This population-based study used National Hospital Discharge Survey data from 1990 through 2002 with U.S. Census data to quantify primary and revision hip and knee arthroplasty rates. It asked how procedural rates and the revision burden changed over time by age and gender. It also positioned itself as the first NHDS study to report revision rates for both joints.
The core teaching point is a simple but powerful equation: if revision burden stays constant, then every increase in primary arthroplasty volume produces a proportional increase in revisions down the line.
This paper documented that the THA revision burden (17.5%) is more than twice the TKA revision burden (8.2%) and that neither budged over 13 years. For a resident, this frames why revision surgery is a permanent and growing part of arthroplasty practice, not a problem that improving primary technique alone will solve.
Know the demographics for boards: rates peak in the 65-84 year range and are higher in women. The dramatic TKA growth is tied to obesity-driven knee osteoarthritis and broader acceptance of the procedure.
This is the most-cited arthroplasty paper and underpins nearly every workforce and policy projection. The authors explicitly argued that prior AAOS projections assuming constant prevalence were a conservative lower bound, because real rates were climbing faster.
This population-based study used National Hospital Discharge Survey data from 1990 through 2002 with U.S. Census data to quantify primary and revision hip and knee arthroplasty rates. It asked how procedural rates and the revision burden changed over time by age and gender. It also positioned itself as the first NHDS study to report revision rates for both joints.
The core teaching point is a simple but powerful equation: if revision burden stays constant, then every increase in primary arthroplasty volume produces a proportional increase in revisions down the line.
This paper documented that the THA revision burden (17.5%) is more than twice the TKA revision burden (8.2%) and that neither budged over 13 years. For a resident, this frames why revision surgery is a permanent and growing part of arthroplasty practice, not a problem that improving primary technique alone will solve.
Know the demographics for boards: rates peak in the 65-84 year range and are higher in women. The dramatic TKA growth is tied to obesity-driven knee osteoarthritis and broader acceptance of the procedure.
This is the most-cited arthroplasty paper and underpins nearly every workforce and policy projection. The authors explicitly argued that prior AAOS projections assuming constant prevalence were a conservative lower bound, because real rates were climbing faster.