口增长预测；另一种是同期的对数线性发病率外推法。两种情况均使用英国国家统计局（ONS）的人口预测数据。
假设2010年THR和TKR的发生率，并考虑年龄、性别和BMI的预计人口变化，估计2035年英国进行的THR和TKR数量分别为：95,877例和118,666例。相比之下，使用对数线性模型对历史发病率进行指数外推，得出2035年THR和TKR数量的估计值要高得多，分别为439,097例和1,219,362例。预计女性的手术数量高于男性。假设未来BMI分布发生变化（而非固定不变），到2035年TKR数量会增加，但THR数量不会增加。
利用历史发病率和人口预测，我们已经预测了到2035年英国THR/TKR手术的数量。这项研究将为需要估计未来手术需求的政策制定者提供信息。将BMI的未来预测纳入关节置换预测中，可能对TKR比对THR更具相关性。
