Background: Over the past decade, there has been an increase in the
number of revision total hip and knee arthroplasties performed in the United
States. The purpose of this study was to formulate projections for the number
of primary and revision total hip and knee arthroplasties that will be
performed in the United States through 2030.
Methods: The Nationwide Inpatient Sample (1990 to 2003) was used in
conjunction with United States Census Bureau data to quantify primary and
revision arthroplasty rates as a function of age, gender, race and/or
ethnicity, and census region. Projections were performed with use of Poisson
regression on historical procedure rates in combination with population
projections from 2005 to 2030.
Results: By 2030, the demand for primary total hip arthroplasties is
estimated to grow by 174% to 572,000. The demand for primary total knee
arthroplasties is projected to grow by 673% to 3.48 million procedures. The
demand for hip revision procedures is projected to double by the year 2026,
while the demand for knee revisions is expected to double by 2015. Although
hip revisions are currently more frequently performed than knee revisions, the
demand for knee revisions is expected to surpass the demand for hip revisions
after 2007. Overall, total hip and total knee revisions are projected to grow
by 137% and 601%, respectively, between 2005 and 2030.
Conclusions: These large projected increases in demand for total hip
and knee arthroplasties provide a quantitative basis for future policy
decisions related to the numbers of orthopaedic surgeons needed to perform
these procedures and the deployment of appropriate resources to serve this