Hansen Erik N, Ong Kevin L, Lau Edmund, Kurtz Steven M, Lonner Jess H
Rothman Institute, Sidney Kimmel Medical College at Thomas Jefferson University, 825 Old Lancaster Ave, PA 19010, USA. Email:
Am J Orthop (Belle Mead NJ). 2018 Dec;47(12). doi: 10.12788/ajo.2018.0113.
Publications on the prevalence of unicompartmental knee arthroplasty in the United States using a single database may have underestimated the "true" number of cases performed, given that several unicondylar knee arthroplasty (UKA) patients are <65 years and have private insurance. The prevalence of UKA in elderly (≥65 years) and younger (<65 years) populations was evaluated using the 2002 to 2011 5% sample of the Medicare data (Part B) and the 2004 to June 2012 MarketScan Commercial and Medicare Supplemental databases, respectively. The prevalence of UKA was stratified by age, gender, census region, Charlson comorbidity index, Medicare buy-in status, and diagnosis. The annual rate of change in the UKA rate was examined using Poisson regression to evaluate temporal changes considering year as a covariate. A total of 5235 and 23,310 UKA procedures were identified from the 5% Medicare and MarketScan databases, respectively. The rates of UKA generally increased until 2008, after which there was a decline. In both cohorts, gender and year of operation were found to be significantly associated with UKA rate. Analysis of data obtained over the past few years revealed that males 55 to 64 years, 65 to 69 years, and 70 to 74 years were the only age-gender groups whose UKA rates appeared to be trending upward. From 2002 to 2011, the rate of UKAs performed in the United States has increased, and a significant proportion of the surgeries were performed in younger (<65 years) patients.
鉴于一些单髁膝关节置换术（UKA）患者年龄小于65岁且拥有私人保险，使用单一数据库得出的关于美国单髁膝关节置换术患病率的出版物可能低估了实际实施的病例数量。分别使用2002年至2011年医疗保险数据（B部分）的5%样本以及2004年至2012年6月的MarketScan商业和医疗保险补充数据库，对老年（≥65岁）和年轻（<65岁）人群中UKA的患病率进行了评估。UKA的患病率按年龄、性别、人口普查区域、查尔森合并症指数、医疗保险参保状态和诊断进行分层。使用泊松回归检查UKA率的年变化率，将年份作为协变量来评估时间变化。分别从5%的医疗保险和MarketScan数据库中识别出5235例和23310例UKA手术。UKA率一般在2008年之前上升，之后有所下降。在这两个队列中，发现性别和手术年份与UKA率显著相关。对过去几年获得的数据进行分析显示，55至64岁、65至69岁以及70至74岁的男性是仅有的UKA率呈上升趋势的年龄 - 性别组。从2002年到2011年，美国实施的UKA率有所上升，并且相当一部分手术是在年轻（<65岁）患者中进行的。
