Abstract
Aims
Several national studies have shown that the rates of joint replacement are rising and this increase may be greater than that expected by population ageing. The aim of this study was to assess local rates of joint replacement at a district general hospital (DGH) and to investigate whether there had been a change in pre-operative functional status of patients over the study period to account for any change in rates of arthroplasty.
Methods
This was a DGH based local joint registry programme with independent functional assessment and follow up. All patients undergoing primary total hip replacement (THR) and total knee replacement(TKR) between 1 January 2000 and 31 December 2009 were eligible. Only after being listed for surgery were patients assessed with WOMAC and Oxford Hip or Oxford Knee scores. Catchment population data was obtained from the Office of National Statistics
Results
5373 joint replacements were performed over the ten year period, 89% had preoperative scoring available. There was an 80% increase in numbers of THR performed and 95% increase in number of TKR performed between 2000 and 2009. This was a significant increase when compared to the local population aged between 60 and 80 years, the size of which increased just 28% over the same period. The average age of the patients remained static over the study period and there was no clinically significant change in any of the pre-operative functional scores.
Conclusions
Whilst the incidence of joint replacement increased over the study period, this was not associated with a change in patients' ages or preoperative functional status. Our results suggest that the increases seen are not due to a change in functional threshold for surgery. This is of particular relevance during this time of austerity when funding for orthopaedic surgery may be threatened.
