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The implications of an aging population and increased obesity for knee arthroplasty rates in Sweden: a register-based study

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@article{384b5a4a675e4e5993322a06032540ca,
title = "The implications of an aging population and increased obesity for knee arthroplasty rates in Sweden: a register-based study",
abstract = "Background and purpose - Total knee arthroplasty (TKA) has increased substantially in Sweden. We quantified the relative risk for TKA in the Swedish population for different BMI categories and age groups to investigate whether the continued increase in TKA is attributable to increased prevalence of obesity and elderly people in the population, and to put forward model predictions for coming needs for TKA. Patients and methods - We used the Swedish Nationwide Health Survey (SNHS) and the Swedish Knee Arthroplasty Register (SKAR) 2009-2015 to calculate the relative risk (RR) of TKA by age (middle-aged 45-64 years and elderly 65-84 years) and BMI (BMI 18.5-24.9 normal weight; BMI 25.0-29.9 overweight; BMI > 30 obese). The RR for TKA was applied to the demographic forecasts for the Swedish population as a forecasting model. Results - Population size increased 5.2% from 2009 to 2015 to 40,000 middle-aged and 250,000 elderly, and the prevalence of obesity increased from 16% to 18% in these 2 age categories. Compared with those of normal weight, the RR for TKA was 2.7 (95% CI 2.5-3.0) higher for the overweight and 7.3 (6.7-8.0) higher for the obese, aged 45-64. The corresponding figures for individuals aged 65-84 were 2.1 (2.0-2.2) and 4.0 (3.8-4.3) higher, respectively. The changes in the prevalence of obesity and an increase in the elderly population accounted for an estimated increase of 1,700 TKAs over the 7 years. Interpretation - The increase in obesity frequency and the rise in the population of middle-aged and elderly may, to some extent, explain the rise in TKA utilization in Sweden.",
keywords = "Age Factors, Aged, Arthroplasty, Replacement, Knee/methods, Body Mass Index, Causality, Female, Forecasting, Health Surveys, Humans, Male, Middle Aged, Obesity/diagnosis, Osteoarthritis, Knee/diagnosis, Prevalence, Procedures and Techniques Utilization/statistics & numerical data, Registries/statistics & numerical data, Risk Factors, Sweden/epidemiology",
author = "Anders Overgaard and Peder Frederiksen and Kristensen, {Lars Erik} and Otto Robertsson and Annette W-Dahl",
year = "2020",
month = dec,
doi = "10.1080/17453674.2020.1816268",
language = "English",
volume = "91",
pages = "738--742",
journal = "Acta Orthopaedica ",
issn = "1745-3674",
publisher = "Taylor & Francis Ltd",
number = "6",

}

RIS

TY - JOUR

T1 - The implications of an aging population and increased obesity for knee arthroplasty rates in Sweden

T2 - a register-based study

AU - Overgaard, Anders

AU - Frederiksen, Peder

AU - Kristensen, Lars Erik

AU - Robertsson, Otto

AU - W-Dahl, Annette

PY - 2020/12

Y1 - 2020/12

N2 - Background and purpose - Total knee arthroplasty (TKA) has increased substantially in Sweden. We quantified the relative risk for TKA in the Swedish population for different BMI categories and age groups to investigate whether the continued increase in TKA is attributable to increased prevalence of obesity and elderly people in the population, and to put forward model predictions for coming needs for TKA. Patients and methods - We used the Swedish Nationwide Health Survey (SNHS) and the Swedish Knee Arthroplasty Register (SKAR) 2009-2015 to calculate the relative risk (RR) of TKA by age (middle-aged 45-64 years and elderly 65-84 years) and BMI (BMI 18.5-24.9 normal weight; BMI 25.0-29.9 overweight; BMI > 30 obese). The RR for TKA was applied to the demographic forecasts for the Swedish population as a forecasting model. Results - Population size increased 5.2% from 2009 to 2015 to 40,000 middle-aged and 250,000 elderly, and the prevalence of obesity increased from 16% to 18% in these 2 age categories. Compared with those of normal weight, the RR for TKA was 2.7 (95% CI 2.5-3.0) higher for the overweight and 7.3 (6.7-8.0) higher for the obese, aged 45-64. The corresponding figures for individuals aged 65-84 were 2.1 (2.0-2.2) and 4.0 (3.8-4.3) higher, respectively. The changes in the prevalence of obesity and an increase in the elderly population accounted for an estimated increase of 1,700 TKAs over the 7 years. Interpretation - The increase in obesity frequency and the rise in the population of middle-aged and elderly may, to some extent, explain the rise in TKA utilization in Sweden.

AB - Background and purpose - Total knee arthroplasty (TKA) has increased substantially in Sweden. We quantified the relative risk for TKA in the Swedish population for different BMI categories and age groups to investigate whether the continued increase in TKA is attributable to increased prevalence of obesity and elderly people in the population, and to put forward model predictions for coming needs for TKA. Patients and methods - We used the Swedish Nationwide Health Survey (SNHS) and the Swedish Knee Arthroplasty Register (SKAR) 2009-2015 to calculate the relative risk (RR) of TKA by age (middle-aged 45-64 years and elderly 65-84 years) and BMI (BMI 18.5-24.9 normal weight; BMI 25.0-29.9 overweight; BMI > 30 obese). The RR for TKA was applied to the demographic forecasts for the Swedish population as a forecasting model. Results - Population size increased 5.2% from 2009 to 2015 to 40,000 middle-aged and 250,000 elderly, and the prevalence of obesity increased from 16% to 18% in these 2 age categories. Compared with those of normal weight, the RR for TKA was 2.7 (95% CI 2.5-3.0) higher for the overweight and 7.3 (6.7-8.0) higher for the obese, aged 45-64. The corresponding figures for individuals aged 65-84 were 2.1 (2.0-2.2) and 4.0 (3.8-4.3) higher, respectively. The changes in the prevalence of obesity and an increase in the elderly population accounted for an estimated increase of 1,700 TKAs over the 7 years. Interpretation - The increase in obesity frequency and the rise in the population of middle-aged and elderly may, to some extent, explain the rise in TKA utilization in Sweden.

KW - Age Factors

KW - Aged

KW - Arthroplasty, Replacement, Knee/methods

KW - Body Mass Index

KW - Causality

KW - Female

KW - Forecasting

KW - Health Surveys

KW - Humans

KW - Male

KW - Middle Aged

KW - Obesity/diagnosis

KW - Osteoarthritis, Knee/diagnosis

KW - Prevalence

KW - Procedures and Techniques Utilization/statistics & numerical data

KW - Registries/statistics & numerical data

KW - Risk Factors

KW - Sweden/epidemiology

U2 - 10.1080/17453674.2020.1816268

DO - 10.1080/17453674.2020.1816268

M3 - Journal article

C2 - 32895012

VL - 91

SP - 738

EP - 742

JO - Acta Orthopaedica

JF - Acta Orthopaedica

SN - 1745-3674

IS - 6

ER -

ID: 62313035