Patel A, Pavlou G, Mújica-Mota R E, Toms A D
Royal Stoke University Hospital, Newcastle Road, Stoke on Trent, Staffordshire, ST4 6QG, UK.
Wrightington Wigan and Leigh NHS Trust Wrightington Hospital, Hall Lane, Appley Bridge, Wigan WN6 9EP, UK.
Bone Joint J. 2015 Aug;97-B(8):1076-81. doi: 10.1302/0301-620X.97B8.35170.
Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are recognised and proven interventions for patients with advanced arthritis. Studies to date have demonstrated a steady increase in the requirement for primary and revision procedures. Projected estimates made for the United States show that by 2030 the demand for primary TKA will grow by 673% and for revision TKA by 601% from the level in 2005. For THA the projected estimates are 174% and 137% for primary and revision surgery, respectively. The purpose of this study was to see if those predictions were similar for England and Wales using data from the National Joint Registry and the Office of National Statistics. Analysis of data for England and Wales suggest that by 2030, the volume of primary and revision TKAs will have increased by 117% and 332%, respectively between 2012 and 2030. The data for the United States translates to a 306% cumulative rate of increase between 2012 and 2030 for revision surgery, which is similar to our predictions for England and Wales. The predictions from the United States for primary TKA were similar to our upper limit projections. For THA, we predicted an increase of 134% and 31% for primary and revision hip surgery, respectively. Our model has limitations, however, it highlights the economic burden of arthroplasty in the future in England and Wales as a real and unaddressed problem. This will have significant implications for the provision of health care and the management of orthopaedic services in the future.
全膝关节置换术（TKA）和全髋关节置换术（THA）是公认的、经证实的针对晚期关节炎患者的治疗手段。迄今为止的研究表明，初次手术和翻修手术的需求在稳步增长。对美国的预计估算显示，到2030年，初次TKA的需求将比2005年的水平增长673%，翻修TKA的需求将增长601%。对于THA，初次手术和翻修手术的预计估算分别为174%和137%。本研究的目的是利用来自国家关节注册中心和国家统计局的数据，看看这些预测对英格兰和威尔士是否相似。对英格兰和威尔士数据的分析表明，到2030年，2012年至2030年间初次和翻修TKA的数量将分别增加117%和332%。美国的数据相当于2012年至2030年翻修手术的累计增长率为306%，这与我们对英格兰和威尔士的预测相似。美国对初次TKA的预测与我们的上限预测相似。对于THA，我们预测初次髋关节手术和翻修髋关节手术将分别增加134%和31%。然而，我们的模型有局限性，它突出了未来英格兰和威尔士关节置换术的经济负担这一现实且未得到解决的问题。这将对未来医疗保健的提供和骨科服务的管理产生重大影响。
