Waikato Medical Research Centre, University of Waikato, Hamilton, New Zealand
Orthopaedic Department, Tauranga Hospital, Tauranga, New Zealand.
BMJ Open. 2019 Sep 20;9(9):e032993. doi: 10.1136/bmjopen-2019-032993.
To (1) explore the regional and ethnic differences in rates of publicly funded osteoarthritis-associated hip and knee replacement surgeries and (2) investigate the mortality after surgery.
Population-based, retrospective, cross-sectional study.
General population in New Zealand.
Patients with osteoarthritis who underwent publicly funded primary hip and knee replacement surgeries in 2005-2017. Patients aged 14-99 years were included.
Age-standardised rate, standardised mortality ratio (SMR) and 30 days, 90 days and 1 year mortality.
We identified 53 439 primary hip replacements and 50 072 primary knee replacements with a diagnosis of osteoarthritis. The number and age-standardised rates of hip and knee replacements increased over time. Māori had the highest age-standardised rate of hip replacements, followed by European/others and Pacific, and Asian had the lowest rate. Pacific had the highest age-standardised rate of knee replacements, followed by Māori and European/others, and Asian had the lowest rate. The Northern Health Network had the lowest rate of hip surgeries, and the Southern Health Network had the lowest rate of knee surgeries. The SMRs of patients undergoing hip and knee replacements were lower than the general population: 0.92 (95% CI 0.89 to 0.95) for hip and 0.79 (95% CI 0.76 to 0.82) for knee. The SMRs were decreasing over time. The patterns of 30 days, 90 days and 1 year mortality were similar to the SMR.
The numbers of publicly funded osteoarthritis-associated primary hip and knee replacements are steadily increasing. Māori people had the highest age-standardised rate of hip replacements and Pacific people had the highest rate of knee replacements. The Northern Health Network had the lowest rate of hip surgeries, and the Southern Health Network had the lowest rate of knee surgeries. Compared with the general population, patients who had hip and knee replacements have a better life expectancy.
（1）探讨公共资金资助的髋膝关节骨关节炎置换手术在地区和种族间的差异，（2）调查术后死亡率。
基于人群的回顾性、横断面研究。
新西兰普通人群。
2005 年至 2017 年接受公共资金资助的初次髋膝关节置换术的骨关节炎患者。纳入年龄 14-99 岁的患者。
年龄标准化率、标准化死亡率比（SMR）以及 30 天、90 天和 1 年的死亡率。
我们共确定了 53439 例初次髋关节置换术和 50072 例初次膝关节置换术的骨关节炎诊断患者。髋关节和膝关节置换术的数量和年龄标准化率随时间增加而增加。毛利人髋关节置换术的年龄标准化率最高，其次是欧洲/其他族裔和太平洋岛民，而亚洲人的比率最低。太平洋岛民膝关节置换术的年龄标准化率最高，其次是毛利人和欧洲/其他族裔，而亚洲人的比率最低。北部卫生网络的髋关节手术率最低，南部卫生网络的膝关节手术率最低。接受髋关节和膝关节置换术的患者的 SMR 低于普通人群：髋关节为 0.92（95%CI 0.89 至 0.95），膝关节为 0.79（95%CI 0.76 至 0.82）。SMR 随时间呈下降趋势。30 天、90 天和 1 年死亡率的模式与 SMR 相似。
公共资金资助的髋膝关节骨关节炎初次置换术的数量稳步增加。毛利人髋关节置换术的年龄标准化率最高，太平洋岛民膝关节置换术的比率最高。北部卫生网络的髋关节手术率最低，南部卫生网络的膝关节手术率最低。与普通人群相比，接受髋关节和膝关节置换术的患者预期寿命更长。
