Epidemiological study of Total Knee Arthroplasty in Iran

Document Type : Original Article

Authors

1 Professor, Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

2 Assistance Professor of Health Economic, Kerman University of Medical Sciences, Kerman, Iran.

3 Assistance Professor of Health Policy, Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

4 Associate Professor of Surgery of the Knee, Orthopedic Department, Kerman University of Medical Sciences, Kerman, Iran.

5 Ph.D. candidate, Department of Health Management, Policy, and Economics, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran.

Abstract

Introduction: The infinite and increasing need for health service providers along with limited health sources has led to an increase in health costs and, consequently, the transfer of government resources from other social services to the health sector. One of the hospital services that has increased the costs in hospitals is total knee arthroplasty. Knee joint is one of the important joints of the body that is affected by various inflammatory and erosive diseases, which ultimately causes destruction of the articular cartilage and loss of proper joint function. Today, we are faced with an increasing demand for total knee arthroplasty. Knowledge of the distribution and extent of TKA provides the basis for health managers to design and implement interventions to reduce TKA surgery.
Method: This study is a cross-sectional study. 14329 records of total knee arthroplasty patients in Iran were selected by census method in 2019-2021. The data collection tool in this study was a standard checklist. Data were analyzed by SPSS version 24 software using descriptive statistics.
Results: The mean age of the patients was 66.1 years. 81.31% of the patients were female. 87.4% of them lived in cities, 31.5% had supplementary insurance, and most of the patients (51.9%) had undergone total knee arthroplasty in private hospitals.
Discussion and conclusion: The pattern of total knee arthroplasty in our country is similar to that of other countries; most surgeries are performed in private hospitals, which may generate induced demand. TKA is more prevalent in the urban population, and most people who have had surgery do not have supplementary insurance coverage, and the northern provinces have the highest TKA;  thus, the attention of researchers and policy makers to the field of health in identifying and preventing the factors leading to knee replacement will make the demands for total knee arthroplasty reasonable.
 

Keywords

References

1. Zehr KJ, Dawson PB, Yang SC, Heitmiller RF. Standardized clinical care pathways for major thoracic cases reduce hospital costs. Ann Thorac Surg. 1998;66(3):914-9. doi: 10.1016/s0003-4975(98)00662-6.
2. Dowsey MM, Kilgour ML, Santamaria NM, Choong PF. Clinical pathways in hip and knee arthroplasty: a prospective randomised controlled study. Med J Aust. 1999;170(2):59-62. doi: 10.5694/j.1326-5377.1999.tb126882.x.
3. Pennington JM, Jones DP, McIntyre S. Clinical pathways in total knee arthroplasty: a New Zealand experience. J Orthop Surg (Hong Kong). 2003;11(2):166-73. doi: 10.1177/230949900301100211.
4. Hooper G, Lee AJ, Rothwell A, Frampton C. Current trends and projections in the utilisation rates of hip and knee replacement in New Zealand from 2001 to 2026. N Z Med J.2014;127(1401):82-93.
5. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89(4):780-5. doi: 10.2106/JBJS.F.00222.
6. Patel A, Pavlou G, Mujica-Mota RE, Toms AD. The epidemiology of revision total knee and hip arthroplasty in England and Wales: a comparative analysis with projections for the United States. A study using the National Joint Registry dataset. Bone Joint J. 2015;97-B(8):1076-81. doi: 10.1302/0301-620X.97B8.35170.
7. Healy WL, Iorio R, Ko J, Appleby D, Lemos DW. Impact of cost reduction programs on short-term patient outcome and hospital cost of total knee arthroplasty. J Bone Joint Surg Am. 2002;84(3):348-53. doi: 10.2106/00004623-200203000-00003.
8. Lavernia C, Lee DJ, Hernandez VH. The increasing financial burden of knee revision surgery in the United States. Clin Orthop Relat Res. 2006;446:221-6. doi: 10.1097/01.blo.0000214424.67453.9a.
9. Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis. 2001;60(2):91-7. doi: 10.1136/ard.60.2.91.
10. Lavernia CJ, Guzman JF, Gachupin-Garcia A. Cost effectiveness and quality of life in knee arthroplasty. Clin Orthop Relat Res. 1997(345):134-9. doi: 10.1097/00003086-199712000-00018.
11. Canale ST, Beaty JH. Campbell’s operative orthopaedics: adult spine surgery e-book. Amsterdam: Elsevier Health Sciences; 2012.
12. H S. Collusion in the operating room. Tehran: Shargh newspaper. 2018. Persian.
13. MN T. Total knee arthroplasty in patients with osteoarthritis: Results of 34 operations. Tehran University Medical Journal TUMS Publications. 2009;67(2):146-50.
14. Ghazisaeedi M, Mohammadzadeh N, Akhlaghi M, Zivdar M. Minimum data requirements to predict the need for total knee arthroplasty in osteoarthritis patients. Journal of Modern Medical Information Sciences. 2018;3(2):1-7.
15. Zeinali M, Rabie H. Short-term results of knee replacement surgery performed at Shahid Sadoughi Hospital in Yazd in 57 cases. Iranian Journal of Orthopaedic Surgery. 2016;14(4):101-6.
16. Mobarakeh K, Saeed M, Nemati M. Knee Replacement Knee Replacement. Iranian Journal of Orthopaedic Surgery. 2007;5(4):165-70.
17. Pal CP, Singh P, Chaturvedi S, Pruthi KK, Vij A. Epidemiology of knee osteoarthritis in India and related factors. Indian J Orthop. 2016;50(5):518-22. doi: 10.4103/0019-5413.189608.
18. Johnsen MB, Hellevik AI, Smastuen MC, Langhammer A, Furnes O, Flugsrud GB, et al. The mediating effect of body mass index on the relationship between smoking and hip or knee
replacement due to primary osteoarthritis. A population-based cohort study (the HUNT Study). PLoS One. 2017;12(12):e0190288. doi: 10.1371/journal.pone.0190288.
19. Kerrigan DC, Johansson JL, Bryant MG, Boxer JA, Della Croce U, Riley PO. Moderate-heeled shoes and knee joint torques relevant to the development and progression of knee osteoarthritis. Arch Phys Med Rehabil. 2005;86(5):871-5. doi: 10.1016/j.apmr.2004.09.018.
20. Lingard EA, Katz JN, Wright EA, Sledge CB, Kinemax Outcomes G. Predicting the outcome of total knee arthroplasty. J Bone Joint Surg Am. 2004;86(10):2179-86. doi: 10.2106/00004623-200410000-00008.
21. Kirkhorn S, Greenlee RT, Reeser JC. The epidemiology of agriculture-related osteoarthritis and its impact on occupational disability. WMJ.2003;102(7):38-44.
Health Management & Information Science
Volume 8, Issue 3
July 2021
Pages 210-216

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