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4.7. Hip and Knee Replacement

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4.7. Hip and Knee Replacement 4. HEALTH CARE ACTIVITIES 4.7. Hip and knee replacement Significant advances in surgical treatment have provided ment increased by over 25% between 2000 and 2009. The effective options to reduce the pain and disability associated growth rate was even higher for knee replacement, nearly with certain musculoskeletal conditions. Joint replacement doubling over the past decade. In the United States, both surgery (hip and knee replacement) is considered the most hip replacement and knee replacement rates nearly effective intervention for severe osteoarthritis, reducing doubled since 2000. In Denmark, while the hip replacement pain and disability and restoring some patients to near- rate increased by only about 20% between 2000 and 2009, normal function. the knee replacement rate almost tripled. The growth rate Ostheoarthritis is one of the ten most disabling diseases in was more modest in other countries such as France and developed countries (WHO, 2010b). Worldwide estimates Israel. are that 10% of men and 18% of women aged over 60 years The growing volume of hip and knee replacement is have symptomatic osteoarthritis, including moderate and contributing to health expenditure growth as these are severe forms. Age is the strongest predictor of the develop- expensive interventions. In 2007, the average estimated ment and progression of osteoarthritis. It is more common price of a knee replacement was nearly USD 15 000 in the in women, increasing after the age of 50 especially in the United States and Australia, USD 12 000 in France, and about hand and knee. Other risk factors include obesity, physical USD 10 000 in Canada, Germany and Sweden. The estimated inactivity, smoking, excess alcohol and injuries (European price of a hip replacement was even higher, reaching more Commission, 2008b). While joint replacement surgery is than USD 17 000 in the United States, about USD 16 000 in mainly carried out among people aged 60 and over, it can Australia, and between USD 11 000 and 12 000 in Canada, also be performed among people of younger ages. France and Sweden (Koechlin et al., 2010). There is considerable variation across countries in the rate of hip and knee replacement (Figures 4.7.1 and 4.7.2). Germany, Switzerland and Austria have high rates of both hip and knee replacement. The United States and Germany have the highest rate of knee replacement, even though the population structure of the United States is much younger Definition and comparability than that of Germany. A number of reasons can explain Hip replacement is a surgical procedure in which the cross-country variations in the rate of hip and knee hip joint is replaced by a prosthetic implant. It is replacement, including: i) differences in the prevalence of generally conducted to relieve arthritis pain or treat osteoarthritis problems; ii) differences in the capacity to severe physical joint damage following hip fracture. deliver and pay for these expensive procedures; and iii) differences in clinical treatment guidelines and practices. Knee replacement is a surgical procedure to replace the weight-bearing surfaces of the knee joint in order There are currently too few comparable studies on the to relieve the pain and disability of osteoarthritis. It prevalence of osteoarthritis to draw any conclusions on may also be performed for other knee diseases such cross-country variations. Nor is there any evidence as to as rheumatoid arthritis. whether the age- and sex-specific incidence of osteo- arthritis has changed in recent decades. However, the Classification systems and registration practices vary number of people suffering from osteoarthritis has across countries, which may affect the comparability increased, and is expected to continue to increase in the of the data. In Ireland, the data only include activities coming years, for two reasons: 1) population ageing, which in publicly-funded hospitals (it is estimated that over is resulting in a growing number of people over 60 with a 10% of all hospital activity in Ireland is undertaken in greater risk of suffering from osteoarthritis; and 2) the private hospitals). Some countries only include total growing prevalence of obesity, which is the main risk factor hip replacement, excluding partial hip replacement for osteoarthritis beyond age and sex. (e.g. Estonia). The number of hip and knee replacement has increased Information on data for Israel: http://dx.doi.org/10.1787/ rapidly over the past decade in most OECD countries 888932315602. (Figures 4.7.3 and 4.7.4). On average, the rate of hip replace- 92 HEALTH AT A GLANCE 2011: OECD INDICATORS © OECD 2011 4. HEALTH CARE ACTIVITIES 4.7. Hip and knee replacement 4.7.1 Hip replacement surgery, per 100 000 population, 4.7.2 Knee replacement surgery, per 100 000 population, 2009 (or nearest year) 2009 (or nearest year) Germany 296 Germany 213 Switzerland 287 United States 213 240 Belgium Switzerland 200 Austria 238 Austria 188 Denmark 236 Finland 178 Norway 232 France 224 Denmark 168 Luxembourg 222 Belgium 168 Sweden 214 Luxembourg 160 Netherlands 213 Australia 158 Slovenia 194 Canada 143 United Kingdom 194 United Kingdom 141 Finland 188 Iceland 132 United States 184 Iceland 173 Sweden 127 Czech Republic 166 Netherlands 124 Australia 154 France 119 OECD 154 OECD 118 Italy 150 Czech Republic 111 New Zealand 149 Spain 102 Greece 140 New Zealand 102 Canada 123 100 Ireland 117 Italy Hungary 99 Korea 98 Spain 93 Slovenia 93 Portugal 88 Norway 75 Estonia 88 Portugal 62 Slovak Republic 78 Israel 47 Israel 51 Hungary 45 Poland 44 42 Chile 19 Ireland Korea 17 Chile 5 Mexico 8 Mexico 3 0 100 200 300 0 100 200 300 Per 100 000 population Per 100 000 population Source: OECD Health Data 2011. Source: OECD Health Data 2011. 1 2 http://dx.doi.org/10.1787/888932524754 1 2 http://dx.doi.org/10.1787/888932524773 4.7.3 Trend in hip replacement surgery, 4.7.4 Trend in knee replacement surgery, 2000-09, selected countries 2000-09, selected countries Canada France Denmark Israel Sweden Switzerland Switzerland United States OECD25 OECD21 Per 100 000 population Per 100 000 population 300 300 250 250 200 200 150 150 100 100 50 50 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Source: OECD Health Data 2011. Source: OECD Health Data 2011. 1 2 http://dx.doi.org/10.1787/888932524792 1 2 http://dx.doi.org/10.1787/888932524811 HEALTH AT A GLANCE 2011: OECD INDICATORS © OECD 2011 93 From: Health at a Glance 2011 OECD Indicators Access the complete publication at: https://doi.org/10.1787/health_glance-2011-en Please cite this chapter as: OECD (2011), “Hip and knee replacement”, in Health at a Glance 2011: OECD Indicators, OECD Publishing, Paris. DOI: https://doi.org/10.1787/health_glance-2011-35-en This work is published under the responsibility of the Secretary-General of the OECD. The opinions expressed and arguments employed herein do not necessarily reflect the official views of OECD member countries. This document and any map included herein are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. You can copy, download or print OECD content for your own use, and you can include excerpts from OECD publications, databases and multimedia products in your own documents, presentations, blogs, websites and teaching materials, provided that suitable acknowledgment of OECD as source and copyright owner is given. All requests for public or commercial use and translation rights should be submitted to [email protected]. Requests for permission to photocopy portions of this material for public or commercial use shall be addressed directly to the Copyright Clearance Center (CCC) at [email protected] or the Centre français d’exploitation du droit de copie (CFC) at [email protected]..
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