Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Public Health Science, Complex Disease and Genome Epidemiology Branch, School of Public Health, Seoul National University, Seoul, South Korea.
BMC Musculoskelet Disord. 2021 Apr 22;22(1):375. doi: 10.1186/s12891-021-04235-3.
The annual number of hip arthroplasties is increasing combined with the aging population worldwide. In accordance with the increasing number of primary hip arthroplasties, the number of revision total hip arthroplasties (THAs) is expected to increase. The incidence and burden of revision THAs in the United States and have been reported by registry studies. To identify potential differences according to ethnics and regional practice, it is important to obtain data from East Asia. Nevertheless, there has been a lack of studies on the burden and future projection of revision THA based on a large-scale database in East Asia. The purpose of this study was to evaluate annual incidence and burden of revision THAs and to project the future burden in South Korea.
We identified primary THAs, primary hemiarthroplasties (HAs) and revision THAs, which were performed from 2010 to 2018, using database of Health Insurance and Review and Assessment (HIRA); nation-wide medical claim system of South Korea. The annual incidence rates (per 100,000) of primary THA, primary HA and revision THA, and the annual burden of revision THA; the number of revision THAs divided by the sum of primary hip arthroplasties and revision THAs, were calculated. The future burden of revision THAs were projected through 2030 using generalized linear model with Quasi-poisson regression.
During the 9-year period, the annual incidences of primary THA, primary HA and revision THA increased by 47, 29 and 3%, respectively, while the revision burden decreased from 0.13 to 0.10. Compared to 2018, the annual incidences of primary THA, HA, and revision THA were projected to increase by 7.2, 2.3 and 1.1% per year, respectively, whereas the burden of revision THA was projected to decrease to 0.07 in 2030.
Trends of revision THA in South Korea were similar with those of national registry studies from the United States. The annual incidence of revision THA has steadily increased, whereas its burden has decreased. Findings of our study could be used for epidemiological comparison between Western countries and East Asia as well as for the establishment of medical policies of revision THA in East Asian countries.
随着全球人口老龄化，每年进行髋关节置换术的人数不断增加。随着初次髋关节置换术数量的增加，预计翻修全髋关节置换术（THA）的数量也将增加。美国的登记研究已经报告了翻修 THA 的发病率和负担。为了根据种族和地区实践确定潜在差异，从东亚获取数据非常重要。然而，基于东亚大规模数据库，关于翻修 THA 的负担和未来预测的研究还很少。本研究的目的是评估翻修 THA 的年度发病率和负担，并预测韩国的未来负担。
我们使用韩国全国性医疗报销系统 Health Insurance and Review and Assessment（HIRA）数据库，确定了 2010 年至 2018 年期间进行的初次 THA、初次半髋关节置换术（HA）和翻修 THA。计算了初次 THA、初次 HA 和翻修 THA 的年度发病率（每 10 万人）、翻修 THA 的年度负担；翻修 THA 数量与初次髋关节置换术和翻修 THA 数量之和的比值。使用广义线性模型与拟泊松回归预测 2030 年前翻修 THA 的未来负担。
在 9 年期间，初次 THA、初次 HA 和翻修 THA 的年度发病率分别增加了 47%、29%和 3%，而翻修负担则从 0.13 降至 0.10。与 2018 年相比，预计 2030 年前初次 THA、HA 和翻修 THA 的年度发病率将分别以每年 7.2%、2.3%和 1.1%的速度增长，而翻修 THA 的负担预计将降至 0.07。
韩国翻修 THA 的趋势与美国国家登记研究相似。翻修 THA 的年度发病率稳步上升，而负担则有所下降。本研究的结果可用于西方国家与东亚之间的流行病学比较，以及东亚国家翻修 THA 医疗政策的制定。
