A research team led by Mayo Clinic has found a national trend toward younger, more diverse patients having total knee replacement surgery. The findings were presented today at the 2010 annual meeting of the American Academy of Orthopaedic Surgeons in New Orleans.
Data from the Centers for Disease Control and Prevention's National Hospital Discharge Survey (http://www.cdc.gov/nchs/nhds.htm) were compared for 1990-1994 and 2002-2006 for patients having total knee replacements (also known as total knee arthroplasty). About 800,000 procedures were performed in 1990-1994, and 2.1 million in 2002-2006.
Researchers found the average age of total knee replacement patients decreased by two years (from 70 years to 68 years) between the two time periods and that the percentage of minorities increased by 1.4 percent (from 8 percent to 9.4 percent).
The study also found that Medicare is paying less for total knee replacements, and the length of hospital stays decreased. The Medicare payment for the procedures dropped from 72 percent to 61 percent. Hospital stays went from 8.4 days to 3.9 days. This coincides with an increase in the number of patients going to short- or long-term care facilities after surgery.
"This information will be useful for planning for the future," says Michele D'Apuzzo, M.D., the Mayo Clinic orthopedic surgery resident who led the study. "Total knee replacements aren't going away any time soon. We're going to be seeing younger patients undergoing this procedure, but we may also see more failures and more revisions, and physicians and medical facilities need to prepare for that."
Rafael Sierra, M.D., Mayo Clinic orthopedic surgeon and senior author on the study, offered several explanations for why younger people are having total knee replacements. "Total knee replacement is becoming a more established procedure," he says. "There's a wider spectrum of diseases we can treat with the procedure. We're also getting better at it. We have better materials that are longer lasting. So we feel more comfortable performing it on younger people now."