Abstract
The volume of knee arthroplasty procedures has increased over the last decade. The aim of this study was to estimate the frequency of these procedures performed within the public healthcare system of the state of São Paulo between 2003 and 2010. Cross-sectional study conducted in the state of São Paulo by researchers at Hospital do Servidor Público do Estado de São Paulo. A sample of 10,952 patients (7,891 females and 3,061 males) who underwent primary total knee arthroplasty (TKA) and revision of total knee arthroplasty (RTKA) in the state of São Paulo between 2003 and 2010 was evaluated. The patients were cataloged using the public healthcare service's TABNET software. All of the patients presented primary osteoarthritis of the knee. The variables of gender, number of primary TKA procedures and number of RTKA procedures were evaluated. A total of 10,952 TKA procedures were performed (annual average of 1369), of which 9,271 (85%) were TKA and 1,681 (15%), RTKA. Of the TKA procedures, 72% were carried out on females (P < 0.0001), while 70% of the RTKA procedures were on females (P < 0.0001). The average ratio of TKA to RTKA was 5.5:1 (P < 0.0001); the ratios in 2003 and 2010 were 9.0:1 and 4.4:1 (P < 0.0001), respectively. The number and frequency of TKA and RTKA procedures increased in the state of São Paulo between 2003 and 2010. This increase was relatively greater in RTKA than in TKA and was predominantly in female patients.
Highlights
It has been estimated that 4% of the Brazilian population over the age of 60 years suffer from osteoarthritis (OA), and the knee is the joint that is second most commonly affected, with 37% of the cases.[1]
In analyzing the data provided by DATASUS, it can be seen that between 2003 and 2010 there was a change in the epidemiological profile of the knee arthroplasty procedures carried out in the state of São Paulo
A further American survey showed linear progression between total knee arthroplasty (TKA) and revision TKA (RTKA) between 1990 and 2002, with the ratio changing from 10.75 to 10.88.24 Our series showed a decrease in this relationship between 2003 and 2010, such that the ratio changed from 9.0 to 4.4
Summary
It has been estimated that 4% of the Brazilian population over the age of 60 years suffer from osteoarthritis (OA), and the knee is the joint that is second most commonly affected, with 37% of the cases.[1]. One of the therapeutic options for advanced symptomatic OA is total knee arthroplasty (TKA), which has shown a long-term success rate of 85% for relieving pain and improving function.[4,5,6,7,8,9,10] With the growth of primary TKA in absolute terms, it is reckoned that the frequency of revision TKA (RTKA) surgery will increase.[11]
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