Ackerman Ilana N, Soh Sze-Ee, de Steiger Richard
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3001, Australia.
Monash-Cabrini Department of Musculoskeletal Health and Clinical Epidemiology, Melbourne, VIC 3144, Australia.
J Clin Med. 2022 Mar 28;11(7):1883. doi: 10.3390/jcm11071883.
National projections of future joint replacement use can help us understand the changing burden of severe osteoarthritis. This study aimed to compare actual utilisation rates for primary total hip replacement (THR) and total knee replacement (TKR) to previously forecast estimates for Australia. Data from the Australian Orthopaedic Association National Joint Replacement Registry and Australian Bureau of Statistics were used to calculate 'actual' THR and TKR utilisation rates for the years 2014-2019, by sex and age group. 'Forecast' utilisation rates for 2014-2019 were derived from an earlier study that modelled two alternate scenarios for THR and TKR in Australia: Scenario 1 assumed a constant rate of surgery; Scenario 2 assumed continued growth in surgery rates. Actual utilisation rates were compared descriptively to forecast rates for females and males (overall and by age group). Rate ratios were calculated to indicate the association between actual and forecast THR and TKR rates, with a rate ratio of 1.00 reflecting perfect alignment. Over the study period, 191,996 THRs (53% in females) and 312,203 TKRs (55% in females) were performed. For both sexes, actual rates lay clearly between the Scenario 1 and 2 forecast estimates. In 2019, actual THR utilisation rates were 179 per 100,000 females (Scenario 1: 156; Scenario 2: 200) and 158 per 100,000 males (Scenario 1: 139; Scenario 2: 191). Actual TKR utilisation rates in 2019 were 289 per 100,000 females (Scenario 1: 275; Scenario 2: 387) and 249 per 100,000 males (Scenario 1: 216; Scenario 2: 312). Age-specific rate ratios were close to 1.00 for all age groups, indicating good alignment between forecast and actual joint replacement rates. These validation analyses showed that linear plus exponential growth forecasting scenarios provided an efficient approximation of actual joint replacement utilisation. This indicates our modelling techniques can be used to judiciously predict future surgery demand, including for age groups with high surgery rates.
对未来关节置换手术使用情况的全国性预测有助于我们了解重度骨关节炎负担的变化。本研究旨在比较澳大利亚初次全髋关节置换术（THR）和全膝关节置换术（TKR）的实际利用率与先前预测的估计值。澳大利亚骨科协会国家关节置换登记处和澳大利亚统计局的数据被用于按性别和年龄组计算2014 - 2019年的THR和TKR“实际”利用率。2014 - 2019年的“预测”利用率来自一项早期研究，该研究为澳大利亚的THR和TKR模拟了两种替代情景：情景1假设手术率恒定；情景2假设手术率持续增长。将实际利用率与女性和男性（总体及按年龄组）的预测率进行描述性比较。计算率比以表明实际与预测的THR和TKR率之间的关联，率比为1.00表示完全一致。在研究期间，共进行了191,996例THR（女性占53%）和312,203例TKR（女性占55%）。对于男女两性，实际率明显介于情景1和情景2的预测估计值之间。2019年，女性的实际THR利用率为每10万人179例（情景1：156例；情景2：200例），男性为每10万人158例（情景1：139例；情景2：191例）。2019年女性的实际TKR利用率为每10万人289例（情景1：275例；情景2：387例），男性为每10万人249例（情景1：216例；情景2：312例）。所有年龄组的特定年龄率比均接近1.00，表明预测和实际关节置换率之间吻合良好。这些验证分析表明，线性加指数增长预测情景提供了实际关节置换利用率的有效近似值。这表明我们的建模技术可用于明智地预测未来手术需求，包括手术率高的年龄组。
