Total Knee and Hip Replacement Surgery Projections Show Meteoric Rise by 2030

Orthopaedic procedures set to continue gaining widespread acceptance as means

to restore quality-of-life

Mar 24, 2006, 00:00 ET from American Academy of Orthopaedic Surgeons

    CHICAGO, March 24 /PRNewswire/ -- The demand for total joint replacement
 is expected to increase so dramatically in the next 25 years that there may
 not be enough orthopaedic surgeons to perform the surgeries, as indicated by
 results from recent research on the topic.  As presented at the 73rd Annual
 Meeting of the American Academy of Orthopaedic Surgeons (AAOS), the study
 projects the number of hip and knee replacement procedures that will be
 performed in the United States through the year 2030.
     Lead author Steven M. Kurtz, PhD, director of the Philadelphia office of
 Exponent Inc., an engineering and scientific consulting firm, and his research
 team projected that the number of procedures for primary (first-time) total
 knee replacement would jump by 673 percent - to 3.48 million - in 2030. The
 number of primary total hip replacements, the authors estimate, will increase
 by 174 percent - to 572,000 - in 2030. Partial joint replacements were
 projected to increase by only 54 percent.  The research team based its
 projections on historical procedure rates from 1990 to 2003, combined with
 population projections from the U.S. Census Bureau.
     Also expected to become more prevalent is the repair or replacement of the
 artificial joint, called revision joint replacement.  The number of revision
 surgeries likely will double by 2015 for total knee replacement and by 2026
 for total hip replacement, according to the authors.  Currently, hip revisions
 outnumber knee revisions, but knee revisions should surpass hip revisions
 after 2007, Kurtz stated.
     "There's definitely going to be a huge need for more orthopaedic
 surgeons," explained Kurtz, who is also research associate professor at Drexel
 University's School of Biomedical Engineering in Philadelphia.  "If the
 massive expected demand for total joint replacement is not planned for before
 2030, patients may end up waiting a long time for a new hip or knee."
     The growing need for joint replacement must be met not only with more
 surgeons, according to Kurtz, but also by increasing economic resources and
 longevity of the artificial joint.  Among the reasons for the expected
 increased demand is that total joint replacement is gaining in acceptance.
 "There are few procedures that return as much quality of life as joint
 replacement," he explained.
     Other reasons include an aging population with arthritis requiring joint
 replacement; the increasing prevalence of obesity, which puts undue stress on
 the knee and hip joints; and the trend toward baby boomers remaining
 physically active later in life, which also places demands on the joints.
     Given these trends and the scientific methods that Kurtz' team used, their
 estimates are realistic, said Joshua J. Jacobs, MD, associate chairman and
 professor of orthopaedic surgery at Rush University Medical Center in Chicago
 and chair of the AAOS Council on Research, Quality Assessment and Technology,
 who was not affiliated with the study.  However, future scientific advances
 could change their projections, he added.
     If joint replacement surgeries increase as the authors projected, it will
 burden an already financially challenged health care system, according to Dr.
 Jacobs.  "We're on a collision course between the demands placed by the
 Medicare population for services - joint replacement being a major one - and
 the ability of our society to pay for them," he explained.
     Costs of revision joint replacement are particularly great and must be
 reduced, Dr. Jacobs stressed.  The best way is to make the original joint
 implant last longer.  For that to happen, there is a need for more research to
 improve surgical materials and technologies, continuing education on best
 practices for surgeons performing the procedures and new medical approaches to
 prevent loosening of the implant.
     Also, the AAOS has called for a national joint-replacement registry.  Such
 a registry could help decrease the need for revision surgery, as it did in
 Sweden, Dr. Jacobs said, by identifying best surgical practices and the best-
 performing implants in primary joint replacement.
     No external funding was received for this study.
     An orthopaedic surgeon is a physician with extensive training in the
 diagnosis and non-surgical as well as surgical treatment of the
 musculoskeletal system, including bones, joints, ligaments, tendons, muscles
 and nerves.
     With more than 29,000 members, the American Academy of Orthopaedic
 Surgeons ( or ( is the premier not-for-profit
 organization that provides education programs for orthopaedic surgeons and
 allied health professionals, champions the interests of patients and advances
 the highest quality musculoskeletal health. Orthopaedic surgeons and the
 Academy are the authoritative sources of information for patients and the
 general public on musculoskeletal conditions, treatments and related issues.
 An advocate for improved patient care, the Academy is participating in the
 Bone and Joint Decade ( - the global initiative in the years
 2002-2011 - to raise awareness of musculoskeletal health, stimulate research
 and improve people's quality of life. The Academy's Annual Meeting is being
 held March 22-26, 2006 at McCormick Place in Chicago.

SOURCE American Academy of Orthopaedic Surgeons