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The epidemiology, economic impact and outcomes of post‐traumatic primary total knee and total hip arthroplasty in Aotearoa , New Zealand

Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Total knee (TKA) and total hip arthroplasty (THA) can be definitive end-stage procedures following hip and knee trauma. In Aotearoa, injury-related costs are funded by the Accident Compensation Corporation (ACC). This study aims to understand the magnitude, characteristics and outcomes of post-traumatic TKA and THA in Aotearoa. METHODS: Retrospective data from ACC and the New Zealand Joint Registry for post-traumatic primary TKA and THA between 1st January 2000 and 31st December 2020 was analysed. RESULTS: Over 20 years, 10 179 primary TKA and 5611 primary THA were funded, totalling 918 million New Zealand Dollars. Social costs (weekly compensation and rehabilitation) exceeded medical costs (medical treatment, hospital, and surgical costs). Most individuals were European males between 55 and 65 years of age at the time of surgery. Following surgery, 21% TKA and 11% THA required more than 6 months of workers' compensation, with risk factors being younger age (TKA RR 1.04, THA RR 1.03), male sex (TKA RR 1.12, THA RR 1.23), and heavy occupations (TKA RR 1.50, THA RR 1.57). For TKA, 10-year revision-free implant survival was 88.7% (95% CI: 0.88-0.90) and for THA 77.7% (95% CI: 0.76-0.79), which is poorer than the 10-year registry survivorship for arthroplasty performed for primary osteoarthritis of 95.7% for TKA (P < 0.001, RR 1.03-1.05) and 94.1% for THA (P < 0.001, RR 1.12-1.17). CONCLUSION: Social costs contribute to a substantial economic burden in post-traumatic lower limb arthroplasty. Targeted rehabilitation strategies are crucial to improving recovery and minimizing time off work.
DOI: 10.1111/ans.70127
Language: English
Subfield: Surgery
Field: Medicine
Open Access status: bronze
OpenAlex ID: W4409368685
FWCI: 0.865
Cites: 22
Cited by: 1
Related to: 10