Health Services/Policy
The changing prevalence and characteristics of total knee replacement recipients from 2003 to 2014 in Ontario, Canada Tristan Watson* Tristan Watson Gillian Hawker Laura Rosella Peter Smith Arjumand Siddiqi
Background
Descriptive studies have shown increasing use of total knee replacements (TKRs) in North America, especially amongst younger patients (< 60 years old). Few studies have examined the prevalence and characteristics of people living with a TKR in Ontario. The current study sought to estimate the trends in the crude and age-standardized prevalence of primary TKR across age and sex in Ontario, Canada.
Methods
We conducted a population-based descriptive study of Ontario adult respondents (age 20-105) from the Canada Community Health Survey (CCHS) linked to health administrative data. The outcome was the prevalence of at least one primary TKR with a 10-year lookback from the survey date. We estimated the crude and standardized TKR prevalence across the six CCHS survey cycles (2003-2014) by age and sex. The 2014 Canadian population structure was used as the standard population.
Results
The estimated 2013 crude and standardized 10-year TKR prevalence in Ontario was 1.24% (95% CI: 1.10-1.38) and 1.30% (95% CI: 1.17-1.45), respectively. The crude and standardized 10-year prevalence increased between 2003 and 2012, with a significant increase in the prevalence in 2009. Across the age-specific 10-year TKR prevalence estimates, the largest relative increase from 2003 to 2014 was seen in the age group 60-69 (prevalence2013 = 4.81%; 92% increase) and 80-105 (prevalence2013 = 7.55%; 157% increase). The crude and standardized prevalence estimates were higher among females than males across all survey years.
Conclusion
We estimate that in 2013 about 125 000 adults in Ontario, Canada, were living with at least one primary TKR in the past 10 years. Given the increasing prevalence of younger patients, these findings highlight a growing group of individuals at risk for costly revision TKRs and may inform health services planning in healthcare provision.