Neue Publikation Lehrstuhl Health Economics, Policy and Management

Key Message

The number of hip replacement surgeries in OECD countries continued to rise between 2011 and 2022, but with a clear shift. While younger patients (≤64 years) are driving growth, utilization among older patients (≥65 years) is declining. Improved implant longevity and the impact of the COVID-19 pandemic have significantly shaped this development.

Background

Back in 2014, we reported a marked increase in hip arthroplasty across OECD countries, particularly among younger patients (Pabinger and Geissler; 2014). Since then, demographics, surgical techniques, and healthcare systems have evolved, while the COVID-19 pandemic led to temporary interruptions in elective procedures. With new data available through 2022, it is now possible to reassess long-term developments and their implications for healthcare delivery.

Study & Design

For this analysis, data from several international sources were combined and compared across two time periods (2005–2011 and 2011–2022):

• OECD Health Statistics and the US Nationwide Inpatient Sample covering 27 countries
• Stratification by age groups (≤64 years vs. ≥65 years)
• Calculation of growth rates (CAGR) and absolute changes (MAD)
• Sensitivity analyses to validate results, particularly for the US

Results

Overall, the number of procedures grew more slowly between 2011 and 2022 than during 2005 to 2011. The age dynamics are particularly striking: utilization among younger patients kept rising, while it declined significantly among older patients. At the same time, cross-country differences narrowed — in 2022, the ratio between the highest and lowest rates was about 3:1, compared to 6:1 in 2005. The sharp drop in 2020 due to the pandemic was largely recovered by 2022 in most countries.

Implications for Practice & Policy

The findings point to a fundamental shift: hip arthroplasty is increasingly becoming a procedure for younger patients. This requires adaptations in care models and has consequences for long-term resource planning. At the same time, the longevity of modern implants may have helped to dampen the expected rise in revision surgeries. Nevertheless, demographic changes and the aftermath of the pandemic will continue to put pressure on healthcare systems.

Publication

Title: Utilization rates of hip arthroplasty in OECD countries revised

Published in: Osteoarthritis and Cartilage