Commentary highlights projected revision arthroplasty growth and gaps in US data

A commentary in The Journal of Bone and Joint Surgery examines Adolf et al.’s projections of hip and knee revision arthroplasty across 17 countries. The study applied age-stratified revision rates to United Nations population estimates using a consistent method across countries, rather than extrapolating raw procedure counts. The commentary considers the implications for resource planning and the limitations of underlying data.

With age-specific revision rates held constant, combined revision volume is projected to increase approximately 1.36-fold by 2060, largely reflecting population aging. The United States accounts for roughly half of projected 2060 volume and most of the absolute increase across the included countries. The commentary notes that the growth estimate persists when any single country is removed from the analysis.

US projections are particularly uncertain: modeling relies on National Inpatient Sample data ending in 2014, making all subsequent US values, including the 2024 baseline, estimates. The commentary cites evidence that ICD-10-PCS correctly identifies revision total hip arthroplasty in only 17% to 22% of cases, limiting reliable contemporary counts.

For service planning, the author cautions that case-volume growth may underestimate workload if resource-intensive revisions for periprosthetic joint infection become more common. The commentary advocates better national registry coverage and coding, alongside investment in implant longevity. These are modeled projections discussed in an opinion article, not observed future trends.