Le Stum Mathieu, Le Goff-Pronost Myriam, Stindel Eric
Université de Brest, UBO, INSERM, Laboratoire de Traitement de l'Information Médicale (LATIM), UMR1101, 22 Avenue Camille Desmoulins, 29200 Brest, France.
Institut Mines-Telecom, IMT Atlantique, LATIM - INSERM UMR 1101, M@rsouin, 655 Avenue du Technopôle, 29280 Plouzane, France.
Orthop Traumatol Surg Res. 2025 Sep;111(5):104006. doi: 10.1016/j.otsr.2024.104006. Epub 2024 Sep 26.
In response to various socio-economic factors and technological advancements, knee arthroplasty procedures have steadily increased. To date, epidemiological analyses have been conducted on a single-country basis. The aims of this article are: (1) to identify arthroplasty databases by country, (2) to verify the international comparability of coding, (3) to study retrospective epidemiological trends, and (4) to analyze projections by country. The hypothesis is that countries will follow similar trends, though with varying time lags.
A literature review from 2005 to 2023 was conducted following PRISMA recommendations on PubMed, Web of Science, and Cochrane, using the keywords: "Knee + Arthroplasty + Trends + Replacement + Epidemiology." Only articles featuring national analyses, based on references recognized by healthcare systems, were included.
Forty-eight articles, representing 16 countries, were selected. Europe was the most represented (47% of occurrences), followed by the USA (22%), Asia (20%), Oceania (8%), and Chile (2%). The data came from national databases or representative extrapolated samples. Extraction methods used precise national codes or specific definitions. Growth rates in volume and incidence were positive but varied between countries, with distinct dynamics and different phases of growth. Females had higher volumes and incidence rates (sex ratio 2/3), but growth was faster in males. Future forecasts, based on regression models (Poisson, linear, or logistic), predicted an increase in volumes of between +30% by 2030 and +805% by 2050.
The analysis of census systems revealed growth in knee arthroplasties in all countries, but with varying intensities depending on the period. These multifactorial disparities appeared to follow a similar pattern, staggered over time based on the countries' economic development.
IV; epidemiological review.
鉴于各种社会经济因素和技术进步，膝关节置换手术的数量稳步增加。迄今为止，流行病学分析都是在单个国家的基础上进行的。本文的目的是：（1）按国家识别关节置换数据库；（2）验证编码的国际可比性；（3）研究回顾性流行病学趋势；（4）分析各国的预测情况。假设是各国将遵循相似的趋势，尽管时间滞后有所不同。
按照PRISMA指南，于2005年至2023年在PubMed、科学网和考克兰图书馆上进行文献综述，使用关键词：“膝关节+关节成形术+趋势+置换+流行病学”。仅纳入基于医疗保健系统认可的参考文献进行国家分析的数据。
共筛选出代表16个国家的48篇文章。欧洲的文章数量最多（占47%），其次是美国（22%）、亚洲（20%）、大洋洲（8%）和智利（2%）。数据来自国家数据库或具有代表性的外推样本。提取方法使用了精确的国家代码或特定定义。手术量和发病率的增长率均为正值，但各国之间存在差异，增长动态和阶段各不相同。女性的手术量和发病率更高（性别比为2/3），但男性的增长速度更快。基于回归模型（泊松、线性或逻辑回归）的未来预测显示，到2030年手术量将增加30%，到2050年将增加805%。
对普查系统的分析表明，所有国家的膝关节置换手术都在增加，但不同时期的增长强度不同。这些多因素差异似乎遵循相似的模式，根据各国的经济发展情况在时间上错开。
IV；流行病学综述。
