Age-Related Trends in Total Joint Arthroplasty in China: A Nationwide Study.

Background: Changes in age-related trends in joint arthroplasty have a significant impact on surgical prognosis and resource allocation. Though these trends have been documented in several high-income countries, the rapid aging process and relatively backward development of joint arthroplasty may shape a different pattern in China. Therefore, we aimed to determine the age-related trends in total knee arthroplasty (TKA) and total hip arthroplasty (THA) in China.

Methods: Patients receiving TKA or THA between 2013 and 2019 were identified from the national inpatient database. A total of 200,478 patients receiving TKA and 161,068 patients receiving THA were included. Poisson regression analyses were used to assess trends in mean age and the proportion of patients across different age groups. The rural-urban and regional disparities in the mean age and proportion of patients over 60 years were compared using Student's t-tests and Chi-square tests.

Results: During the study period, the mean age significantly increased from 66 to 67 years for TKA and from 56 to 58 years for THA (P for trend < 0.001). The proportion of patients over 60 years increased from 79.1 to 85.6% for TKA and from 43.4 to 48.5% for THA (P for trend < 0.001). Rural-urban and regional variations in age structure were observed, with higher mean ages and a greater proportion of patients over 60 years in urban areas and Eastern China (P < 0.001). Additionally, the mean age and the proportion of patients over 60 years continued to increase in those receiving cross-regional healthcare.

Conclusion: There has been a significant increase in the mean age and the proportion of patients over 60 years undergoing TKA and THA in China, along with notable regional and rural-urban disparities. Greater efforts are needed to meet the growing demand for arthroplasty and to reallocate medical resources.