A new study shows knee replacement procedures have increased dramatically over the past two decades.
The number of total knee arthroplasty (TKA) procedures went up 162 percent -- 243,802 -- from 1991 to 2010 and the per capita rate rose 99 percent -- to 62.1 per 10,000 enrollees, according to an analysis of fee-for-service Medicare records by Dr. Peter Cram of the University of Iowa in Iowa City and colleagues.
Shorter hospital stays posted over the period were offset by rising readmissions and complications in revision procedures, particularly wound infections, the group reported in the Sept. 26 issue of the Journal of the American Medical Association.
Study results:
162% increase in TKA
106% increase in revisions of TKA
4 days shorter hospital stays
50% increase in would infections (revisions) 100% increase in serious side effects - hemmorhage, DVT's, heart attacks
Trends in utilization from 1991 to 2010, showed a:
162 percent increase in the total volume of primary procedures, from 93,230 to 243,802
106 percent rise in revision TKA volume, from 9,650 to 19,871
99 percent increase in the per capita rate of primary knee replacement, from 31.2 to 62.1 per 10,000 Medicare enrollees
59 percent increase in per capita revision procedures, from 3.2 to 5.1 per 10,000 Medicare enrollees
However, it's not clear whether the growth "represents growth in appropriate use of a highly effective procedure or overuse of a highly reimbursed procedure for which indications still depend on clinical judgment," the researchers wrote.